Association of salivary parameters and erosive tooth wear in preschool children.

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

Banda ortodôntica como alternativa de tratamento conservador provisório para primeiros molares permanentes com hipomineralização molar incisivo (HMI): relato de caso / Orthodontic banding as an alternative provisional conservative treatment for permanent first molars with incisor molar hypomineralization (IMH): case report

Introdução: a Hipomineralização Molar Incisivo (HMI) é um defeito qualitativo de desenvolvimento de esmalte que pode ocasionar fraturas pós-eruptivas (FPE), lesões de cárie e sensibilidade. Objetivo: relatar o tratamento de HMI severa através da cimentação de bandas ortodônticas para preservação da estrutura dentária em primeiros molares permanentes inferiores com FPE. Relato do caso: criança do sexo feminino, 10 anos de idade, apresentou-se com queixa de hipersensibilidade e fratura dentária associada à restauração prévia. Clinicamente, observou-se presença de HMI severa, com FPE associada à lesão de cárie em dentina nas superfícies oclusal e vestibular do dente 36 e restauração insatisfatória com cimento de ionômero de vidro (CIV) na superfície vestibular do dente 46 que apresentava opacidades demarcadas branco-creme. Radiograficamente, observou-se ausência de comprometimento pulpar. Após manejo por meio de abordagens não-invasivas (controle de biofilme e dieta e aplicação de verniz fluoretado), o tratamento proposto foi a cimentação de banda ortodôntica com CIV modificado por resina (Riva Light Cure®, SDI) nos dentes 36 e 46 para maior longevidade das restaurações. O tratamento restaurador atraumático (TRA) foi realizado no dente 36 previamente à cimentação da banda ortodôntica. Resultados: após o tratamento, a criança não relatou dor ou desconforto e as restaurações mantiveram-se intactas. A mãe da criança foi orientada quanto à importância de acompanhamento periódico a cada 4 meses. Conclusão: a cimentação das bandas ortodônticas com CIV possibilitou o manejo conservador de molares permanentes com HMI severa, com manutenção de sua funcionalidade oclusal, saúde pulpar e gengival, proporcionando melhor qualidade de vida à paciente.

Introduction: molar Incisor Hypomineralization (MIH) is a qualitative developmental enamel defect that can cause posteruptive enamel breakdown (PEB), caries lesions, and sensitivity. Objective: to report the treatment of a child with severe MIH through the cementation of orthodontic bands in lower first permanent molars with PEB to preserve tooth structure. Case report: female child, 10 years old, presenting hypersensitivity complaints and tooth fracture associated with previous restoration. Severe MIH was observed, with PEB associated with dentin caries on the occlusal and buccal surfaces of tooth #36 and unsatisfactory glass ionomer cement (GIC) restoration on the buccal surface of tooth #46 which had creamy-white marked opacities. There was no pulp involvement radiographically. After management through non-invasive approaches (biofilm and diet control and application of fluoride varnish), the proposed treatment was the cementation of an orthodontic band with resin-modified GIC (Riva Light Cure®, SDI) on teeth #36 and #46 to long-term lifespan restorations. Atraumatic restorative treatment (ART) was performed on tooth #36 prior to the cementation of the orthodontic band. Results: after treatment, the child did not report pain or discomfort and the restorations remained intact. The child's mother was instructed about the importance of periodic follow-up visits every 4 months. Conclusion: the cementation of orthodontic bands with GIC allowed the conservative management of permanent molars with severe MIH, maintaining their functional occlusion, pulpal and gingival health, providing a better quality of life to the patient.

