2-year survival and cost analysis of occlusoproximal ART restorations using encapsulated glass ionomer cement in primary molars: a randomized controlled trial.

BACKGROUND: The survival of ART restorations can be influenced by the choice of the restorative material. The aim of this randomized non-inferiority controlled trial was to compare the 2-year survival rate and cost analysis of two encapsulated glass ionomer cements (GIC) as occlusoproximal restorative materials in primary molars. METHODS: Children from public schools in Tietê (Brazil), aged 4-8 years with occlusoproximal dentine carious lesions in primary molars were selected and randomly assigned to receive either Equia Forte (EF) or Riva Self Cure (RSC) as restorative materials. Treatment was carried out by two trained final-year dental students in schools following ART premises. Restorations were assessed by a trained and calibrated examiner after 2, 6, 12, 18, and 24 months. The primary outcome was restoration survival after 2 years, analyzed using Kaplan-Meier survival and Cox regression analysis (α = 5%). Professional and materials costs for each group were collected in Brazilian Reais (R$) and converted into US dollars (US$) and analyzed using Monte-Carlo simulation. RESULTS: A total of 152 children (76 per group) were included in the study, and 121 (79%) were evaluated after 2 years. The overall 2-year restoration survival rate was 39% (EF = 45%; RSC = 32%) with no difference between the groups. The baseline and 2-year total cost of restorations using RSC was lower when compared to EF (incremental cost: US$ 6.18). CONCLUSION: After two years of follow-up, Riva Self Cure shows comparable restoration survival rates to Equia Forte, being more cost-effective in the Brazilian perspective. TRIAL REGISTRATION: This randomized clinical trial was registered on ClinicalTrials.Gov - NCT02730000.

Silver modified atraumatic restorative treatment: a paradigm shift in dental caries management.

Silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) are treatment modalities that are minimally invasive and used for the prevention and control of dental caries. The amalgamation of these two techniques has led to the development of silver modified atraumatic restorative treatment (SMART). In this approach the carious lesion is restored with glass-ionomer cement (GIC) after SDF application. SMART effectively arrests caries without removing additional tooth structure, making it a promising option for caries management in children who lack cooperative ability.This article reviews the literature on SMART, the evidence regarding its applications in dental practice, its advantages, drawbacks, the scope for research, and clinical use.

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

Aim: This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. Materials and methods: The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). Results: The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. Conclusion: A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Clinical significance: Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. How to cite this article: da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Odontologia minimamente invasiva em atenção primária à saúde: integração ensino-serviço / Odontología mínimamente invasiva en la atención primaria de salud: integración enseñanza-servicio / Minimally invasive dentistry in primary health care: education-service integration

O objetivo do presente estudo foi apresentar um relato de experiência com utilização de Odontologia Minimamente Invasiva em intervenção, tratamento e prevenção de cárie em crianças de escola pública por meio da integração de uma Instituição de Ensino Superior com o sistema público de saúde e comunidade. Para tal ação, a intervenção foi dividida em: Fase 1 -aplicação funcional das diretrizes de atendimento odontológico seguindo o Tratamento Restaurador Atraumático (ART) e Fase 2 -análise crítica da efetividade das ações da fase 1, para potencial reprodução sob contexto de retomada das atividades escolares presenciais. Na Fase 1, graduandos do último período de Odontologia de uma universidade estadual realizaram o levantamento clínico e atendimento com a técnica do ART em 275 pacientes provenientes de uma escola da rede pública municipal de ensino fundamental, em escolares na faixa etária de 6 a 15 anos de idade. A partir da Fase 2 (Análise crítica de efetividade de ações) foi possível reconhecer, por meio de uma análise descritiva das experiências vivenciadas e da avaliação do resultado do primeiro controle realizado dois meses após realização ART, que essa atividade foi efetivamente um modelo desucesso na integração ensino-serviço, capaz de exemplificar uma experiência potencialmente significativa para emprego em contextos de retomada das atividades escolares presenciais, minimizando os problemas gerados pelo distanciamento social e interrupção temporária das consultas eletivas em Odontologia. A integração ensino-serviço com a ação realizada promoveu a qualidade de vida e redução da vulnerabilidade e riscos à saúde bucal (AU).

