Effect of silver diamine fluoride combined with photodynamic therapy on primary enamel microhardness.

OBJECTIVES: This study aimed to assess the effect of silver diamine fluoride (SDF) combined with photodynamic therapy (PDT) on primary enamel microhardness. MATERIALS AND METHODS: This in vitro, experimental study was conducted on 40 extracted primary molars with sound buccal/lingual surfaces. The baseline enamel microhardness of the teeth was initially measured by a Vickers hardness tester. Next, the teeth were randomly assigned to four groups (n=10) for treatment with SDF, PDT, SDF plus PDT, and control (no intervention). After the intervention, the teeth underwent a 14-day pH-cycling, and enamel microhardness was measured again. The change in microhardness was calculated for each group, and comparisons were made by two-way ANOVA and t-test (alpha=0.05). RESULTS: The mean secondary microhardness of the three intervention groups was significantly higher than that of the control group (P<0.05). Despite slightly higher microhardness in SDF + PDT group, followed by the SDF group, the difference in secondary microhardness was not significant among the three intervention groups (P>0.05). CONCLUSION: Treatment of primary enamel with SDF or PDT can increase its microhardness and enhance remineralization. However, combined use of SDF and PDT had no additional advantage over the use of SDF alone.

Antimicrobial Efficacy of Saline, Chlorhexidine, and Zataria Multiflora and Mentha Piperita Essential Oils in Root Canal Irrigation of Primary Molars.

Objectives: This study aimed to compare the antimicrobial efficacy of saline, 0.5% and 2% Zataria multiflora (Z. multiflora) essential oil, 0.5% and 2% Mentha piperita (M. piperita) essential oil, and 0.2% chlorhexidine (CHX) as root canal irrigants for primary molar teeth. Materials and Methods: A total of 64 primary molars were used in this in vitro study. The teeth were randomly assigned to six groups (N=10). The root canals were prepared up to file #35, and all teeth were sterilized before contamination with Enterococcus faecalis (E. faecalis; ATCC 29212) suspension. After 48 hours of incubation, the root canals in each group were irrigated with the respective irrigants. Sterile paper points were then used to collect microbial samples from the root canals. A colony counter was used to count the number of colony-forming units (CFUs). Data were analyzed by SPSS version 20 (alpha=0.05). Results: The colony count was significantly different among the groups (P<0.001), and 2% M. piperita (P=0.009), 0.5% Z. multiflora (P=0.021), and 0.2% CHX (P=0.002) were significantly more effective than saline in elimination of E. faecalis. The ascending order of microbial count after irrigation was as follows: saline > 0.5% M. piperita > 0.2% CHX > 2% M. piperita > 0.5% Z. multiflora. Conclusion: The current study showed the optimal antibacterial activity of 0.5% Z. multiflora essential oil and 2% M. piperita essential oil against E. faecalis, and indicated their possible efficacy for use as an irrigant for root canal irrigation of primary molars.

Union between deciduous and permanent as intrusive luxation sequelae: A case report.

Traumatic dental injuries (TDI) are common in children due learning to walk and lack of balance that leads to falls. Luxation is the trauma that occurs most frequently in the deciduous, being that the intrusive and the avulsive are the ones that cause more damage to the permanent successors. The potential to cause disturbances to the developing permanent germ is high due to anatomical proximity and depends on age, direction of intrusion, severity and treatment. The consequences to the permanent range from hypocalcifications of enamel to retention of the permanent germ. In this case, the developmental disturbance of the tooth 21 presenting with acute dentoalveolar abscess was a result of a three-degree intrusive luxation of the deciduous predecessor. The tooth 61 was misdiagnosed initially as avulsion, but it was a total intrusion as uncovered after a radiographic examination that showed an image suggestive of the presence of the deciduous tooth. The deciduous was extracted along with his permanent successor through outpatient procedure under antibiotic coverage and local anesthesia. The macro and microscopic analysis of the piece evidenced the presence of elements 21 and 61 closely united, as well as alterations provoked in both. There was remission of the infectious process and after 7 days it was verified the correct healing of the surgical wound. The radical outcome of this case emphasizes the relevance of appropriate clinical support as soon as possible in all TDI.