Dental care for patients with special needs at a private higher education institute / Atendimento odontológico a pacientes com necessidades especiais em uma instituição privada de ensino superior

Objetivo: Pacientes com necessidades especiais são aqueles indivíduos que necessitam de cuidados especiais por tempo indeterminado ou por toda a vida. O presente estudo tem como objetivo abordar o atendimento odontológico de pacientes com necessidades especiais em uma instituição privada de ensino superior da cidade de São Paulo. Material e Métodos: Foi realizado um estudo descritivo, retrospectivo, para análise de 210 prontuários odontológicos de pacientes com necessidades especiais atendidos no Departamento de Odontologia para Pacientes Especiais da Universidade Cruzeiro do Sul entre 2012 e 2018. Dados sobre sexo, idade, diagnóstico da condição debilitante, motivo da consulta, uso continuado de medicamentos, imagens radiográficas e tratamentos odontológicos prestados foram todos coletados e posteriormente submetidos à análise estatística descritiva e inferencial (teste do qui-quadrado) ao nível de significância de 5%. Resultados: Quanto aos tipos de procedimentos odontológicos avaliados no presente estudo, dos 210 pacientes, 24% necessitaram de tratamentos curativos dentários em que a terapia periodontal foi o tipo mais prevalente, enquanto os tratamentos endodônticos tiveram a menor prevalência, representando apenas 4%. Houve alta prevalência de doenças crônicas sistêmicas, acometendo 56% dos casos, cuja faixa etária era superior a 40 anos. Conclusão: Check-ups odontológicos regulares devem ser priorizados em pacientes com necessidades especiais para evitar intervenções mais invasivas como em nosso grupo (AU)

Objective: Patients with special needs are those individuals who need special care for an undetermined period of time or for lifetime. The present study is aimed to address the dental care of special needs patients at a private higher education institute in the city of São Paulo. Material and Methods: A descriptive, retrospective study was performed for analysis of 210 dental records of special needs patients who were treated at the Dental Department for Special Patients of the Cruzeiro do Sul University between 2012 and 2018. Data on gender, age, diagnosis of the debilitating condition, reason of the consultation, continued use of medications, radiographic images and dental treatments provided were all collected before being submitted to descriptive and inferential statistical analysis (chi-square test) at a significance level of 5%. Results: As for the types of dental procedures assessed in the present study, of the 210 patients, 24% needed dental curative treatments in which periodontal therapy was the most prevalent type, whereas endodontic treatments had the lowest prevalence, representing 4% only. There was a high prevalence of chronic systemic diseases, affecting 56% of the dental records, whose age group was above 40 years old. Conclusion: Regular dental check-ups should be prioritized in patients with special needs to avoid more invasive interventions as found in our group (AU)

Association of salivary parameters and erosive tooth wear in preschool children

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

Low-Level Laser Therapy for Management of Hypersensitivity in Molar-Incisor Hypomineralization and Oral Health-Related Quality of Life: Case Report.

The aim was to report the use low-level laser therapy (LLLT) in the management of hypersensitivity in an adolescent with molar incisor hypomineralization (MIH) and the impact of LLLT on his oral health-related quality of life (OHRQoL). Clinical examination revealed severe MIH with hypersensitivity, in all first permanent molars and incisors. The treatment proposed was desensitization with fluoride and esthetic rehabilitation of the affected teeth. Then, LLLT was applied perpendicularly in a continuous mode (wavelength of 808 nm, power of 100 mW, dose of 1 J, and fluence of 35 J/cm2). The visual analogue scale was applied each session of LLLT. The child perceptions questionnaire (CPQ11-14) was administered at the beginning and the end of the treatment. It was concluded that LLLT can be indicated in the management of hypersensitivity in an adolescent with severe MIH to control pain and to improve his OHRQoL.

Gingival inflammation and hematological parameters in children with visceral leishmaniasis: A cross-sectional study.

