Permanent teeth pulpotomy survival analysis: retrospective follow-up.

OBJECTIVES: The aim of the present study is to evaluate risk factors influencing the success rates of pulpotomies both in young and adult populations. METHODS: Pulpotomies (n=273) performed by a single endodontic specialist were analyzed, and data on success rates were collected. Additionally, possible explanatory variables were noted such as: age, gender, clinical findings (teeth, type of restoration after pulpotomy), radiographic findings (dentin bridge formation) and systemic conditions. The follow-up period varied from 1 to 29 years, and the results were analyzed by Kaplan-Meier survival curves and also by Cox regression. RESULTS: Age at the time of pulpotomy ranged from 8 to 79 and had not influenced the success rates (p=0.35). The formation of dentin bridge had a strong protective effect (hazard ratio-HR=0.16, p<0.001). The prosthetic crown restorations following pulpotomy had the smallest failure rate, and amalgam has not increased the risk of failure significantly in relation to prosthesis. Resin composite restorations following pulpotomy increased in 263% the risk of failure (HR=3.63, p<0.001). CONCLUSION: This study allowed inferences that pulpotomy may be a successful treatment at any age, and not only for young permanent teeth. It was also possible to conclude that the use of direct composite restorations following pulpotomies is associated with higher failure rates.

Endodontics in primary molars using ultrasonic instrumentation.

PURPOSE: The purpose of this study, which is a series of consecutive case reports, was to describe and evaluate the protocol used in the treatment of pulpal necrosed of primary molars, used by the dental service of Social Support Foundation of the Moinhos de Vento Hospital, Porto Alegre, RS, Brazil. METHODS: Eighteen primary molars in 15 children, ranging from 4 to 10 years of age, were endodontically treated using ultrasonic instrumentation. RESULTS: Clinical and radiographic controls showed a success rate of 94%, considering an evaluation time of 14.1+/-6.3 months. CONCLUSIONS: The use of ultrasonic instrumentation in primary molars with pulpal necrosis succeeded in reducing appointment time and showed a high success rate.

Morphology evaluation of primary enamel exposed to antihistamine and fluoride dentifrice--an in vitro study.

This in vitro study sought to evaluate the action of a pediatric medication with low pH and high acidity in primary enamel submitted (or not) to daily applications of fluoride dentifrice. For this study, 70 blocks of primary molars (n = 10 per subgroup) were analyzed using scanning electron microscopy. Six subgroups (two control and four experimental) were submitted to different treatments for 10 days. Microscopically, the enamel blocks of the subgroups that received medication and fluoride demonstrated the largest areas of partially or totally conditioned superficial enamel. The opposite was observed in the subgroups that were not exposed to fluoride; erosions in the internal enamel and in the transition zone between deep enamel and dentine showed superior percentiles. It was concluded that the medication modified the morphology of the primary enamel and that the use of fluoride was able to reduce the erosive effect of the formulation.

Orthodontic extrusion anchored in osseointegrated implants: a case report.

Rapid orthodontic extrusion is indicated for cases involving biological space invasion of the periodontal ligament in which the surgical increase of the clinical crown can compromise esthetics or the support of the adjacent teeth. This article presents the case report of a tooth with radicular perforation 1.0 mm below the bone crest. A procedure to restore the biological distances was necessary. Rapid orthodontic extrusion of the affected tooth, with anchorage in the adjacent osseointegrated implants, was selected.

[Polarization of dental caries in a city without fluoridated water]. / Polarização da cárie em município sem água fluoretada.

Increased overall exposure of the Brazilian population to fluoridated water and fluoridated dentifrices has been identified as the main factor in the reduction of caries prevalence. Thus, the objective of the present study was to evaluate the distribution of caries in a group of 437 children ranging from 6 to 12 years of age, residing in a city without a water supply fluoridation system and without a preventive dentistry program, with the aim of orienting future health measures towards improved cost-effectiveness. Clinical examination was performed on all the children, focusing on the indices defs (decayed, extracted, and filled primary dentition surfaces) and DMFS (decayed, missing, and filled permanent dentition surfaces), representing the number of dental surfaces that were either decayed, missing or with extraction indicated, or restored. Analysis of accumulated disease frequency in relation to the population showed that 37% of the children presented 70% of all the tooth disease, with a mean defs + DMFS of 28.6. This distribution demonstrates the phenomenon of polarization, in which most of the disease and treatment needs are concentrated in a small portion of the population.

Clinical comparative study of the effects of two types of mandibular space-regaining devices.

This study evaluated the results obtained by two space-regaining devices in children with mixed dentition and premature loss of mandibular deciduous molars. There were no statistical differences between the amount of space regained by each device; however, the distalizing screw regained space at a faster rate.

[Different forms of payment systems for dental services and their impact on care]. / Remuneração dos serviços de saúde bucal: formas e impactos na assistência.

The Brazilian dental care sector is facing a paradoxical crisis characterized by a surplus of dentists and a large contingent of people lacking dental care, thus highlighting the need to improve management strategies. One necessary step is to analyze the various payment schemes for dental services. This paper reviews two important approaches, fee for service and capitation, and considers the impacts and consequences of payment strategies on the dental care system.

Effect of home bleaching and smoking on marginal gingival epithelium proliferation: a histologic study in women.

BACKGROUND: Animal studies have suggested that home bleaching agents can cause morphological alterations and changes in the proliferative rate of oral epithelium. METHODS: A bleaching agent containing 10% carbamide peroxide with carbopol was used in 11 women (five smokers and six non-smokers) during a 5-week period. Two biopsies were performed, one of them 15 days before the beginning of the home bleaching treatment and the other immediately after the 5-week bleaching treatment. Two analyses were performed in the histological sections obtained from the biopsies: epithelium morphometry and assessment of the epithelium's proliferative activity by proliferating cell nuclear antigen (PCNA) immunohistochemistry. RESULTS: The home bleaching agent increases epithelium thickness and the PCNA index in both smoker and non-smoker patients. CONCLUSION: Carbamide peroxide (10%) caused an augmentation in the proliferative activity within the basal and parabasal layers of the gingival epithelium, resulting in a change in this tissue's morphometry.