El presente estudio tuvo como objetivo presentar un relato de experiencia con el uso de la Odontología Mínimamente Invasiva en la intervención, tratamiento y prevención de caries en escolares públicos a través de la integración de una Institución de Educación Superior con el sistema de salud pública y la comunidad. Para esta acción, la intervención se dividió en: Fase 1 -aplicación funcional de las pautas de atención dental siguiendo el Tratamiento Restaurador Atraumático (TRA) y Fase 2 -análisis crítico de la efectividad de las acciones de la fase 1, para la reproducción potencial en el contexto de reanudación de actividades escolares presenciales. En la Fase 1, estudiantes del último período de Odontología de una universidad estatal realizaron la encuesta clínica y atención con la técnica de TRA en 275 pacientes deuna escuela de la red de escuelas primarias públicas municipales, en estudiantes de 6 a 15 años. A partir de la Fase 2 (Análisis crítico de la efectividad de las acciones) se pudo reconocer, mediante un análisis descriptivo de las experiencias vividas y la evaluación del resultado del primer control realizado dos meses después de la realización de la TAR, que esta actividad fue efectivamente un modelo de éxito en la integración enseñanza-servicio, capaz de ejemplificar una experiencia potencialmente significativa para su uso en contextos de reanudación de actividades escolares presenciales, minimizando los problemas generados por el distanciamiento social y la interrupción temporal de las consultas electivas en Odontología. La integración enseñanza-serviciocon la acción realizada promovió la calidad de vida y redujo la vulnerabilidad y los riesgos para la salud bucal (AU).

The aims of this study were to present an experience case report on the use of Minimally Invasive Dentistry in the intervention, treatment, and prevention of dental cavities in children attending public schools through the integration of a Higher Education Institution along with the Brazilian public health system known as Unified Health System, and the community. For this action, the intervention was dividedinto: Phase 1 -application of the dental care guidelines following the Atraumatic Restorative Treatment (ART) and Phase 2 -critical analysis of the effectiveness of phase 1 actions, for potential reproduction under the context of resumption of face-to-face school activities after COVID-19 pandemic. During Phase 1, last period undergraduates of Dentistry from a state university carried out a clinical survey with the ART technique in 275 patients from a public municipal elementary school, in schoolchildrenaged 6 to 15 years old. Based on Phase 2 findings, it was possible to recognize, through a descriptive analysis of the experiences lived and the evaluation of the first follow-up, carried out two months after performing ART, that this initiative was highly successful. It served as a valuable model in the context of resuming face-to-face school activities, mitigating the challenges caused by social distancing measures and the temporary suspension of elective dental appointments due to the pandemic. The education-service integration with the implemented action promoted a better quality of life and reduced vulnerability and risks to oral health (AU).

Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

ABSTRACT Objective: To evaluate the association of oral health-related quality of life (OHRQoL) with the longevity of ART-restorations in children after 18 months. Material and Methods: A longitudinal clinical study with 62 six- to seven-year-old children, both genders, 31 of whom underwent four weeks of oral health education strategy (OHES) followed by ART (GOHES+ART) and the others only ART (GART). The Brazilian short-version of the Child Perceptions Questionnaire (16-CPQ8-10) was used to evaluate the OHRQoL and the perception of change in oral health was assessed by a single question. Data was analyzed using Mann-Whitney, Wilcoxon and Friedman's tests. Results: After 18 months, GOHES+ART reported a greater impairment on OHRQoL, mainly in oral symptoms domain (p<0.05). In this period, greater impairment of oral symptoms was reported in children with failed restorations and with treatment considered to have a minor failure (p<0.05). In inter-group analysis, the GOHES+ART, with 2 to 4 restorations, Class I, of small size, located in the upper arch and with a smaller failure, reported more oral symptoms than the GART. Conclusion: In the long-term, children submitted to OHES followed by ART reported more oral symptoms. Factors such as number, class, size and location of the restorations need to be considered for the implementation of an efficient and effective oral health program, as well as for greater longevity of ART-restorations.