AIMS: This cross-sectional study aimed to assess gingival inflammation in 67 children aged 1-8 years (mean age 3.07) with visceral leishmaniasis (VL) at the time of hospitalization (D1) and 7 days after the first interview (D7) and compare the main hematological changes between the two time points. METHODS AND RESULTS: The biofilm index was verified at D1 and D7 using the Simplified Oral Hygiene Index (OHI-S) and the gingival inflammation index based on the gingival index (GI), along with hematological parameters. The mean OHI-S was 2.35 ± 0.93 at D1 and 1.47 ± 0.75 at D7. The mean GI was 0.56 ± 0.59 at D1 and 0.11 ± 0.32 at D7. The variable OHI-S at D1 could predict GI at D1, as an increase in the OHI-S value by one unit was associated with an increase in the GI D1 value by 0.36 units (p < .05). Multivariate linear regression analysis showed that none of the hematological variables were predictive of gingival inflammation at D1 and D7. CONCLUSION: Children with VL had poor oral hygiene on the first day of hospitalization. Clinically, the oral hygiene status progressed from poor at D1 to regular at D7. After 7 days the gingival bleeding scores also reduces.

Temporomandibular disorder in individuals with spinal cord injuries.

OBJECTIVE: This study evaluated Temporomandibular Disorder (TMD) in individuals with Spinal Cord Injuries (SCI) compared to individuals without physical disabilities. DESIGN: Cross-sectional. SETTING: International Fair of Technologies in Rehabilitation and Accessibility (REATECH) and School of Dentistry at the University of São Paulo (USP), Brazil. PARTICIPANTS: In total, 19 patients with SCI and 19 patients without SCI (36.9 ± 11.4 years old) were examined by a calibrated examiner. METHODS: using the following parameters: cervical spine mobility, palpation of muscle groups of the head and neck, functional manipulation of the lateral and medial pterygoids, and joint palpation (Diagnostic Criteria). The pattern and amplitude of mandibular movements were determined during screening using the Helkimo index. STATISTICAL ANALYSES: Student's t-test, chi-square, Fisher's exact and Shapiro-Wilk test were used. RESULTS: The groups did not differ in the presence of noise, pain, temporomandibular joint palpation, locking, dislocation, jaw pain, muscle sensitivity, or in pain, mobility of the cervical spine and functional manipulation. With respect to the jaw mobility index, the groups differed in range of movement (P = 0.020) and maximum right lateral movement (P = 0.007), with the worst values in the SCI group. The groups also differed in relation to lateral flexion in cervical mobility, in which the group without SCI presented better results (P = 0.046). CONCLUSION: The Spinal Cord Injuries group showed higher levels of TMD in terms of range of movement, lateral flexion, and maximum right lateral movement, than the individuals without physical disabilities, demonstrating a clinical significance between cervical and mandibular disability in this group.

Prevalence of White Spot Caries Lesions in Primary Teeth in Preschool Children: Systematic Review and Meta-analysis.

BACKGROUND: The first clinically detectable stage of caries lesion is a non-cavitated white spot lesion (WSL). The detection of early stages of caries lesions allows non-invasive management by fluoride usage, oral hygiene and diet control. There is a lack of information in the literature regarding the prevalence of these caries lesions in preschool children, which is important especially for public health strategies. OBJECTIVE: The aim of this study was to conduct a systematic review with meta-analysis to verify the WSLs prevalence in primary teeth of preschool children. METHODS: A literature search with MEDLINE/PubMed, Scopus, Web of Science, and Open Gray databases was conducted. Included studies fulfilled the eligibility criteria. Meta-analyses were performed using random effects model, for prevalence of pooled WSLs and subgroups analyses. RESULTS: The search strategy identified 4922 potentially relevant articles, with final inclusion of 16 studies. The pooled prevalence of WSLs in primary teeth was 14.0% (95% CI: 8.0-24.0), without publication bias (p=0.2668). For subgroup analyses, an increase in WSLs prevalence for children of low-income economy (24.0%; 95% CI: 20.0-28.0), for age >31 months (22.0%; 95% CI: 12.0-37.0), for validated visual criteria assessment (20.0%; 95% CI: 11.0-33.0), and for tactile assessment with ball-ended probe (26.0%; 95% CI: 11-50.0) were detected. CONCLUSION: It is suggested that the prevalence of WSLs in primary teeth of preschool children increases in countries with low income economy, with age greater than 31 months or texture assessment with visual validated criteria or ball-ended probe. PROSPERO Registration: Protocol number #CDR42017078434.