A Randomized Controlled Clinical Trial Comparing Clinical and Radiographic Success Rates of MTA and rhBMP2 in Pulpotomy of Primary Teeth.

Objectives: In an ideal pulpotomy, the radicular pulp remains vital, healthy, and fully encased within an odontoblastic layer. Mineral trioxide aggregate (MTA) and bone morphogenetic proteins (BMPs) have been suggested to facilitate this outcome. We aimed to compare the clinical and radiographic failure and success rates of MTA and rhBMP2 as pulpotomy medicaments. Materials and Methods: Sixty-eight teeth from 3-6-year-old children were randomly assigned to two groups using a split-mouth design. Cervical pulpotomy was performed using MTA in one group and rhBMP2 in the other. Subsequently, the teeth were restored with stainless-steel crowns. Clinical and radiographic assessments were performed at 3, 6, 9, and 12-month follow-up intervals to evaluate success and failure rates. Data were analyzed using Chi-square test and Kaplan-Meier survival analysis (P<0.05) Results: At six and nine months, one tooth in the BMP2 group and one tooth in the MTA group showed internal resorption, respectively. After 12 months, one tooth in the BMP2 group exhibited PDL widening. The radiographic success rate was 100% for the MTA- and 97.1% for the BMP2-group at six months, 96.7% for both groups at nine months, and 96.7% and 93.3%, respectively, at 12 months. No clinical failure criteria were observed in any of the teeth. Survival analysis revealed no significant difference between the two groups. Conclusion: The study reveals comparable outcomes between rhBMP2 and MTA, suggesting rhBMP2 as a viable alternative for pulpotomy in primary teeth. With minimal incidences of complications and no significant differences noted, rhBMP2 demonstrates potential for clinical use.

Occlusion development after premature loss of deciduous anterior teeth: preliminary results of a 24-month prospective cohort study

ABSTRACT Objective: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. Methods: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). Results: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. Conclusion: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.

RESUMO Objetivo: Este estudo teve como objetivo avaliar o desenvolvimento da oclusão após perda prematura ou extração de dentes decíduos anteriores, por meio de um estudo de coorte prospectivo. Métodos: Quinze bebês e crianças de 1 a 5 anos foram avaliados longitudinalmente (com perda ou extração de dentes anteriores decíduos [n = 9] e sem perdas dentárias [n = 6]). Foram realizadas fotografias e modelos dentais no início e após 24 meses de acompanhamento. Os modelos dentários foram escaneados e medidas lineares foram feitas nos modelos digitalizados (espaço dentário perdido, perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos). O teste t foi utilizado para comparações entre grupos (α = 0,05). Resultados: A média de idade dos indivíduos no início do estudo foi de 2,93 (± 1,18) anos. Não foram observadas diferenças estatisticamente significativas no espaço dentário perdido no grupo com perda dentária durante os 24 meses de acompanhamento (p > 0,05). O perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos não apresentaram diferenças entre os grupos (p> 0,05). A avaliação fotográfica qualitativa revelou alterações nas arcadas dentárias e na oclusão, como: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção ou estabelecimento de má oclusão, entre outras. Conclusão: Os resultados sugerem que a perda prematura de dentes anteriores decíduos não afeta o perímetro, comprimento e largura das arcadas dentárias; entretanto, outras alterações que levam à má oclusão poderiam ser estabelecidas.

The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Knowledge of Physical Education Students about Tooth Avulsion Before and After Receiving an Informative Leaflet

Abstract Objective: To evaluate the knowledge of Physical Education students about tooth avulsion (TA) in both dentitions before and after receiving an informative leaflet (IL). Material and Methods: The questionnaire contained information about TA in dentition and its management and was applied to the Physical Education students before and after reading an IL. Results: A total of 118 students, 96.61%, attended a first aid course, and 17.80% received information about TA. Most students (88.98%) never had an experience with TA, and 90.68% considered its management important. The other questions, before and after reading the IL, respectively, were: would not perform deciduous tooth replantation (42%; 88%); knew how to handle the avulsed permanent tooth (APT) (38%; 92%); knew how to clean the APT (50%; 99%); knew that permanent tooth replantation (PTR) must be immediate (15%; 95%); knew the ideal time to seek for the dentist right after TA without performing PTR (6%; 83%); knew how to store APT (31%; 97%). Conclusion: The knowledge of Physical Education students in this research revealed a limited understanding of dental tooth avulsion. After receiving an informative leaflet, the students showed a significant improvement in knowledge about traumatic avulsion management, including tooth replantation and proper actions.