Silver Modified Atraumatic Restorative Technique: A Way towards "SMART" Pediatric Dentistry during the COVID-19 Pandemic.

As the coronavirus disease-2019 pandemic outbreak continues to be a global public health concern, dentists should seek means to provide oral health care with minimal risk. To meet the recommendations of the Center for Disease Control, alternative non-aerosol generating techniques have been proposed to minimize the risk of disease transmission to patients and dental healthcare personnel. Among recent materials, silver diammine fluoride (SDF) has been shown to be effective in preventing and arresting caries. This along with an atraumatic restorative treatment with glass ionomer cements (GICs) makes it a potentially attractive adjunctive therapy for caries management in pediatric patients. In this technique, SDF is applied over carious tissue and the lesion is restored with auto-polymerizing GIC. This review article aims to provide a practical background and clinical guide for the application of silver-modified atraumatic restorative technique (SMART) as a safe way to provide dental services to children during the pandemic.

SMART: Silver diamine fluoride reduces microtensile bond strength of glass ionomer cement to sound and artificial caries-affected dentin.

Silver-modified atraumatic restorative technique (SMART) is an emerging restorative technique; however, the effect of silver diamine fluoride (SDF) application on the bond strength of glass ionomer cement (GIC) is unknown. This study aimed to determine if SDF application to sound and artificial caries-affected dentin (ACAD) immediately prior to GIC restoration affected microtensile bond strength (µTBS). Caries was induced on extracted molars using a pH-cycling protocol that was validated against natural caries (similar µTBS). Dentin surfaces were treated with 38% SDF, control groups with de-ionized water and immediately restored. Beam-shaped specimens were sectioned and subjected to tensile forces for µTBS determination. Two hundred and eighty-seven specimens from 40 teeth were tested. SDF application significantly (p<0.001) reduced µTBS in sound dentin (19.00±8.20 MPa vs. 14.60±6.68 MPa), while no difference was found in ACAD. No difference was found in failure mode among groups. For SMART, SDF application on sound dentin before immediate GIC restoration may decrease bond strength.

Manejo de cárie radicular: um guia para o dentista brasileiro baseado na tradução e adaptação cultural do consenso internacional/ORCA E EFCD / Management of root caries: a guide for the Brazilian dentist based on the translation and cultural adaptation of the international consensus/ORCA and EFCD

Objetivo: A cárie radicular é um problema da Odontologia moderna, porém é notável a falta de diretrizes sobre o seu manejo. Objetivamos elaborar e adaptar um guia a partir da tradução das recomendações do consenso in-ternacional European Organization for Caries Research (ORCA) e European Federation of Conservative Dentistry (EFCD) para as tomadas de decisão clínica na intervenção do processo de cárie na pessoa idosa, com foco na cárie radicular. Materiais e métodos: O protocolo de tradução das recomendações do consenso internacional consistiu nas etapas: (1) tradução inicial, (2) síntese da tradução, (3) retradução, (4) revisão por comitê de especialistas, com adaptação cultural. A partir da tradução, foi desenvolvido um guia com diretrizes para tratamento de cárie radicular no Brasil. Resultados: Para prevenção de novas lesões é recomendada a escovação diária com dentifrício >1.500ppm/F. Dentifrícios com 5.000ppm/F ou vernizes (>20.000ppm/F) podem ser indicados para paralisar lesões radiculares ativas e para prevenção em pessoas idosas com alta suscetibilidade à cárie radicular, e o Diamino Fluoreto de Prata (>30%) para paralisar lesões ativas. Intervenções invasi-vas diretas são indicadas dependendo da situação clínica. Discussão: Nota-se uma falta de interesse em estudos primários sobre tratamentos para cárie radicular, criando assim uma lacuna em relação ao seu manejo, que reflete no nível de evidência detectado pelo consenso. Conclusão: Guias clíni-cos são importantes para reduzir a lacuna entre a pesquisa e a prática clínica. Essa tradução para o português facilitará o acesso dos dentistas bra-sileiros em relação a evidência consolidada até o momento para o manejo de cárie radicular.