Shprintzen-goldberg craniosynostosis: craniofacial and oral characteristics, diagnosis, and clinical management of a very rare syndrome / Craniossinostose de shprintzen-goldberg: características craniofaciais e orais, diagnóstico e manejo clínico de uma síndrome muito rara

ABSTRACT Shprintzen-Goldberg craniosynostosis syndrome, characterized by craniosynostosis and marfanoid habitus, is a very rare entity described in 75 individuals worldwide. This study aimed to present a case report of a 6-year-old female Brazilian child with Shprintzen-Goldberg's craniosynostosis syndrome. We described the craniofacial and oral characteristics and its clinical management, comparing to the existing literature. The patient presented with intellectual disability, craniosynostosis, ocular proptosis, low-set anomalous ears, and other skeletal and connective tissue defects. Oral features included malocclusion, micrognathia, pseudo-cleft palate, dental caries, and inefficient biofilm control. The treatment started with guidance on cariogenic foods, oral hygiene, and an indication to discontinue bottle feeding. Subsequently, the carious lesions were restored with composite resins, and the patient was referred for orthopedic surgery, orthodontic treatment, speech therapy, and nutritional counseling. The patient was followed for 5 years. This case report emphasizes the importance of knowing the craniofacial and oral characteristics for the diagnosis and clinical management of a female child with a rare Shprintzen-Goldberg's craniosynostosis syndrome. The case also highlights the need for oral health care in individuals with intellectual disabilities.

RESUMO A síndrome Shprintzen-Goldberg é uma entidade muito rara descrita em 75 pessoas, caracterizada por craniossinostose e habitus marfanóide. O objetivo deste estudo é apresentar o relato de um caso clínico de uma criança brasileira de 6 anos com síndrome da craniossinostose de Shprintzen-Goldberg, apresentando as características craniofaciais e orais e seu manejo clínico, comparando com a literatura. O paciente apresentava deficiência intelectual, craniossinostose, proptose ocular, orelhas anômalas de implantação baixa e outros defeitos esqueléticos e do tecido conjuntivo. As características orais incluíram má oclusão, micrognatia, pseudo fenda palatina, atividade de cárie e controle ineficiente do biofilme. O tratamento foi iniciado com orientações sobre alimentos cariogênicos, higiene oral e indicação de suspensão do uso de mamadeira. Em seguida, as lesões cariosas foram restauradas com resina composta e o paciente encaminhado para cirurgia ortopédica, tratamento ortodôntico, fonoaudiologia e nutricionista. O paciente foi acompanhado periodicamente por 5 anos. Este relato de caso enfatiza a importância do conhecimento das características craniofaciais e orais para o diagnóstico e manejo clínico de uma criança do sexo feminino com síndrome de craniossinostose de Shprintzen-Goldberg rara, destacando a necessidade de cuidados com a saúde bucal em indivíduos com deficiência intelectual.

Relationship between children physical activity, inflammatory mediators and lymphocyte activation: possible impact of social isolation (COVID-19).

OBJECTIVE: Lifestyle and body composition may be simultaneously responsible for immune response modulation. This study aimed to compare plasmatic adipokines concentration and lymphocyte cytokine production in children with different daily steps (DS) range, as well as to discuss the potential negative impact of the social isolation during COVID-19 pandemic in this context. DS can be a useful and low-cost way of monitoring children's health status. STUDY DESIGN: Fifty children were classified into clusters based in DS measured by pedometer: Sedentary Group (DS = 9338 ± 902 steps) and Active Group (DS = 13,614 ± 1003 steps). Plasma and lymphocytes were isolated and cultured to evaluate cytokine production. RESULTS: Sedentary group presented lower adiponectin (7573 ± 232 pg/mL), higher leptin (16,250 ± 1825 pg/mL) plasma concentration, and higher lymphocyte production of IL-17, IFN-gamma, TNF-, IL-2 in relation to active group, suggesting predominance of Th1 response. Otherwise, the active group presented higher lymphocyte supernatant concentration of IL-10 and higher regulatory T cell (Treg) percentage. CONCLUSION: These results indicate that lymphocytes of children performing higher DS have an anti-inflammatory profile, especially of Treg. Besides, the prolonged social isolation in children during the COVID-19 pandemic, limiting physical mobility and exercise, reduces DS and increases adiposity, which could impair the immune system function and raise the susceptibility to inflammatory diseases.

