Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety. MATERIAL AND METHOD: FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods. RESULTS: A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE. CONCLUSION: Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels. CLINICAL RELEVANCE: A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.

Oral Health Literacy as a Predictor of Dental Anxiety in Parents of Children Undergoing Dental Treatment.

PURPOSE: The purpose of this cross-sectional study was to evaluate the association between parents' dental anxiety (DA) and independent variables. METHODS: One hundred sixty-eight dyads of parents and six- to 12-year-old children who were undergoing treatment at a university pediatric dentistry clinic were recruited. Two examiners evaluated parents' DA and oral health literacy (OHL) using the Brazilian version of Corah's dental anxiety scale and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), respectively. Children's DA was reported by parents through the dental anxiety question (DAQ). Demographic data was also collected. A single examiner used the decayed, missing, and filled permanent teeth and primary teeth (DMFT/dmft) indices to assess the children's oral health status. The data analysis involved univariate and multivariate Poisson regression. RESULTS: In the multivariate regression, higher levels of parents' DA were associated with a household income equal to or less than the Brazilian monthly minimum wage (prevalence ratio [PR]=4.9; 95 percent confidence interval [CI]=2.1 to 11.7) and a lower degree of OHL (PR=1.68; 95 percent CI=1.01 to 2.8). Associations between parents' DA and children's DA and DMFT/dmft index were not found. CONCLUSION: Parents' dental anxiety was related to a low household income and low oral health literacy.

Dental age estimation in Brazilian HIV children using Willems' method.

The notification of the Human Immunodeficiency Virus (HIV) in Brazilian children was first reported in 1984. Since that time more than 21 thousand children became infected. Approximately 99.6% of the children aged less than 13 years old are vertically infected. In this context, most of the children are abandoned after birth, or lose their relatives in a near future, growing with uncertain identification. The present study aims to estimate the dental age of Brazilian HIV patients in face of healthy patients paired by age and gender. The sample consisted of 160 panoramic radiographs of male (n: 80) and female (n: 80) patients aged between 4 and 15 years (mean age: 8.88 years), divided into HIV (n: 80) and control (n: 80) groups. The sample was analyzed by three trained examiners, using Willems' method, 2001. Intraclass Correlation Coefficient (ICC) was applied to test intra- and inter-examiner agreement, and Student paired t-test was used to determine the age association between HIV and control groups. Intra-examiner (ICC: from 0.993 to 0.997) and inter-examiner (ICC: from 0.991 to 0.995) agreement tests indicated high reproducibility of the method between the examiners (P<0.01). Willems' method revealed discrete statistical overestimation in HIV (2.86 months; P=0.019) and control (1.90 months; P=0.039) groups. However, stratified analysis by gender indicate that overestimation were only concentrated in male HIV (3.85 months; P=0.001) and control (2.86 months; P=0.022) patients. The significant statistical differences are not clinically relevant once only few months of discrepancy are detected applying Willems' method in a Brazilian HIV sample, making this method highly recommended for dental age estimation of both HIV and healthy children with unknown age.

Bone marrow mesenchymal stem cells stimulated by bFGF up-regulated protein expression in comparison with periodontal fibroblasts in vitro.

OBJECTIVE: The aim of this study was to evaluate, in vitro, the role of bFGF in the proliferation and expression of collagen type I and fibronectin of dog bone marrow mesenchymal stem cells (dBMMSCs) in comparison with the expression of the same proteins in dog periodontal fibroblasts (dPLFs). DESIGN: dBMMSCs from the iliac crest were cultivated in Dulbecco's Modified Eagle's Medium (DMEM). Flow cytometry analysis (FCA) was used to characterize dBMMSC. Cells were stimulated with bFGF (1, 5 and 10 ng/mL) after 24 and 48 h. Real time RT-PCR was performed to verify collagen type I and fibronectin expressions. MTT assay was used to confirm cellular proliferation. Statistical analyses were performed (ANOVA and Kruskal-Wallis tests; p<0.05). RESULTS: FCA showed 55.98% of CD34+ and 32.67% of CD90+ after bone marrow aspiration; 3.33% of CD34+ and 33.0% of CD90+ before P1. After P2, 10.54% of dBMMSCs expressed CD90, whereas after P3, this number decreased to 1.58%. dPLFs presented 4.04% of CD90+ and 1.05% of CD34+ after P3. MTT evaluation showed increase in dBMSC proliferation with 5 ng/mL bFGF-stimulus after 24-h. Both collagen I and fibronectin expression were very similar between the two cells groups after 24-h stimulation with 1 ng/mL bFGF concentration. Fibronectin and collagen I expressions were higher after 24-h stimulation with 5 ng/mL bFGF. CONCLUSION: dBMMSCs (1 ng/mL-bFGF stimulus after 24 h) are very similar to dPLFs as regards morphological and immunostaining characteristics, and collagen and/or fibronectin production. The dBMMSCs presented the highest protein expression rates with 5 ng/mL-bFGF stimulus after 24-h.

Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service.

AIM: The purpose of this study is to evaluate the developmental disturbances in permanent teeth as a result of luxation injuries in the primary teeth predecessors. MATERIALS AND METHODS: A total of 5330 records, corresponding to 10 years attendance at the Emergency Center of Baby Clinic, Londrina State University, Brazil, were analyzed. Three hundred and eighty nine children were involved in this study, totaling 620 traumatized primary teeth. Clinical and radiographic examinations were carried out in the permanent successor teeth. RESULTS: In total, 623 permanent teeth were examined and developmental disturbances were detected in 126 teeth (20.2%). The white or yellow-brown discoloration of enamel was the clinical disturbance most observed (78.0%) and the crown alteration most detected through radiographic analysis was hypoplasia (86.0%). Root alterations were rare; root dilaceration was observed in only one case. The age of the children when their primary teeth received damage varied between 6 and 36 months (P = 0.000325). Intrusive luxation and avulsion were related with most of the cases of sequelae in the successor permanent teeth (P = 0.000001). CONCLUSION: The results of the present investigation emphasize the special attention required for children who suffered dental trauma at an early age, especially in cases of intrusive luxation and avulsion.