Aim: Root caries are a problem in modern dentistry, but the lack of guidelines regarding their management is notable. We aim to develop and adapt a guide based on the translation of the recommendations of the international consensus as outlined by the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) for clinical decision-making in the intervention of the caries process in the elderly, with a focus on root caries. Materials and methods: The protocol for translating the recommendations of the international consensus consisted of the following steps: (1) initial translation, (2) synthesis of the translation, (3) back-translation, (4) review by an expert committee with cultural adaptation. Based on the translation, a guide was developed with guidelines for the treatment of root caries in Brazil. Results: To prevent new lesions, daily brushing with toothpaste >1,500ppm/F is recommended. Toothpaste with 5,000ppm/F or varnishes (>20,000ppm/F) may be recommended to paralyze active root lesions and for prevention in elderly people with high susceptibility to root caries, and Silver Diamine Fluoride (>30%) to paralyze active lesions. Direct invasive interventions are indicated depending on the clinical situation. Discussion: There is a lack of interest in primary studies on treatments for root caries, thus creating a gap in relation to its management, which is reflected by the level of evidence detected in the consensus. Conclusion: Clinical guidelines are important to reduce the gap between research and clinical practice. This translation into Portuguese will facilitate access by Brazilian dentists to the consolidated evidence gathered to date for the management of root caries.

New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial.

Background: The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim: This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods: A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results: The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion: All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance: Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements.Trial registration number RBR-9nqszr. How to cite this article: da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.

Comparison of the effectiveness of 38% silver diamine fluoride and atraumatic restorative treatment for treating dental caries in a school setting: A randomized clinical trial.

BACKGROUND: Dental caries is an infectious microbial disease of the teeth, affecting mostly young children. It is caused by the interplay of numerous factors that are more common in susceptible and lower-income groups. Therefore, there is a dire need for a simple yet effective method of treating dental caries. OBJECTIVES: The aim of the study was to compare the effectiveness of 38% silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in the treatment of dental caries in a school setting. MATERIAL AND METHODS: A randomized clinical trial (RCT) using a parallel-group design was conducted among schoolchildren aged 6-12 years. Oral hygiene practices and sugar exposure were recorded at baseline. In the schoolchildren, 190 dental caries lesions were restored using 38% SDF (group 1) or ART (group 2). The χ 2 test and the Kaplan-Meier survival analysis were done to assess the 2 treatment modalities. The RCT was carried out and reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) checklist. RESULTS: A total of 190 children fulfilled the inclusion criteria and the mean age of the study population was 9.3 ±1.3 years. The majority of the participants brushed their teeth once daily, using a toothbrush, rinsed their mouth after meals and had optimal sugar exposure. In measuring the outcome of the interventions after 9 months, 58.9% of the participants from group 1 had their restorations intact as compared to 47.8% in group 2, and this was found to be statistically significant (p = 0.004). The survival analysis using the log rank test showed 38% SDF to be better in comparison with ART. CONCLUSIONS: This study indicated that SDF was better at arresting caries, and hence it can be considered a viable treatment option in areas with limited access to oral healthcare.

Bone formation in sinus augmentation with different xenograft particle sizes: systematic review and meta-analysis / Formação óssea em levantamento de seio maxilar com diferentes tamanhos de partículas de enxerto xenográfico: revisão sistemática e meta-análise

ABSTRACT The commercial bovine bone mineral most commonly used is available in two particle sizes and studies have demonstrated contradictory results regarding bone formation volume using small or large particles. The aim of this systematic review and meta-analysis was to compare the bone formation volume and residual bovine bone volume in sinus floor augmentation using small and large particles. The following outcome measures were assessed: bone formation volume (%) and residual bovine bone particles volume (%) assessed by histomorphometric analysis. The initial screening resulted in 236 records. After removal of duplicated articles and analysis of titles, abstracts and full texts, three articles were included in the meta-analysis. The bone formation volume and residual bovine bone volume did not differ between small and large particles, with low heterogeneity of studies. The particle size of bovine bone mineral did not influence bone formation percentage; small and large particles of bovine bone graft presented similar residual bone mineral; more randomized clinical trials should be performed to completely confirm that bovine bone mineral particle size does not affect the result of sinus floor augmentation.