An In-Vitro Comparative Study of Fluoride Varnish and Two Calcium-Containing Fluoride Products on the Remineralization of Primary Teeth Enamel.

Objectives: To compare the effectiveness of fluoride varnish and two calcium-based fluoride products on the remineralization of primary teeth enamel. Materials and Methods: Surface-microhardness (SMH) of 36 extracted anterior primary teeth was measured by Vickers test (50gr/5 seconds) to provide a baseline for later comparisons. All teeth were immersed in demineralizing solution for 96 hours to create caries-like lesions and SMH was determined for the artificially-induced caries. The teeth were randomly assigned to three groups consisting of 5% fluoride varnish once daily/10 seconds, Clinpro™ 5000 toothpaste once daily/2 minutes, and Remin Pro cream once daily/3 minutes for 28 days. All specimens were kept in artificial saliva with pH cycling during the study period. After remineralization, SMH was evaluated for the last time. Data were analyzed by one-way ANOVA, Mauchly's sphericity, and RM-ANOVA with Bonferroni correction for inter-and- intra-group comparisons at the three stages of the study. Results: Neither the baseline SMH nor the SMH of the artificially created caries showed significant differences among the samples (P>0.05). The post-treatment SMH was highest in the Clinpro group (296.4±73.1kgf/mm2), followed by Remin Pro (283.8±119.3kgf/mm2), and varnish (270.9±78.3 kgf/mm2). There was no significant difference among the groups after treatment (P>0.05). We also did not observe a significant difference among the three different study stages (P>0.05). Conclusion: Within the limitations of this in-vitro study, daily application of low fluoride-calcium compound seems to be as effective as the professional use of fluoride varnish or high-content fluoride toothpaste in remineralizing initial caries of primary teeth.

Accuracy of the American Association of Endodontists diagnostic criteria for assessing pulp health in primary teeth.

OBJECTIVES: There is a lack of studies evaluating the accuracy of the 2009 American Association of Endodontists (AAE) diagnostic criteria for diagnosing pulpal health in primary teeth. This study aimed to estimate and correlate the diagnostic accuracy of clinical diagnosis of reversible and irreversible pulpitis using the 2009 AAE criteria with histological findings in primary teeth. METHODS: Eighty primary teeth that were clinically diagnosed with normal pulp (n = 10), reversible pulpitis (n = 30), irreversible pulpitis (n = 30) and pulp necrosis (n = 10) were collected. The teeth were histo-processed, and pulp tissues were diagnosed histologically as uninflamed pulp, reversible or irreversibly inflamed and necrosis based on previously proposed criteria. RESULTS: The clinical diagnosis of pulp necrosis (sensitivity 70%, specificity 96%) and normal pulp (sensitivity 91%, specificity 100%) matched the histological diagnosis of necrosis and uninflamed pulp in 70% and 100%, respectively. The clinical diagnosis of irreversible pulpitis (sensitivity 64%, specificity 72%) matched the histological diagnosis of irreversible pulp inflammation for 47% of teeth evaluated. For the clinical diagnosis of reversible pulpitis (sensitivity: 65%, specificity: 86%), 80% matched the histological diagnosis of reversible pulp inflammation. Teeth with histologically diagnosed irreversible pulp inflammation were more likely to have lingering (OR 5.08; 95% CI 1.48-17.46, P = 0.010) and nocturnal tooth pain (OR 15.86; 95% CI 1.57-160.47, P = 0.019) when compared to teeth with reversible pulp inflammation. Using the classification and regression tree model, the presence of widened periodontal ligament space and nocturnal tooth pain were useful predictors of irreversible pulp inflammation with an accuracy of 78%. CONCLUSION: The 2009 AAE criteria was acceptable for primary teeth with pulp necrosis and normal pulp but poor for reversible pulpitis and irreversible pulpitis.

