Effect of thermo mechanical stimulation duringlocal anesthesia in pediatric dentistry: a pilot randomized clinical trial / Efeito de estimulação termomecânica durante anestesia local em odontopediatria: um ensaio clínico randomizado piloto

Objetivo: Avaliar a eficácia de um dispositivo de estimulação termomecânica (Buzzy®) em relação à dor, medo e ansiedade durante anestesia local em crianças. Materiais e métodos: Estudo realizado no período de maio de 2018 a julho de 2019, com crianças de 7 a 11 anos, sem experiência prévia envolvendo anestesia nos últimos 2 anos e que necessitassem de tratamento odontológico (extração, restauração ou endodontia) sob anestesia local em molares decíduos. A amostra foi randomizada em grupo controle, que recebeu anestesia convencional, e grupo intervenção, que recebeu anestesia com Buzzy®. Os níveis de ansiedade, medo e percepção de dor de ambos os grupos foram verificados por meio de: Venham Modified Picture Test (VPTM); frequência cardíaca; Escala Comportamental Venham; Faces Pain Scale ­ Revised (FPS-R) e Face, Legs, Activity, Cry, Consolability (FLACC). Resultados: A maioria das crianças (55%) apresentou baixa ansiedade antes e depois do tratamento (P<0,05). A aceitabilidade das crianças ao Buzzy® foi de 100% e a maioria (90%) gostaria de usar novamente. Discussão: O aparelho testado é uma ferramenta interessante para complementar as técnicas de manejo durante as consultas, tendo em vista a excelente aceitabilidade e interesse por parte dos pacientes e familiares. Conclusão: Este estudo demonstrou que o uso da estimulação termomecânica é viável na clínica odontológica, devido ao seu fácil uso e boa aceitabilidade no meio clínico, além de não apresentar riscos em seu uso.

Aim: To evaluate the effectiveness of a thermo mechanical stimulation device (Buzzy®) in relation to pain, fear and anxiety during local anesthesia in children. Materials and methods: Study carried out from May 2018 to July 2019, with children aged 7 to 11 years, without previous experience involving anesthesia in the last 2 years and who needed dental treatment (extraction, restoration or endodontic) under local anesthesia in deciduous molars. The sample was randomized into a control group, which received conventional anesthesia, and an intervention group, which received anesthesia with Buzzy®. The levels of anxiety, fear and pain perception of both groups were verified using: Come Modified Picture Test (VPTM); heart rate; Behavioral Scale Come; Faces Pain Scale ­ Revised (FPS-R) and Face, Legs, Activity, Cry, Consolability (FLACC). Results: Most children (55%) had low anxiety before and after treatment (P<0.05). The acceptability of the children to Buzzy® was 100% and the majority (90%) would like to use it again. Discussion: The tested device is an interesting tool to complement management techniques during consultations, in view of the excellent acceptability and interest on the part of patients and family members. Conclusion: This study demonstrated that the use of thermo mechanical stimulation is feasible in the dental clinic, due to its easy use and good acceptability in the clinical environment, in addition to not presenting risks in its use.

Conhecimentos e atitudes de cirurgiões-dentistas da rede pública de Pelotas-RS frente aos maus-tratos infantis / Knowledge and attitudes of dentists in the public health system of Pelotas-RS regarding child maltreatment

O presente estudo objetivou identificar e analisar os conhecimentos e as atitudes dos cirurgiões-dentistas (CD) da rede pública de Pelotas-RSfrente aos maus-tratos infantis (MTI). Os dados foram coletados por um questionário semiestruturado. Coletaram-se informações sociodemográficas, relativas ao trabalho, conhecimentos e atitudes dos CD. Realizou-se uma análise estatística descritiva e associações entre as variáveis independentes com os conhecimentos e atitudes por meio do teste de Exato de Fisher e Qui-quadrado (p<0,05). Dos 45 CD incluídos na amostra, mais dametade afirmaram nunca ter recebido informações sobre o tema, 71,1% entenderam ser responsabilidade do CD a identificação de casos suspeitos, 50% não souberam informar a respeito da implicação legal sobre a falta de notificação e 86,7% acreditaram que se deve avisar ao médico ou enfermeiro para que eles tomem alguma atitude. Observou-se que 60% dos profissionais nunca suspeitaram de um caso e 25% dos que suspeitaram tomaram alguma atitude. Houve associação estatística entre a responsabilidade do CD e o sexo e o tempo de formação, da atitude correta frente a um caso suspeito e a pós-graduação, e ainda, da implicação legal com a idade e tempo de formação. Os conhecimentos e atitudes dos CD sobre MTI foram melhores entre profissionais mais jovens, do sexo feminino, com menor tempo de formados, possuindo ou cursando alguma pós-graduação. Os CD conhecem sua importância frente a essa violência, porém apresentam dificuldades quanto às atitudes a tomar (AU).