RESUMO O enxerto ósseo bovino comercial mais comumente utilizado está disponível em dois tamanhos de partícula, que tem demonstrado resultados contraditórios em relação à formação óssea usando partículas pequenas ou grandes. O objetivo desta revisão sistemática e meta-análise é comparar o volume de formação óssea e o volume de enxerto residual em levantamento de seio usando partículas pequenas e grandes. Os seguintes dados foram comparados: volume de formação óssea (%) e volume residual de partículas de enxerto (%) dados por análise histomorfométrica. A seleção inicial resultou em 236 artigos. Após remoção de artigos duplicados e análise dos títulos, resumos e textos completos, três artigos foram incluídos na meta-análise. Os volumes de formação óssea e de enxerto residual não diferenciam entre os tamanhos de partícula pequeno e grande, com baixa heterogeneidade dos artigos. O tamanho de partícula de enxerto ósseo bovino não influencia o percentual de formação óssea; partículas de enxerto ósseo bovino pequenas e grandes apresentaram enxerto residual similar; mais ensaios clínicos randomizados deveriam ser realizados para confirmar que o tamanho de partícula de enxerto não afeta os resultados de levantamento de seio maxilar.

Aesthetic-functional rehabilitation of deciduous anterior teeth without removal of carious tissue: series of clinical cases / Reabilitação estético-funcional em dentes anteriores decíduos sem remoção de tecido cariado: série de casos clínicos

ABSTRACT The treatment of cavity carious lesions in anterior deciduous teeth is a frequent demand in the pediatric dentistry clinic, since the control of the disease in early childhood still presents itself as an inter-factor challenge in child health care. While the scientific evidence on the minimally invasive principles of approach in Dentistry is presented at an increasing level, the alternatives for restorative treatment in anterior deciduous teeth still face the low availability of reports that associate minimal intervention with the aesthetic needs inherent to the treatment. Thus, this article presents a series of cases in which direct restorations in composite resin, without removing carious tissue using polyvinyl matrices, were treatment alternatives for moderate and severe caries lesions in anterior deciduous teeth. It was observed, therefore, that the use of this artifact helped the rehabilitation of compromised dental elements with speed and satisfactory 50 result, suggesting that this is an appropriate approach for application in Pediatric Dentistry, 51 since it offers resistance, durability, besides providing aesthetics and functionality, it presents lower cost and agility as it eliminates the laboratory phase.

RESUMO O tratamento de lesões cavitadas de cárie em dentes decíduos anteriores é uma demanda frequente na clínica de odontopediatria, visto que o controle da doença na primeira infância ainda se apresenta como um desafio interfatorial nos cuidados em saúde infantil. Enquanto a evidência científica nos princípios minimamente invasivos de abordagem em Odontologia apresenta-se em nível crescente, as alternativas para tratamento restaurador em dentes decíduos anteriores ainda esbarram na baixa disponibilidade de relatos que associem a mínima intervenção às necessidades estéticas inerentes ao tratamento. Assim, este artigo apresenta uma série de casos em que as restaurações diretas em resina composta, sem a remoção de tecido cariado utilizando matrizes de polivinila foram alternativas de tratamento para lesões de cárie moderadas e severas em dentes decíduos anteriores. Observou-se que o uso desse artefato auxiliou a reabilitação dos elementos dentários comprometidos com rapidez e resultado satisfatório, sugerindo que essa é uma abordagem adequada para aplicação em Odontopediatria, já que oferece resistência, durabilidade, além de proporcionar estética e funcionalidade, apresenta menor custo e agilidade na medida que dispensa a fase laboratorial.