Microbiological Profile of Primary Teeth with Irreversible Pulpitis and Pulp Necrosis with/without Abscess and their Susceptibility to Three Antibiotics as Intracanal Medication.

Context: The ineffective disinfection potential of conventional intracanal medicaments to eliminate enteropathogens from root canal systems leads to their persistence contributing to endodontic treatment failures. Hence, the use of appropriate intracanal medicament becomes the essential phase to accomplishing comprehensive decontamination of the root canal system. When applied topically as an intracanal medicament, antibiotics eradicate residual microorganisms from tortuous endodontic spaces, minimizing the risk of systemic toxicity. Aims and objectives: To evaluate the prevalence of various bacterial species associated with signs of irreversible pulpitis and pulp necrosis with/without abscess in primary teeth root canals and their susceptibility against three antimicrobial agents. Materials and methods: The pulp tissue and organic debris were retrieved from deciduous teeth (n = 50) from children between the age of 3-10 years and cultured. The bacterial identification and antibacterial profiling of isolated bacteria were done against clindamycin, metronidazole, and doxycycline through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assay. The MIC and MBC of each antibiotic were expressed as mean ± standard deviation (SD), range, and standard error (SE of the mean). The intergroup comparisons were done by the Kruskal-Wallis test, while intragroup pair-wise comparisons were done using the Wilcoxon signed-rank test. The confidence level will be set at 95%. Results: Aerobic bacteria were found in 54%, microaerophilic bacteria in 76%, facultative anaerobes in 26%, and obligatory anaerobes were isolated from 30% of teeth. The intragroup and intergroup comparisons of test agent MIC revealed a nonsignificant difference (p > 0.05). The intragroup MBC comparisons of all the test agents revealed statistically nonsignificant (p > 0.05), while intergroup comparisons demonstrated nonsignificant (p > 0.05) to highly significant difference (p < 0.001). Conclusion: Clindamycin demonstrated promising antibacterial activity against most of the isolated bacteria, while against metronidazole and doxycycline, most of the bacteria were moderate to highly resistant. Clinical significance: Determining the antibacterial agents' efficacy along with modifications can help to target maximum pathogenic microbes and reduce catastrophic endodontic therapy failures. How to cite this article: Dahake PT, Kothari S. Microbiological Profile of Primary Teeth with Irreversible Pulpitis and Pulp Necrosis with/without Abscess and their Susceptibility to Three Antibiotics as Intracanal Medication. Int J Clin Pediatr Dent 2023;16(2):312-320.

Biocompatibility of Ajwain Oil Combined with Eugenol and Zinc Oxide as a Deciduous Root Canal Obturating Material: An In Vivo Study.

Aim and objectives: The present study was intended to assess the biocompatibility of newly formulated materials such as zinc oxide (ZO) admixed with ajwain oil (A) as well as ajwain eugenol (E) (1:1 ratio) against ZOE through an animal model as root canal obturating materials in deciduous teeth. Materials and methods: The study involved randomly selected 24 albino rats, which were divided into three groups based on test materials. Two polyethylene tubes (PETT) (8 mm long × 1 mm internal diameter) were inserted into connective tissues of the dorsal side on either side of each rat viz empty tube (negative control) and another containing test material (test group). Animals were sacrificed at the end of the 7th and 21st days. PETT with surrounding connective tissues were excised. Histopathological evaluations of the material's biocompatibility were done by determining inflammatory tissue responses. Non-parametric tests such as Kruskal-Wallis and Mann-Whitney U were used for statistical analysis (p < 0.05). Results: Histopathological examination on the 7th day showed increased polymorphonuclear cells for all test materials compared to the negative control (p = 0.92), suggesting acute inflammation. The inflammation subsided gradually after 21 days (p = 0.48). The lymphocytes increased after 21 days for all the materials indicating chronic inflammation (p = 0.79), as well as fibroblasts (p = 0.34) and capillaries (p = 0.35), indicating healing and repair. Conclusion: The newly formulated obturating materials were found to be biocompatible compared to ZOE. How to cite this article: Dahake PT, Joshi SS, Kale YJ, et al. Biocompatibility of Ajwain Oil Combined with Eugenol and Zinc Oxide as a Deciduous Root Canal Obturating Material: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(3):431-436.