The present study aimed to identify and analyze the knowledge and attitudes of dentists inthe public health system in Pelotas-RS regarding child maltreatment(CM).Data were collected through semi-structured questionnaire. Sociodemographic information, work-related dataandknowledge and attitudes of dentists were collected.Descriptive statistical analysis and associations between independent variables and knowledge and attitudesof dentists were performed using Fisher's Exact Test and Chi-Square Test (p<0.05).Of the 45 dentists included in the sample, more than halfreportedthat they had never received information on the subject, 71.1% understood the dentist'sresponsibilityin the identification of suspicious cases, 50% were unable to inform about the legal implication of the lack of notification and 86.7% believed that the doctor or nurse should be notified so that they can take action. It was observed that 60% of professionals never suspected a case of CM and 25%of those who suspected took action. There was statistical association between the dentist'sresponsibilityand gender and the time since graduation,betweencorrect attitude towards a suspiciouscase and postgraduate degree and also betweenlegal implication with age and time since graduation.Knowledge and attitudes of dentists about CM were better among younger professionals, females, with less time since graduation, having or attending some postgraduate course. Dentists know their importance towards this violence, but they show difficulties regarding attitudes that they should take (AU).

The role of human milk and sucrose on cariogenicity of microcosm biofilms.

This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Reabilitação de dentes afetados pela Hipomineralização Molar-Incisivo (HMI): um relato de caso com 16 meses de acompanhamento / Rehabilitation of teeth affected by Molar-Incisor Hypomineralization (MIH): a case report with 16 months of follow-up

Objetivo: relatar um caso clínico de uma criança diagnosticada com Hipomineralização Molar-Incisivo (HMI) severa, apresentando a proposta terapêutica e o acompanhamento. Relato de caso: uma paciente do sexo feminino, com 6 anos de idade, foi levada a um serviço odontológico com queixa principal de "dor no dente de baixo (lado direito)". No exame clínico, foram constatadas opacidades demarcadas no esmalte dentário, de coloração variando de branco a tons de marrom, características de hipomineralização, nas superfícies vestibulares dos dentes 12, 11, 21, 32, 31 e 41 e nas oclusais do 16 e 26, sem perda de estrutura dentária. Nos dentes 36 e 46, observaram-se, além das opacidades demarcadas, fraturas de esmalte pós-eruptivas associadas com lesões ativas de cárie em dentina. Clinicamente e radiograficamente, não havia sinais de comprometimento da saúde pulpar. A criança foi então diagnosticada com HMI. O tratamento consistiu em restauração direta em resina composta dos elementos 36 e 46. Após 16 meses, observou-se que não houve perda de material restaurador em ambas as restaurações. A criança não relatou sensibilidade dentinária e nem sintomatologia dolorosa. Considerações finais: o tratamento proposto para o caso mostrou-se satisfatório durante o período avaliado, pois recuperou a funcionalidade dos dentes afetados pela HMI e não houve mais eventos de sensibilidade e dor. (AU)

Objective: to report a clinical case of a child diagnosed with severe Molar-Incisor Hypomineralization (MIH) and to present the therapeutic proposal and follow-up. Case report: female patient, six years old, referred to a dental service with the major complaint of "pain in the lower tooth (right side)". The clinical examination showed demarcated opacities on the dental enamel ranging from white to brownish shades, typical of hypomineralization, on the buccal surfaces of teeth 11, 12, 21, 32, 31, and 41 and occlusal surfaces of teeth 16 and 26, without loss of dental structure. Teeth 36 and 46 showed, in addition to the demarcated opacities, post-eruptive enamel fractures associated with active dentin carious lesions. Clinically and radiographically, there were no signs of compromise to pulp health. The child was diagnosed with MIH. The treatment consisted of direct resin composite restorations of elements 36 and 46. After 16 months, no loss of restorative material was observed in both restorations. The child reported neither dentin sensitivity nor painful symptomatology. Final considerations: the treatment proposed for the case was satisfactory during the time evaluated, recovering the functionality of the teeth affected by the MIH without showing further episodes of sensitivity and pain. (AU)

The role of human milk and sucrose on cariogenicity of microcosm biofilms

Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Prevalence and severity of molar incisor hypomineralization in students of Belém, Brazil

To measure the prevalence of Molar Incisor Hypomineralization (MIH), its severity and association with dental caries among public school children from Belém/PA, Brazil.Material and Methods:This is a cross-sectional study conducted with children enrolled in three public schools of Belém, which were selected by simple random sampling. MIH diagnosis was carried out according tocriteria of the European Academy of Pediatric Dentistry.Results:Among the 260 students that met the inclusion criteria, 56.92% were male and 43.07% female. The average age was 10.22 years. Of these, 8.84% (n = 23) had MIH, but there was no statistically significant difference in this prevalence between sexes (p = 0.6244). The most affected teeth were the upper first permanent molars, followed by lower first permanent molars and upper permanent central incisors. About 43.48% of students had at least one tooth with severe defect in enamel and 30.43% of students with MIH presented dental caries in the affected teeth. Conclusion:Severe MIH was not the most prevalent among schoolchildren, but the relationship with dental caries found demonstrates the importance of knowledge about diagnosis and treatment of enamel defects, which should be part of promotion and prevention actions in oral health due to its epidemiological impact in the demographic change of dental caries...