Initial Mechanical Stabilization of Conventional Glass Ionomer Cements with Different Active Principles

ABSTRACT Objective: To determine the initial mechanical stabilization of conventional glass ionomer cements (GICs) indicated for the atraumatic restorative treatment (ART) in different storage periods. Material and Methods: Specimens were divided according to the GIC (n=12): IZ - Ion-Z, KM - Ketac Molar Easymix, RS - Riva Self Cure, and GL - Gold Label 9. They were prepared and stored in distilled water. Superficial microhardness (SMH) was evaluated (KHN) in three phases: (A) after 1, (B) 3, and (C) 7 days of storage. Data were submitted to 2-way ANOVA and Tukey tests (α = 5%). Results: The average KHN values for phases A, B, and C were, respectively, 33.05 ± 9.74; 33.21 ± 10.31 and 52.07 ± 11.75 (IZ); 50.35 ± 11.39; 66.05 ± 10.48 and 67.77 ± 13.80 (KM); 89.63 ± 15.59; 71.31 ± 23.86 and 57.70 ± 16.89 (RS); 42.18 ± 9.03; 68.54 ± 6.83 and 57.95 ± 8.24 (GL). Significant differences were observed: GIC, time, and interaction of both (p<0.05). KHN values differed between the groups, except in the GIC parameter for KM and GL. The time parameter values of phase A were lower than those of B and C, except for IZ and RS. Conclusion: The initial mechanical stabilization differed between the types of GIC tested and the storage time, and after the final period, all had similar SMH.

Monitoring enamel caries on resin-treated occlusal surfaces using quantitative light-induced fluorescence: an in vitro study.

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.

In vivo assessment of the corrosion of nickel-titanium orthodontic archwires by using scanning electron microscopy and atomic force microscopy.

This study was undertaken to assess in vivo the corrosion in two commercial nickel-titanium (NiTi) orthodontic archwires removed from the oral cavity of patients using fluoride mouthwashes. Five volunteers took part in this study on the corrosion behavior of two brands of NiTi archwires (3M and AO (brand of archwire)) during use of two mouthwashes with neutral sodium fluoride 1.1%, one with acidulated fluoride 1.1%, and one with placebo and a control group. Each patient used one mouthwash in three different periods of time for 1 min a day for 30 days. The archwires were assessed with scanning electron microscopy and atomic force microscopy for qualitative and quantitative analysis. The values obtained with atomic force microscopy (AFM) were submitted to normality test, two-way analysis of variance, and Tukey's test at a significance level of 5%. The AFM images showed a gradual qualitative increase in the roughness of both types of wire between the treatments: control < placebo < neutral fluoride < acidulated fluoride. The arithmetic average of the roughness and root mean square of the roughness were similar. As for 3M archwires, only the acidulated fluoride group differed statistically from the others. As for AO archwires, the control and placebo groups did not differ from each other, but differed from the other fluoride treatments. The group using neutral fluoride also differed significantly from the acidulated fluoride group. 3M archwires were not affected by daily oral challenges. AO archwires were not affected by daily oral challenges either; their association with fluoride, either neutral or acidulated, increased their roughness.