Restorative treatment in patient with Williams Syndrome: case report / Tratamento restaurador em paciente com Síndrome de Williams: relato de caso

ABSTRACT In Dentistry, any user with one or more limitations, of temporary or permanent mental nature, of physical, sensory, emotional or medical growth, is considered to be a Patient with Special Needs, preventing him from being subjected to a conventional dental situation. These patients form a group which may be considered at high risk for the development of oral diseases, according to the kind of pathogen. Among them, is the Williams-Beuren Syndrome, a rare congenital disease with cardiovascular involvement, mental retardation, dysmorphic face, idiopathic hypercalcemia, musculoskeletal problems, dental and growth anomalies. Familial and sporadic cases are thought to result from deletion of genetic material from adjacent genes located on the long arm of chromosome 7. This article reports a clinical case involving a four-year-old boy with Williams-Beuren Syndrome, referred to the clinic of the Specialization Course for Patients with Special Needs, at the São Leopoldo Mandic Dental Research Center, Campinas (SP). As the patient was resistant to dental care, in order to reduce anxiety and increase collaboration in clinical sessions, the Hixizine® medication was administered. For atraumatic restorative treatment and restorations, the following materials were used: Cleanjoy®, Futurabond DC®, Ionofil Plus® Grandioso®, Grandio® and Profluorid®. As result, it was possible to reach a level of excellence using the indicated materials and specific protocols. Based on this work and the lived experience, it can be observed that these patients can receive welcoming dental care in specialized clinics.

RESUMO Na Odontologia é considerado Paciente com Necessidades Especiais todo usuário que apresenta uma ou mais limitações, temporárias ou permanentes, de ordem mental, física, sensorial, emocional, de crescimento ou médica, que o impeça de ser submetido a uma situação odontológica convencional. Esses pacientes formam um grupo que pode ser considerado de alto risco para o desenvolvimento de doenças bucais, de acordo com o tipo de patogenia. Dentre elas, tem-se a Síndrome de Williams-Beuren, uma desordem congênita rara com envolvimento cardiovascular, retardo mental, face dismórfica, hipercalcemia idiopática, problemas musculoesqueléticos, anomalias dentárias e de crescimento. Os casos são hereditários ou esporádicos e a causa está na concepção com a deleção no braço longo do cromossomo 7. Este artigo relata um caso clínico envolvendo um menino de quatro anos, portador da síndrome, encaminhado para atendimento na Clínica do Curso de Especialização em Pacientes com Necessidades Especiais do Centro de Pesquisas Odontológicas São Leopoldo Mandic, Campinas (SP). Como o paciente apresentava resistência ao atendimento odontológico, com o objetivo de diminuir a ansiedade e aumentar a colaboração, nas sessões de atendimento foi administrado o medicamento Hixizine®. Para o tratamento restaurador atraumático e restaurações estéticas utilizou-se os seguintes materiais: Cleanjoy®, Futurabond DC®, Ionofil Plus®, Grandioso®, Grandio® e Profluorid®. Como resultado, foi possível atingir grau de excelência utilizando os materiais indicados e protocolos específicos. Mediante o caso relatado e frente à experiência vivenciada, pode-se perceber que esses pacientes podem receber um atendimento odontológico acolhedor nas clínicas especializadas.

Avaliação das taxas de sucesso de restaurações com cimento de ionômero de vidro de alta viscosidade durante o tratamento restaurador atraumático: uma revisão de escopo / Assessment of the success rates of high viscosity glass ionomer cement restorations in atraumatic restorative treatment: a scoping review

