A clinical report of functional and esthetic oral rehabilitation in a high-caries-risk child: one-year follow-up / Caso clínico de reabilitação oral estética e funcional em criança de alto risco à cárie: um ano de acompanhamento

Este caso discutiu a abordagem multidisciplinar da reabilitação oral estética e funcional de uma criança com alto risco à cárie com perda prematurade dentes decíduos devido a complicações do tratamento endodôntico associado a cárie dentária generalizada. O paciente foi diagnosticado com mordida aberta anterior e deglutição atípica. O mesmo apresentou ansiedade e baixa auto-estima devido ao comprometimento estético. Combinação de procedimentos clínicos direcionados, com ênfase e foco no cuidado bucal domiciliar e o envolvimento ativo dos pais fez parte do processo de tratamento integral do paciente. Este foi examinado mensalmente por um odontopediatria, o qual orientou sobre hábitos alimentares, exposição a fluoretos, presença de biofilme, prevalência de cárie e má oclusão. Evidente melhora foi observada na função mastigatória,estética facial e comportamento psicológico aos 12 meses de acompanhamento clínico do caso.

This case discusses a multi-disciplinary approach to oral functional and esthetic rehabilitation on a high-caries-risk child with prematurely lost primary teeth due to endodontic complications associatedwith wide-spread dental caries. The patient was diagnosed with an anterior open bite and atypical swallowing. He exhibited anxiety and low selfesteemdue to esthetic impairment. A combination of targeted clinical procedures, a focus on oral home care and active parental involvement was integral to the treatment process. The patient was examined monthly by a pediatric dentist regarding dietary habits, fluoride exposure, biofilm= presence, caries prevalence, and malocclusion. Improvement was evident in patient’s masticatory function, facial esthetics, and psychological behavior at a 12-month follow-up evaluation.

Effect of milk and soy-based infant formulas on in situ demineralization of human primary enamel.

PURPOSE: The effect of infant formulas sweetened or not with sucrose on primary enamel demineralization and dental biofilm is not known. This study's purpose was to evaluate the effect of infant formula and sucrose association on demineralization of primary enamel and dental biofilm formed. METHODS: A cross-over, split-mouth, and blind in situ study was conducted during 3 phases, each of 10 days duration, during which 11 volunteers wore palatal appliances containing slabs of human primary enamel. The dental slabs were extraorally subjected 8 times a day to 6 groups of treatment: distilled and deionized water; 10% sucrose solution; and milk-based and soy-based formula with or without 10% sucrose added. After each phase, the acidogenicity, biochemical and microbiological composition of dental biofilm formed was analyzed, and enamel demineralization was assessed by microhardness. RESULTS: Both formulas induced significant enamel mineral loss, which increased when sucrose was added. Both formulas were fermented, resulting in a decrease of biofilm pH, irrespective of sucrose addition. Also, lactobacilli counts were higher in biofilm formed in the presence of both formulas when compared to the water group. CONCLUSIONS: Milk and soy-based formulas present potential to induce demineralization in primary enamel, which increased when sweetened with sucrose.