Cinco años de seguimiento de tratamiento no invasivo para lesiones auto-infligidas en un niño con parálisis cerebral / Five year follow-up of non-invasive treatment for self-inflicted oral trauma in a child with cerebral palsy

ABSTRACT Introduction: Cerebral palsy involves loss or impairment of motor function attributed to non-progressive disturbances occurring in the developing fetal or infant brain. Self-inflicted oral trauma is a recurrent parafunctional habit in individuals with cerebral palsy. Objective: Describe two treatment modes for self-inflicted oral trauma in a 6-year-old male patient with cerebral palsy over a 5-year follow-up period. Case presentation: The child had been having pain due to injuries to the mouth floor and lingual frenum regions. Initially, low-level laser therapy was applied to accelerate the healing process of the wounds. Five years later, the child started to present worse oral injuries and placement of a fixed oral appliance was proposed. Intraoral examination showed that the wounds had healed completely in response to the oral appliance. Conclusions: Different therapies may be useful to control the recurrence of self-inflicted oral injuries(AU)

RESUMEN Introducción: La parálisis cerebral provoca una pérdida o deterioro de la función motora atribuida a trastornos no progresivos del desarrollo cerebral fetal o infantil. La lesión autoinfligida es un hábito parafuncional recurrente en personas con parálisis cerebral. Objetivo: Describir dos modalidades de tratamiento para las lesiones autoinfligidas en un niño de 6 años de edad con parálisis cerebral durante un periodo de seguimiento de 5 años. Presentación del caso: El niño presentaba dolor debido a lesiones en la región del suelo de la boca y el frenillo lingual. Inicialmente se aplicó terapia con láser de baja intensidad para acelerar el proceso de cicatrización de las heridas. Cinco años más tarde el niño empezó a presentar lesiones bucales más severas, por lo que se propuso la colocación de un dispositivo oral fijo. El examen intraoral mostró que las lesiones habían cicatrizado completamente en respuesta al dispositivo oral instalado. Conclusiones: Diferentes terapias pueden ser útiles para controlar la recurrencia de las lesiones orales autoinfligidas(AU)

Overweight/obese children are associated with lower caries experience than normal-weight children/adolescents.

AIM: To compare (a) enamel carious (EC) and dentin carious (DC) lesions and (b) caries risk, between normal-weight (NW) and overweight/obese (OW) children/adolescents. DESIGN: In this cross-sectional study, 91 participants aged 6-12 years were classified according to the body mass index (BMI): NW (n = 50) and OW (n = 41). Caries experience was evaluated using the International Caries Detection and Assessment System (ICDAS) with two thresholds: "EC/DC" (ICDAS 1-3/4-6) and "DC" (ICDAS 4-6). Caries risk was determined by the Caries Management by Risk Assessment (CAMBRA) system. A logistic regression analysis was performed to determine the association among OW, caries thresholds, and caries risk. RESULTS: Caries experience was similar for both groups at the "EC/DC" threshold (P = .477) and higher for the NW group at the "DC" threshold (P = .009). For CAMBRA, caries risk classification was similar for both groups (P = .082). The logistic regression showed the OW group was less likely to exhibit radiographically visible proximal carious lesions (odds ratio [OR] of 0.330, P = .019), thick biofilm visible on the tooth surface (OR = 0.360, P = .019), high caries risk (OR = 0.367, P = .039), and moderate-to-high caries levels (OR = 0.190, P = .022). CONCLUSION: OW children/adolescents had lower caries experience, at both ICDAS thresholds, and lower caries risk, compared to NW children/adolescents.

Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment.

The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1ß, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1ß levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1ß and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1ß, IL-6 and IL-8.

Caries Experience According to ICDAS in Preschool Children from Private and Public Schools of a Community with a Nonfluoridated Water Supply.

PURPOSE: Using the ICDAS (International Caries Detection and Assessment System), to assess caries experience in the primary dentition of preschool children living in a socioeconomically poor area with a nonfluoridated water supply, and to compare the stages of caries manifestation between children from private and public schools. MATERIALS AND METHODS: This census included all children aged 3 to 5 years from public and private schools from Teixeira, Brazil. Clinical examinations were carried out by two calibrated examiners using ICDAS, the results of which were converted into components of dmf-s and dmf-t. RESULTS: The majority of children had caries; the prevalence of enamel and dentin lesions was 81.7%. The prevalence of dentin lesions alone was 62.1%. The mean values of the d2mf2-s/d2mf2-t indices (enamel and dentin lesions) and d3mf3-s/d3mf3-t indices (dentin lesions) were 13.5 ± 14.9/6.8 ± 5.8 and 7.4 ± 10.9/3.0 ± 3.6, respectively. There was no significant difference between the dmf-s/dmf-t indices of children from private vs public schools (p > 0.05). CONCLUSION: Caries was highly prevalent in the primary dentition of this Brazilian population, and the presence of noncavitated lesions was the most prevalent condition. Children from private and public schools showed similar caries experience.