Desenvolvimento de dentes decíduos artificiais para práticas laboratoriais em Odontopediatria / Desarrollo de dientes temporales artificiales para prácticas de laboratorio en Odontopediatría / Development of artificial primary teeth for laboratory practices in Pediatric Dentistry

Na formação em Odontologia os acadêmicos realizam treinos pré-clínicos para aperfeiçoar suas técnicas. O objetivo deste estudo é relatar a experiência de produção de dentes decíduos artificiais por impressão tridimensional (3D), com baixo custo, para práticas laboratoriais acadêmicas em Odontopediatria. Partiu-se de uma pesquisa laboratorial e experimental, tendo sido realizada uma revisão bibliográfica para obtenção dos dados. A obtenção das imagens 3D se deu a partir da biblioteca gratuita de dentes permanentes Brenner e edição no programa Meshmixer para incorporação das características de dentes decíduos, seguida de impressão 3D utilizando estereolitografia. Posteriormente, foram preenchidos os condutos radiculares com cera 7 e poliacetato de vinila (PVA)vermelha. Foi realizada também a pintura do cemento e da coroa, com tinta de esmalte marrom e branca, respectivamente. As duas resinas exibiram fidelidade anatômica externa, entretanto, para viabilidade do uso na Endodontia, foi analisada a anatomia interna, imagem radiográfica, tempo de impressão, custo de produção e custo/benefício. A combinação de resina Anycubic para a representação dos tecidos mineralizados com cera 7 para simulação da polpa possibilitou a adequada reprodução da anatomia interna de dentes decíduos (AU).

En la formación en Odontología, los alumnos realizan una formación preclínica para mejorar sus técnicas. El objetivo de este estudio es relatar la experiencia de producción de dientes temporales artificiales por impresión tridimensional (3D), a bajo costo,para prácticas académicas de laboratorio en Odontopediatría. Se inició con una investigación de laboratorio y experimental, habiéndose realizado una revisión bibliográfica para la obtención de los datos. Las imágenes 3D se obtuvieran de la biblioteca gratuita de dientes permanentes de Brenner y se editó en el programa Meshmixer para incorporar las características de los dientes temporales, seguida de una impresión 3D mediante estereolitografía. Posteriormente se obturaron los conductos radiculares con cera7 y acetato de polivinilo rojo (PVA). El cemento y la corona también se pintaron con pintura de esmalte marrón y blanco, respectivamente. Las dos resinas exhibieron fidelidad anatómica externa, sin embargo, para la factibilidad de uso en Endodoncia se analizó la anatomía interna, imagen radiográfica, tiempo de impresión, costo de producción y costo/beneficio. La combinación de la resina Anycubic para la representación de tejidos mineralizados con la cera 7 para la simulación de la pulpa permitió reproduciradecuadamente la anatomía interna de los dientes temporales (AU).

During Dentistry training, students undertake pre-clinical training to improve their techniques. The objective of this study is to report the experience of producing artificial deciduous teeth using three-dimensional (3D) printing, at low cost, for academic laboratory practices in Pediatric Dentistry. The starting point was laboratory and experimental research, and a bibliographic review was carried out to obtain data. The 3D images were obtained from the free Brenner permanent teeth library and edited in the Meshmixer program to incorporate the characteristics of deciduous teeth, followed by 3D printing using stereolithography. Subsequently, the root canals were filled with wax 7 and red polyvinyl acetate (PVA). The cementum and crown were also painted with brown and white enamel paint, respectively. The two resins exhibited external anatomical fidelity, however, for feasibility of use in Endodontics, the internal anatomy, radiographic image, printing time, production cost and cost/benefit were analyzed. The combination of Anycubic resin to represent mineralized tissues with wax 7 to simulate the pulp made it possible to adequately reproduce the internal anatomy of deciduous teeth (AU).