Objetivo: Esta revisão de escopo teve como objetivo comparar a taxa de sucesso de restaurações confeccionadas com cinco marcas diferentes de Cimento de Ionômero de Vidro de Alta Viscosidade (CIVAV), referência no Tratamento Restaurador Atraumático (Atraumatic Restorative Treatment-ART).Métodos: Buscas no PubMed, Scopus e Web of Science foram feitas. Buscas no OpenGrey e no Google Scholar também foram feitas. Critérios de inclusão foram estudos (ensaios clínicos e estudos de acompanhamento) que avaliavam a taxa de sucesso de restaurações confeccionadas com CIVAV. Não houve restrição de idioma ou data. Título/resumo e texto completo das referências encontradas foram avaliados por dois autores. Referências que preencheram os critérios de inclusão foram selecionadas. Extração de dados foi feita. Modelos de regressão de Cox foram idealizados para comparação da probabilidade de sucesso das restaurações com diferentes tipos de CIVAV. Os resultados foram relatados em razão das chances (RC) e intervalos de confiança (IC). Análises de Kaplan Meyer foram feitas para o cálculo da probabilidade de sucesso de restaurações com CIVAV. Resultados: Nove artigos avaliando o ChemFil Rock, ChemFlex, Equia Fil, Ketac Molar ou Fuji IX foram incluídos. Restaurações com cimentos de ionômero de vidro Fuji IX (RC = 3,51; IC = 1,96 ­ 6,28), Ketac Molar (RC = 4,01; IC = 2,40-6,68) e ChemFlex (RC = 4,20; IC = 1,01-17,66) apresentaram uma taxa de sucesso significativamente maior do que aquelas com ChemFil Rock. EquiaFil alcançou a segunda menor eficácia, ligeiramente maior que o ChemFil Rock. Conclusão:Restaurações com Fuji IX, Ketac Molar e ChemFlex apresentaram altas taxas de sucesso ao longo do tempo de avaliação do ART.

Aim: This scoping review aimed to compare the success rate of restorations using five different brands of High Viscosity Glass Ionomer Cement (HVGIC), reference material in Atraumatic Restorative Treatment (ART). Methods: Searches were carried out in PubMed, Scopus, and Web of Science. OpenGrey and Google Scholar searches were also performed. Inclusion criteria were studies (clinical trials and follow-up studies) that evaluated the success of restorations using HVGIC. Title, abstract, and full text of the references were evaluated by two authors. Articles that met the inclusion criteria were included. Data extraction was performed. Cox regression models were created to compare the success rate of restorations produced with different types of HVGIC. The results were reported as odds ratio (OR) and confidence intervals (CI). Kaplan Meyer analyses were performed to calculate the HVGIC restorations' probability of success.Results: Nine articles evaluating ChemFil Rock, ChemFlex, Equia Fil, Ketac Molar, or Fuji IX were included. Restorations with glass ionomer cements Fuji IX (OR = 3.51; CI = 1.96 - 6.28), Ketac Molar (OR = 4.01; CI = 2.40-6.68), and ChemFlex (OR = 4.20; CI = 1.01-17.66) had a significantly higher success rate than those with ChemFil Rock. EquiaFil achieved the second lowest efficacy, slightly higher than ChemFil Rock.Conclusion: Restorations with Fuji IX, Ketac Molar, and ChemFlex showed high success rates over the ART evaluation time.

Adherence to the CONSORT statement of randomized clinical trials on ART restorations in children: current status and reporting characteristics

Abstract: Appropriate research reports are important to facilitate the evaluation of studies and the decision-making by dentists and policymakers. This meta-research study assessed the conformity of randomized clinical trials (RCTs) on atraumatic restorative treatment (ART) restorations with the CONSORT recommendations and their risk of bias (RoB). Cochrane Library, MEDLINE, BBO, LILACS, Scopus, and Web of Science databases were searched from April 2019 to June 2021 for RCTs that assessed the longevity of ART restorations in children. A specific tool was used to assess adherence to the CONSORT recommendations; RoB was evaluated with the Cochrane risk-of-bias tool. Descriptive analyses included the number of studies by journal, follow-up period, country, and quality assessments. A total of 2,181 papers were retrieved and 36 of them were analyzed qualitatively. The overall CONSORT mean score (CONms) was 22.52 ± 6.17 out of 32 points. The best described items were intervention and outcomes, whereas allocation concealment was described in only 22% of the papers. Significant differences in CONms were detected in the analysis by country and publication dates. High CONms were observed in recently published papers (26.7 ± 3.1) when compared to first ART studies (18.1 ± 4.6; p < 0.001). RoB was low in four studies, unclear in 11, and high in 21. Adherence of the papers to the CONSORT recommendations was not fully achieved and most of the papers had unclear and high RoB (PROSPERO registration #CRD42020201460).