Effects of treatments for drooling on caries risk in children and adolescents with cerebral palsy

Background: Neuromuscular impairment makes individuals with cerebral palsy (CP) more prone to drooling. Among the treatment options, there are procedures that interfere with saliva production. It is imperative to evaluate the effect of the different modalities since the reduction in salivary flow rate/production may exacerbate the risk of dental caries. Material and Methods: The aim of this study was to compare the effects of different treatments for drooling on caries risk and salivary parameters in children and adolescents with CP. Study design: A total of 142 children and adolescents with CP, aged 6 to 18 years, were assigned to groups based on the different treatments they had received for drooling: G1-anticholinergic drugs (n = 18), G2-botulinum toxin injection (n = 16), G3-salivary glands surgery (n = 16), G4-no treatment (n = 42), and G5-non-drooling subjects (n = 50). All participants were evaluated on the Simplified Oral Hygiene Index, and for the prevalence of dental caries (decayed, missing, and filled teeth index and white spot lesions). Unstimulated whole saliva was collected, and salivary flow rate and osmolality were measured. Chi-square, ANOVA and Poisson regression were calculated. Prevalence ratios and their respective 95 % confidence intervals were obtained. The significance level was fixed at 5%. Results: No differences were found in the decayed, missing, and filled teeth index (p = 0.128) and Simplified Oral Hygiene Index (p = 0.674) among the different groups. G3 presented significantly higher percentages of WSL (p < 0.001), lower values of salivary flow rate (p < 0.001), and higher values of osmolality (p < 0.001). The white spot lesion prevalence ratio was higher only for G3 (Prevalence ratio = 14.36; IC 95% = 4.64-44.40; p < 0.001). Conclusions: Children and adolescents with CP who had received surgical treatment for drooling exhibited higher number of white spot lesions because of the reduced salivary flow rate and higher salivary osmolality

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Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment

Abstract The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1β, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1β levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1β and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1β, IL-6 and IL-8.

Correlation of salivary immunoglobulin A with Body Mass Index and fat percentage in overweight/obese children

Abstract Obesity is considered a risk factor for periodontal health due to the low- grade inflammation promoted by the increased adipose tissue. Objective: This study aimed to determine correlations and associations between gingival inflammation (Simplified Oral Hygiene Index, and Gingival Index), salivary immunoglobulin A (s-IgA), and salivary parameters (salivary flow and osmolality) in normal-weight and overweight/obese children. Material and Methods: Ninety-one children, aged 6 to 12 years old (8.6±1.9 years), were divided into two groups according to their body mass index (BMI), circumferences, skinfold measurements and body fat percentage: normal- weight group (NWG; n =50) and overweight/obese group (OG; n =41). A calibrated examiner performed the clinical examination using the Simplified Oral Hygiene Index, Gingival Index, and salivary collection. Data analysis included descriptive statistics and association tests ( p <0.05). Results: OG presented statistically higher s-IgA values compared with NWG, especially among the obese children ( p <0.05). Significant positive correlations between s-IgA and salivary osmolality in OG ( p <0.05), and between s-IgA and BMI values ( p <0.05) and body fat percentage ( p <0.05) were observed among all the children. Effect size varied from moderate for s-IgA values ( d =0.57) to large for BMI ( d =2.60). Conclusion: Gingival inflammation and salivary parameters were similar for NWG and OG; however, s-IgA presented higher values in OG, with correlations between BMI and body fat percentage.