Pediatric dentistry procedures performed in the Unified Health System in the State of Rio Grande do Sul before and during the COVID-19 pandemic: difference between the years 2018 and 2021 / Procedimientos de odontopediatría realizados en el Sistema Único de Salud del Estado de Rio Grande do Sul antes y durante la pandemia de COVID19: diferencia entre los años 2018 y 2021 / Procedimentos odontopediátricos realizados pelo Sistema Único de Saúde no Rio Grande do Sul, antes e durante a pandemia de covid-19: diferença entre os anos de 2018 e 2021

Objective: To analyze the difference in the number of dental procedures in the primary dentition performed in the Unified Health System in the state of Rio Grande do Sul, before and during the COVID-19 pandemic. Methods: Descriptive ecological study, using secondary data from the Sistema de Informações Ambulatoriais (SIA-SUS), from 2018 to 2021, in the state and in the seven health macro-regions. The relative and absolute frequencies and the percentage difference of the dental procedures performed were calculated. Results: 94,443 and 36,151 dental procedures were registered before and during the pandemic, respectively, which corresponded to a reduction of 61.7%. Relevant percentage reductions were observed in restorative procedures, which reached 20 percentage points in the southern region of the state. An increase in the percentage of exodontic and endodontic procedures was observed. Conclusion: The results suggest that the COVID-19 pandemic had negative repercussions on the performance of dental procedures in the primary dentition in the state.

Objetivo: Analizar la diferencia en el número de procedimientos odontológicos en dentición temporal realizados en el Sistema Único de Salud del estado de Rio Grande do Sul, antes y durante la pandemia de COVID-19. Métodos: Estudio ecológico descriptivo, utilizando datos secundarios del Sistema de Información Ambulatorio del SUS (SIA-SUS), de 2018 a 2021, en el estado y en las siete macrorregiones de salud. Se calcularon las frecuencias relativas, absolutas y la diferencia porcentual de los procedimientos odontológicos realizados. Resultados: se registraron 94.443 y 36.151 procedimientos odontológicos antes y durante la pandemia, respectivamente, lo que corresponde a una reducción del 61,7%. Se observaron reducciones porcentuales relevantes en los procedimientos restaurativos, que alcanzaron 20 puntos porcentuales en la región sur del estado. Se observó un aumento en el porcentaje de procedimientos de exodoncia y endodoncia. Conclusión: Los resultados sugieren que la pandemia de COVID-19 tuvo repercusiones negativas en la realización de procedimientos odontológicos en dentición temporal en el estado.

Objetivo: analisar a diferença no número de procedimentos odontológicos na dentição decídua, realizados pelo Sistema Único de Saúde (SUS) no estado do Rio Grande do Sul, Brasil, antes e durante a pandemia de covid-19. Métodos: estudo ecológico descritivo, utilizando-se dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), de 2018 a 2021, no estado e em suas sete macrorregiões de saúde; foram calculadas as frequências relativas e absolutas, e a diferença percentual dos procedimentos odontológicos realizados. Resultados: foram registrados 94.443 e 36.151 procedimentos odontológicos antes e durante a pandemia, respectivamente, correspondendo a uma redução de 61,7%; reduções percentuais relevantes foram observadas nos procedimentos restauradores, atingindo 20 pontos percentuais na região Sul do estado; observou-se aumento no percentual de procedimentos exodônticos e endodônticos. Conclusão: os resultados sugerem que a pandemia de covid-19 teve repercussões negativas sobre a realização dos procedimentos odontológicos na dentição decídua, no estado gaúcho.