Survival Rate and Cost-Effectiveness of Conventional and Atraumatic Restorative Treatment Restorations among Anganwadi Preschool Children in Bengaluru City: A Follow-up Study.

BACKGROUND: Atraumatic restorative treatment (ART) approach helps reduce barriers to restorative care for the patients. This study was done to compare the survival rate and cost-effectiveness of conventional and ART restorations at time-intervals of 6, 12, and 18 months among anganwadi preschool children in Bengaluru city. MATERIALS AND METHODS: 133 children aged 3-5 years attending anganwadi centers in Bengaluru city based on inclusion and exclusion criteria were recruited for the present study. A split-mouth technique was used in which the participants received two types of carious cavity excavation techniques (conventional and ART) followed by restoration using glass ionomer cement. Comparison and evaluation were made at the end of 6 months, 12 months and 18 months intervals to check for the survival rate and cost-effectiveness. RESULTS: The survival rates of ART when compared to conventional restorations were higher at 6 months and 12 months 97.7% and 93.07%, respectively, and at 18 months survival rate of conventional restorations were higher. The cost-effectiveness ratio (CER) of the ART restoration was lower when compared to conventional restorations. CONCLUSION: The carious cavities restored using ART techniques had a better survival rate at 12 months and lower CER when compared to the conventional technique.

A comparative survival analysis of high viscosity glass ionomer restorations using conventional cavity preparation and atraumatic restorative treatment technique in primary molars: A randomized clinical trial.

BACKGROUND: This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars. MATERIALS AND METHODS: In this RCT, 139 schoolchildren aged 6-9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan-Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant. RESULTS: The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan-Meier estimate (P = 0.255). CONCLUSION: Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

Abstract: This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.

Peculiarities of Dental Treatment among Paediatric Oncological Patients: a Case Report.

OBJECTIVES: According to the National Cancer Institute of Lithuania, cancer is diagnosed for almost 100 children each year. Oncological patients suffer from complications during and after treatment. Radiation therapy also affects dental hard tissues. Many oncological patients lose motivation to take care of their oral hygiene because they are focused on cancer diagnosis. This case report discusses prevention and dental treatment severity after radiation therapy treatment. MATERIAL AND METHODS: A 9-year-old boy with cancer diagnosis visited a dentist in 2017. The patient was complaining about poor aesthetic quality of the teeth, but there were no complaints about teeth sensitivity or pain. Different stages of active caries, poor oral hygiene, visible abundant plaque, swollen, red and bleeding gums were observed during appointment. A motivational interview explaining the importance of oral hygiene was conducted. Non-surgical caries treatment was prescribed during the first visit. Restorative treatment was performed after 1 month. RESULTS: The motivational interview explaining the importance of oral hygiene was conducted during every appointment per 3-year period. Unfortunately, oral hygiene is still poor due to the lack of motivation. Active-cavitated caries lesions were restored with glass ionomer cement and composite resin. The aesthetics of teeth was improved. CONCLUSIONS: Oncological and recovered patients after radiation therapy should be assigned to a high risk of caries. These patients should be treated individually by the algorithm. Psychological or psychotherapeutic assistance is necessary for patients due to motivation for treatment and oral care.

Minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper.

The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital tooth bleaching with a mixture of sodium perborate and 30% hydrogen peroxide rolled in Japanese paper for a traumatically injured tooth, and in-office vital-tooth bleaching for the upper front six teeth and first premolars, were performed. Five-year follow-up showed satisfactory stability in the bleaching effects and did not show any problems in the traumatically injured tooth. The use of Japanese paper for non-vital tooth bleaching may minimize damage to discolored non-vital teeth.