Effectiveness of comprehensive intervention on primary dental caries in 3-year-old children in Bengbu / 中国学校卫生

Objective@#To explore the effectiveness of the comprehensive intervention on prevention of deciduous primary caries in 3-year-old children, so as so provide reference for the prevention, health care and treatment of oral caries.@*Methods@#Three-year-old children selected by drawing lots from 10 public kindergartens in 5 districts of Bengbu were examined in 2021, and were randomly divided into intervention group ( n =300) and control group ( n =300). During the initial examination, caries loss (dmf) including dental caries, missing teeth, filling teeth were assessed in the two groups. At the initial examination, the intervention group received caries intervention while no intervention was administered in the non-intervention group until half a year later. Intervention measures included education, diet, self-cleaning and fluoride application intervention. The number of cases and the mean of caries loss in the two groups were compared by χ 2 test.@*Results@#Before the intervention, 43 children in the control group suffered from caries, with 88 dmf, including 44 dmf for boys and 44 dmf for girls. There were 45 children in the intervention group, with 101 dmf, including 49 dmf for boys and 52 dmf for girls. There was no significant difference in the number of dmf between the intervention group and the control group ( χ 2=0.91, P >0.05), and there was no significant difference in the prevalence rate (15.0%, 14.3%, χ 2=0.05, P >0.05). After the intervention, there were 26 new dental caries and 43 dmf in intervention group, including 25 dmf for boys and 18 dmf for girls. In the control group, there were 83 new dental caries and 168 dmf, including 72 dmf for boys and 96 dmf for girls. Compared with the control group, the new dmf in the intervention group was significantly different ( χ 2=75.38, P < 0.05). The number of new dental caries patients in the intervention group was significantly different from that in the control group ( χ 2=36.42, P <0.05).@*Conclusion@#Comprehensive interventions to prevent dental caries can significantly reduce the incidence of primary teeth caries in children. It is suggested to intervene dental caries as early as possible to reduce the incidence of dental caries and other oral diseases.

Association of salivary parameters and erosive tooth wear in preschool children

Abstract The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial

Abstract Background Hall technique (HT) has been indicated for teeth with dentinal caries lesion; however, extensive cavities, with more than two surfaces still seem challenging for restorative treatment in pediatric dentistry, resulting in a higher failure rate and an increased need for retreatment. Objectives To compare the survival rate of the Hall technique preformed metal crown (HT) with resin composite restoration (RC) for multi-surface cavitated caries lesions in primary molars. Methodology In this multicenter two-arm randomized clinical trial, children between 4 and 9 years of age with at least one primary molar with cavitated caries lesion involving more than two surfaces, including one buccal or palatal/lingual surface, were selected from 17 Brazilian cities. A total of 364 teeth were allocated into two groups: (1) teeth treated with selective caries removal and RC and (2) treated with the HT. The survival rate was assessed at 6 and 12 months after the interventions. Survival analysis was performed with the Kaplan‒Meier method. Cox regression was used to determine the influence of explanatory variables on the survival rate (α=5%). Results After 12 months, 292 teeth were re-evaluated. A total of 358 teeth were re-evaluated at least once during the study and included in the survival analysis. The HT (87.8%) resulted in a higher survival rate than RC restoration (75.7%) (p=0.004). Conclusion HT has a higher survival rate than RC as a treatment for multi-surface cavitated caries lesions in primary teeth. ClinicalTrials.gov: NCT02782390

Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Procedimentos odontopediátricos realizados pelo Sistema Único de Saúde no Rio Grande do Sul, antes e durante a pandemia de covid-19: diferença entre os anos de 2018 e 2021 / Procedimientos de odontopediatría realizados en el Sistema Único de Salud del estado de Rio Grande do Sul antes y durante la pandemia de COVID-19: diferencia entre los años 2018 y 2021 / Pediatric dentistry procedures performed within the Brazilian National Health System in the state of Rio Grande do Sul before and during the COVID-19 pandemic: difference between the years 2018 and 2021

Objective: to analyze the difference in the number of primary teeth dental procedures performed within the Brazilian National Health System (SUS) in the state of Rio Grande do Sul, before and during the COVID-19 pandemic. Methods: this was a descriptive ecological study, using secondary data from the SUS Outpatient Information System (SIA-SUS), from 2018 to 2021, in the state and in its seven health macro-regions; we calculated the relative and absolute frequencies and the percentage difference of the dental procedures performed. Results: 94,443 and 36,151 dental procedures were recorded before and during the pandemic, respectively, corresponding to a 61.7% reduction; relevant percentage reductions were found in restorative procedures, which reached 20% in the southern region of the state; an increase in the percentage of exodontic and endodontic procedures was found. Conclusion: the results suggest that the COVID-19 pandemic had negative repercussions on the performance of primary teeth dental procedures in Rio Grande do Sul.

Objetivo: analizar la diferencia en el número de procedimientos odontológicos en dentición temporal realizados en el Sistema Único de Salud del estado de Rio Grande do Sul, antes y durante la pandemia de COVID-19. Métodos: estudio ecológico descriptivo, utilizando datos secundarios del Sistema de Información Ambulatorio del SUS (SIA-SUS), de 2018 a 2021, en el estado y en las siete macrorregiones de salud. Se calcularon las frecuencias relativas, absolutas y la diferencia porcentual de los procedimientos odontológicos realizados. Resultados: se registraron 94.443 y 36.151 procedimientos odontológicos antes y durante la pandemia, respectivamente, lo que corresponde a una reducción del 61,7%. Se observaron reducciones porcentuales relevantes en los procedimientos restaurativos, que alcanzaron 20 puntos porcentuales en la región sur del estado. Se observó un aumento en el porcentaje de procedimientos de exodoncia y endodoncia. Conclusión: los resultados sugieren que la pandemia de COVID-19 tuvo repercusiones negativas en la realización de procedimientos odontológicos en dentición temporal en el estado.

Objetivo: analisar a diferença no número de procedimentos odontológicos na dentição decídua, realizados pelo Sistema Único de Saúde (SUS) no estado do Rio Grande do Sul, Brasil, antes e durante a pandemia de covid-19. Métodos: estudo ecológico descritivo, utilizando-se dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), de 2018 a 2021, no estado e em suas sete macrorregiões de saúde; foram calculadas as frequências relativas e absolutas, e a diferença percentual dos procedimentos odontológicos realizados. Resultados: foram registrados 94.443 e 36.151 procedimentos odontológicos antes e durante a pandemia, respectivamente, correspondendo a uma redução de 61,7%; reduções percentuais relevantes foram observadas nos procedimentos restauradores, atingindo 20 pontos percentuais na região Sul do estado; observou-se aumento no percentual de procedimentos exodônticos e endodônticos. Conclusão: os resultados sugerem que a pandemia de covid-19 teve repercussões negativas sobre a realização dos procedimentos odontológicos na dentição decídua, no estado.

Non-Invasive Methods and the Use of Infiltrating Resins for the Control of Caries Progression in Deciduous Teeth: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the influence of non-invasive treatment associated with the use of infiltrating resin for managing caries lesions in primary teeth. Material and Methods: A systematic review was performed by selecting articles from 6 online databases, using a search algorithm and eligibility criteria for data extraction and data synthesis for the papers included. Clinical trials involving primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the outer dentin) were included, presenting full text and answering the study's guiding question. This study used the RoB 2 tool for the risk of bias assessment and GRADE for certainty of evidence. Random effects meta-analyses were implemented, and lesion progression treatment effects were estimated through relative risk (RR) and associated 95% confidence intervals. Results: A total of 440 studies were found. After analyzing the inclusion criteria and removal of duplicates, eight studies were analyzed for quality evidence. Five of the eight studies included in this review contributed to the meta-analysis, all with some reflections regarding the risk of bias. Overall, the results of the meta-analysis showed that non-invasive treatment, when associated with the use of infiltrating resins, significantly reduced the risk of caries progression in relation to the treatment without this addition for follow-up periods ranging from 12 months to 2 years (RR 0.51 [0.40-0.65]). Conclusion: There is moderate certainty of evidence that the use of infiltrating resins associated with non-invasive treatments decreases the risk of caries progression in primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the dentin outer) when combined with non-invasive control methods alone.

Tumor necrosis factor α, and agonist and antagonists of cannabinoid receptor type 1 and type 2 alter the immunophenotype of stem cells from human exfoliated deciduous teeth

ABSTRACT Objective To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. Methods Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. Results The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. Conclusion Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules.