Association between genetic factors and molar-incisor hypomineralisation or hypomineralised second primary molar: A systematic review.

OBJECTIVE: To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic review. DESIGN: A search was performed in Medline-PubMed, Scopus, Embase and Web of Science databases; manual search and search in gray literature were also performed. Selection of articles was performed independently by two researchers. A third examiner was involved in cases of disagreement. Data extraction was performed using an Excel® spreadsheet and independent analysis was performed for each outcome. RESULTS: Sixteen studies were included. There was an association between MIH and genetic variants related to amelogenesis, immune response, xenobiotic detoxification and other genes. Moreover, interactions between amelogenesis and immune response genes, and SNPs in the aquaporin gene and vitamin D receptors were associated with MIH. Greater agreement of MIH was found in pairs of monozygotic twins than dizygotic twins. The heritability of MIH was 20 %. Hypomineralised second primary molars was associated with SNPs in the hypoxia-related HIF-1 gene and methylation in genes related to amelogenesis. CONCLUSION: With very low or low certainty of evidence, an association was observed between MIH and SNPs in genes associated with amelogenesis, immune response, xenobiotic detox and ion transport. Interactions between genes related to amelogenesis and immune response as well as aquaporin genes were associated to MIH. With very low certainty of evidence, hypomineralised second primary molars was associated to a hypoxia-related gene and to methylation in genes related to amelogenesis. Moreover, higher agreement of MIH in pairs of monozygotic twins than dizygotic twins was observed.

Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial.

BACKGROUND: Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis. AIM: To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis. DESIGN: Eighty-eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months. RESULTS: At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p = .45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00). CONCLUSION: After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis.

The impact on the quality of life caused by the early loss of primary molars.

INTRODUCTION: Evidence regarding the impact of early loss of primary molars (ELPM) on Oral Health-Related Quality of Life (OHRQoL) is lacking. The aim of the present study was evaluating the impact of ELPM on OHRQoL of Brazilian schoolchildren aged 6-10 years. METHODS: This observational prospective cohort study was conducted with 163 schoolchildren, assigned in the primary tooth loss group (PTLG), in which all tooth loss was caused by carious lesions, and in a control group without tooth loss (CG). Two calibrated examiners conducted the clinical oral assessments to determine caries experience and tooth loss. OHRQoL was assessed using the Child Perception Questionnaire 8-10 years (CPQ8-10) instrument administered at baseline and at 10-12 months of follow-up. RESULTS: Children in PTLG exhibited significantly more negative impact on OHRQoL at baseline (p < 0.01) than CG, and also after the follow-up period (p < 0.01). It was also possible to observe a significant reduction in the negative impact on OHRQoL in both CG and PTLG in the longitudinal analysis (p < 0.01). Nevertheless, there was an even more substantial reduction in the negative impact on OHRQoL in children in PTLG. CONCLUSIONS: This study provides evidence that early tooth loss is associated with negative impact on OHRQoL. Moreover, it indicates that access to dental treatment can have a positive impact on the OHRQoL of children with dental caries and ELPM.

Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting.

BACKGROUND: Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months. METHODS: Children (5-10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. PRIMARY OUTCOME: restoration survival over 36-months (using Kaplan-Meier survival analysis, log rank test, and Cox regression). SECONDARY OUTCOMES: (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months). RESULTS: One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. PRIMARY OUTCOME: restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17-0.47); HT = 93.4% (0.05; 0.72-0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007). CONCLUSIONS: Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child's tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%). TRIAL REGISTRATION: This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.

Prevalencia de infraoclusión en molares primarios de niños de 7 y 8 años, Valdivia, Chile, 2019 / Prevalência de infraoclusão em molares decíduos de crianças de 7 e 8 anos, Valdivia, Chile, 2019 / Prevalence of infraocclusion in primary molars of children 7 and 8 years old, Valdivia, Chile, 2019

Objetivo: Determinar la prevalencia de infraoclusión en molares primarios de niños de 7 y 8 años, Valdivia, Chile. Materiales y métodos: Estudio descriptivo de corte transversal. Se examinaron niños de 7 y 8 años en establecimientos educacionales de Valdivia. Fue evaluada la presencia y severidad de infraoclusión en molares primarios utilizando la clasificación de Brearley & McKibben. Para establecer diferencias estadísticas entre sexo y presencia de infraoclusión fue realizada la prueba de chi-cuadrado. Además un análisis de ANOVA fue utilizado para establecer diferencias entre la localización de la infraoclusión y el grado de severidad. El nivel de significancia estadística se estableció con un valor de p<0,05. Resultados: Fueron evaluados 359 niños y un 41,78% presentó infraoclusión. Según grado de severidad, 82,06% fueron leves, 15,28% moderadas y 2,66% severas. No se encontraron diferencias significativas entre sexo y presencia de infraoclusión. Se evidenciaron diferencias estadísticamente significativas al evaluar localización y grado de severidad (p<0,05). Conclusión: Existe una alta prevalencia de infraoclusión en niños de 7 y 8 años en Valdivia, Chile.

Objective: To determine the prevalence of infraocclusion in primary molars of children aged 7 and 8 in Valdivia, Chile. Materials and methods: Descriptive cross-sectional study. Children aged 7 and 8 were examined in educational institutions in Valdivia. The presence and severity of infraocclusion in primary molars was evaluated using the Brearley & McKibben classification. The chisquare test was performed to establish statistical differences between sex and presence of infraocclusion. In addition, an ANOVA test was used to establish differences between infraocclusion location and degree of severity. The level of statistical significance was established at p <0.05. Results: Of 359 children evaluated, 41.78% had infraocclusion. As per degree of severity, 82.06% of cases were mild, 15.28% moderate and 2.66% severe. No significant differences were found between sex and presence of infraocclusion. Statistically significant differences appeared when assessing location and degree of severity (p <0.05). Conclusion: There is a high prevalence of infraocclusion in children aged 7 and 8 in Valdivia, Chile

Objetivo: Determinar a prevalência de infraoclusão em molares decíduos de crianças de 7 e 8 anos, Valdivia, Chile. Materiais e métodos: Estudo transversal descritivo. Crianças de 7 e 8 anos foram examinadas em estabelecimentos de ensino em Valdivia. A presença e gravidade da infraoclusão em molares decíduos foram avaliadas pela classificação de Brearley & McKibben. Para estabelecer diferenças estatísticas entre sexo e presença de infraoclusão, foi realizado o teste do qui-quadrado. Além disso, uma análise ANOVA foi usada para estabelecer diferenças entre a localização da infra-oclusão e o grau de gravidade. O nível de significância estatística foi estabelecido com um valor de p <0,05. Resultados: 359 crianças foram avaliadas e 41,78% apresentaram infra-oclusão. De acordo com o grau de gravidade, 82,06% eram leves, 15,28% moderados e 2,66% graves. Não foram encontradas diferenças significativas entre sexo e presença de infra-oclusão. Diferenças estatisticamente significantes foram evidenciadas na avaliação da localização e do grau de gravidade (p <0,05). Conclusão: Existe uma alta prevalência de infra-oclusão em crianças de 7 e 8 anos em Valdivia, Chile

Randomized controlled clinical trial of resin infiltration in primary molars: 2 years follow-up.

OBJECTIVE: The aim of this split-mouth, randomized, controlled clinical trial was to evaluate the efficacy of resin infiltration in controlling the progression of non-cavitated proximal lesions in primary molars after two-years follow-up. METHODS: Fifty healthy children presenting at least two primary molars with proximal lesion detected radiographically (in the inner half of enamel or the outer third of dentin) were included in the study. The proximal lesions were randomly allocated into resin infltration + flossing (test group) or flossing (control group). All patients received oral hygiene instructions for daily brushing with fluoride toothpaste (1100 ppmF) and flossing. The proportion of caries progression was compared using the McNemar test. The main outcome after 2-years, caries progression in the radiography was assessed by pair-wise reading by an independent examiner who was blind regarding the treatment. RESULTS: The sample comprised 28 (56%) girls and 22 (44%) boys with a defs of 7,3 (SD = 6,5), mainly of moderate (46%) to high (48%) caries risk. Results after one year were published previously. After 2-years, 29 (58%) patients were assessed. Caries progression was observed in 24.1% (7/29) of the test lesions, compared with 55.2% (16/29) of the control lesions (p = 0.012). The therapeutic effect was 31.1% and the relative risk reduction (RRR) was 56.3%. Eigth lesions from the control group and two lesions from the test group progressed to the inner third of dentin and were restored. CONCLUSIONS: In conclusion, resin infiltration was more efficacious in controlling proximal caries lesions in primary molars than non-invasive approach alone. CLINICAL SIGNIFICANCE: The results indicate that resin infiltration was an efficacious method in controlling proximal caries lesions in primary molars after 2 years, even in patients with high caries risk, reaffirming the results of 1-year follow-up.

Effect of Pseudocolor Filter in Micro-computed Tomography Images for Detection of Proximal and Occlusal Caries Lesions in Primary Molars.

AIM: This study aimed to evaluate the effect of pseudocolor filter in micro-computed tomography (CT) images for the detection of proximal and occlusal caries lesions in primary molars. MATERIALS AND METHODS: For this in vitro analysis, 26 extracted human primary teeth were scanned using a compact micro-CT device (Skyscan 1172, Bruker micro-CT, Kontich, Belgium) and the projection images were reconstructed into cross-sectional slices (NRecon v.1.6.9, Bruker micro-CT, Kontich, Belgium). The original and pseudocolor images were evaluated twice by three calibrated radiologists. The tooth surfaces were scored according to Mejàre et al. criteria. The agreement was assessed by the Kappa coefficient, and the Chi-square test was used to evaluate the association between radiolucent lesion depth in enamel and dentin. RESULTS: There was a good intra-observer agreement for detecting proximal caries lesions with or without using pseudocolor filter (k >0.60). The inter-examiner agreement had similar results, and the agreement rates were good or moderate for the proximal surfaces. There were no statistically significant differences between the original and pseudocolor images (p >0.05). The pseudocolor filter showed high sensitivity and specificity when compared with the original image with the exception of the occlusal face in enamel. CONCLUSION: The pseudocolor filter appears to be a promising enhancement tool for micro-CT images used for the detection of caries lesions in primary molars; even if it was not significantly different from the original images. CLINICAL SIGNIFICANCE: The pseudocolor filter converts grey scale images into color images. It is present in micro-CT software and must increase the diagnostic capacity of detecting caries lesion in occlusal and proximal surfaces.

Clinical and Radiographic evaluation of mixture of Zinc Oxide powder and Nanohydroxyapatite as an obturating material in primary molars / Avaliação clínica e radiográfica da associação do pó de óxido de zinco com nanohidroxiapatita como um material obturador utilizado em primeiros molares

Pulpectomy is the treatment alternative in rescuing the pulpally involved carious primary teeth. Various obturating materials are being used to conserve an infected deciduous dentition. The present study documents the use of a novel obturating material in primary molars due to the disadvantages associated with of the currently used materials. Objective: To evaluate clinically and radiographically the success rate of the mixture of zinc oxide powder and nanohydroxyapatite with saline as an obturating material in primary molars and also to compare its efficiency with Endoflas. Material and Methods: Thirty pulpectomy indicated primary molars were randomly divided into two equal groups; Group I (mixture of zinc oxide powder and nanohydroxyapatite with saline) and Group II (Endoflas FS). The teeth were evaluated using various clinical and radiographic criteria at 3, 6 and 9-month intervals. The obtained results were statistically analyzed (P <0.05). Results: The overall present study findings revealed 100% clinical success in both the groups. Whereas radiographically, success reported was 66% for Group I and 100% for Group II at the end of 9 months followup. The difference in the radiographic success rate between the two groups was statistically significant (P <0.05). Conclusion: Endoflas FS had demonstrated high success rate both clinically and radiographically when compared to the novel combination of a mixture of zinc oxide powder and nanohydroxyapatite with saline as obturating material. (AU)

Pulpectomia é uma alternativa de tratamento que visa resgatar polpas envolvidas em processos cariosos de dentes decíduos. Vários materiais obturadores estão sendo usados para conservar a dentição decídua infectada. O presente estudo relata o uso de um novo material obturador em molares decíduos devido às desvantagens dos materiais atualmente utilizados. Objectivo: Avaliar clínica e radiograficamente a taxa de sucesso da mistura de pó de óxido de zinco e nanoidroxiapatita como material obturador em molares decíduos e também comparar sua eficiência com Endoflash. Material e Métodos: Trinta molares decíduos que foram indicados para pulpectomias foram divididos aleatoriamente em dois grupos iguais; Grupo I (mistura de pó de óxido de zinco e nanoidroxiapatita) e Grupo II (Endoflash). Os dentes foram avaliados utilizando vários critérios clínicos e radiográficos em intervalos de 3, 6 e 9 meses. Os resultados obtidos foram analisados estatisticamente (P <0,05). Resultados: Os achados gerais do presente estudo revelaram sucesso clínico de 100% em ambos os grupos. Enquanto que radiograficamente, o sucesso relatado foi de 66% para o Grupo I e 100% para o Grupo II ao final de 9 meses de acompanhamento. A diferença na taxa de sucesso radiográfico entre os dois grupos foi estatisticamente significante (P <0,05). Conclusão: O Endoflas demonstrou alta taxa de sucesso tanto clínica como radiograficamente quando comparado à nova combinação de pó de óxido de zinco e nanoidroxiapatita como material obturador (AU)

Prevalence of early loss of primary molar and its impact in schoolchildren's quality of life.

BACKGROUND: Evidence regarding the impact of premature loss of primary molars on oral health-related quality of life (OHRQoL) is lacking. AIM: To evaluate the prevalence of premature loss of primary molars in schoolchildren and its impact on OHRQoL. DESIGN: We randomly selected 667 children aged 8-9 years enrolled in public and private schools from Aracaju (Brazil). The presence of untreated dental caries and early loss of primary molars were recorded, and its impacts on OHRQoL evaluated using Child Perceptions Questionnaire (CPQ8-10 ). Influence of some variables on tooth loss and OHRQoL was assessed by multilevel Poisson's regression analysis (P < 0.05). RESULTS: The prevalence for early tooth loss was 65.4% (95% confidence interval 51.1%-77.3%). Children with untreated dental caries and attending public schools presented higher prevalence of early tooth loss. Moreover, early loss of primary molars provoked negative impact on OHRQoL considering total score of CPQ8-10 and domains "oral symptoms," "functional limitations" and "emotional well-being." Children presenting early teeth loss presented significantly higher scores of CPQ8-10 , as well as females and children with dental caries in other teeth. CONCLUSIONS: The prevalence of early loss of primary molars is high, and it impacts the OHRQoL of children aged 8-9 years.

Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial.

OBJECTIVE: The main purpose of this split month, randomized, controlled clinical trial was evaluate the efficacy of caries infiltration in controlling the progression of non-cavitated proximal lesions in primary molars. Anxiety and time required for the caries infiltration was also evaluated. MATERIALS AND METHODS: Fifty healthy children, 5 to 9 years, presenting two primary molars with proximal caries lesions (1/2 of the enamel or outer 1/3 of dentin), were included. Lesions were randomly allocated to the test group (fluoridated toothpaste + flossing + infiltration) or to the control group (fluoridated toothpaste + flossing). Caries risk was based on the Cariogram model. The main outcome after 1-year radiographic follow up was assessed by an independent blinded examiner A facial image scale (FIS) was applied to assess dental anxiety and time required to perform the infiltration was recorded. RESULTS: Of the sample, 92.9% corresponded to high or medium caries risk. In 42 patients (1-year follow up), caries progression was observed in 11.9% (5/42) of the test lesions compared with 33.3% (14/42) of the control lesions (p < 0.05). Five control and three test lesions progressed to the middle 1/3 of dentin and were restored. No side effects were observed. Anxiety was both low before and after the treatment, and mean time required for the infiltration was 11.29 min (± 1.16 min). CONCLUSIONS: Caries infiltration of proximal caries lesions in primary molars is significantly more efficacious than standard therapy alone (fluoride toothpaste + flossing). CLINICAL RELEVANCE: Caries infiltration is an applicable and well-accepted method be used in children, representing a promising micro-invasive approach.

Uso de restaurações indiretas na correção da infra-oclusão: relato de caso / Use of indirect restorative technique for the correction of retained primary molar: case report

A infraoclusão de molares decíduos é uma situação clínica que pode causar prejuízos ao desenvolvimento da oclusão do paciente, mas com o desenvolvimento das técnicas e materiais odontológicos nos últimos anos, esse quadro clínico pode ser solucionado através de uma terapia mais conservadora. Este trabalho tem como objetivo apresentar a reabilitação de um dente em infraoclusão através da utilização de uma restauração indireta em resina composta. Esta técnica permite restabelecer as dimensões anatômicas, o equilíbrio oclusal e a estética da criança. Ao final pôde-se concluir que as restaurações indiretas em resina são uma boa opção de tratamento conservador para os casos de infraoclusão na dentição decídua.

Infraoccluded primary molars is a common clinical situation that can cause several damages for the development of occlusion, but with today?s development of the techniques and dental materials these clinical situation has several ways to be resolved, returning the oclusal balance for the patient. This article had as aim present a clinical report of a rehabilitation of an infraoccluded primary molar with the use of an indirect restoration in composite resin, designed to restore the anatomical size, the occlusion and esthetics of the child. At the end we can conclude that this technique presents several advantages, especially in Pediatric Dentistry.

Efeito do Bisel no Esmalte Sobre a Microinfiltração em Preparos Classe I em Molares Decíduos / Effect of Enamel Bevel on Microleakage in Class I Cavities in Primary Molars

Objetivo: Avaliar in vitro a influência da terminação marginal do preparo cavitário Classe I sobre a qualidade adesiva em restaurações compósitas realizadas em primeiros e segundos molares decíduos.Método: Dois preparos cavitários foram realizados na oclusal de vinte molares decíduos hígidos, sendo 20 preparos em primeiros molares e 20 em segundos molares, totalizando quarenta preparos cavitários. Após escolha aleatória, 20 preparos não receberam o bisel reto (grupo controle, GI, n=20) enquanto os demais preparos, grupo experimental, (GII, n=20) receberam um bisel reto com 0,5 mm de extensão no ângulo cavo û superficial feito com ponta diamantada ultra-fina 2200 FF. Para o procedimento restaurador, utilizou-se condicionamento ácido total com ácido fosfórico a 37% por 30s, sistema adesivo Prime & Bond NT® e compósito TPH® Spectrum cor A2. Para avaliação da qualidade adesiva, os dentes foram isolados com verniz, exceto às restaurações e 1,0 mm além das suas margens, e permaneceram em contato direto com uma solução aquosa de nitrato de prata a 50%, por 24 h. Em seguida, estes dentes foram clivados mesiodistalmente, e as restaurações avaliadas com 40 vezes de aumento. Dois avaliadores calibrados classificaram independentemente as restaurações de acordo com escores que variaram de zero (ausência de microinfiltração) a três (máxima microinfiltração). Os dados foram analisados descritivamente e tratados com os testes de Wilcoxon, Qui-quadrado e exato de Fisher a um nível de confiança de 95%.Resultados: O GII mostrou maiores escores de microinfiltração que o GI (p<0.001; p=0.0001). Os primeiros molares decíduos sofreram mais microinfiltração na presença de bisel (p=0.0003). Conclusão: O bisel no ângulo cavo-superficial em preparos Classe I aumentou a infiltração marginal nas restaurações compósitas em molares decíduos, principalmente nos primeiros molares

Objective: To evaluate in vitro the influence of Class I cavity marginal preparation on the adhesive quality in composite resin restorations placed in first and second primary molars.Method: Two cavities were prepared on the oclusal face of twenty sound primary molars, being twenty cavities in first molars and twenty in second molars, totalizing forty cavities. After random allocation, twenty cavities did not receive a straight bevel (control group, GI, n=20) while in the other cavities (experimental group, GII, n=20) a 0.5 mm straight bevel was made in the cavosurface angle with ultra-fine diamond bur 2200 FF. The restorative procedure included 37% phosphoric acid etching for 30 s, application of Prime & Bond NT®adhesive system and placement of TPH®Spectrum composite resin (shade A2). For evaluation of the adhesive quality, the teeth were coated with varnish, except for the restorations and a 1.0-mm-wide window beyond its margins, and were immersed in a 50% silver nitrate aqueous solution for 24 h. Next, the teeth were cleaved mesiodistally and the restorations were examined at ×40 magnification. Two independent calibrated examiners classified the restorations according to scores from zero (absence of microleakage) to three (maximum microleakage). Data were analyzed descriptively and treated with Wilcoxon, Chi-Square and FisherÆs exact tests at a confidence level of 95%.Results: GII presented higher microleakage scores than GI (p<0.001; p=0.0001). The primary first molars showed greater microleakage in the presence of bevel (p=0.0003). Conclusion: Beveling the cavosurface angle in Class I cavities increased marginal microleakage in the composite resin restorations placed in primary molars, especially in the first molars

Comportamiento clínico y radiográfico del formocresol y la pasta iodoformada en el tratamiento de pulpotomías en molares primarios

OBJETIVO: evaluar el comportamiento clínico y radiográfico de tratamientos de pulpotomía realizados con formocresol y con pasta iodoformada en molares primarios. MATERIALES Y MÉTODOS: se seleccionó una muestra no probabilística de 21 niños de ambos sexos con edades comprendidas entre 3 y 8 años, que asistieron al Servicio de Odontopediatría del Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Mérida - Venezuela, a los que se le realizaron tratamientos de pulpotomía en molares primarios vitales con exposición pulpar por caries. Los molares seleccionados fueron divididos aleatoriamente en dos grupos en función al tipo de material (grupo 1: formocresol y grupo 2: pasta iodoformada). La muestra fue observada al mes, a los dos y a los tres meses de realizados los tratamientos, para evaluar la presencia de signos y síntomas clínicos y radiográficos de patología pulpar. RESULTADOS: el Test exacto de Fisher demostró que no existen diferencias estadísticamente significativas entre los materiales empleados (p=0,351 y 0,176). Encontrándose un éxito del 81,8% con la técnica del formocresol y un 90,9 % con la técnica de la pasta iodoformada. Los hallazgos clínicos y radiográficos observados durante el tiempo de evaluación fueron, inflamación, fístula, zonas radiolúcidas perifurcales, reabsorción radicular patológica externa, reabsorción radicular interna, siendo este último hallazgo el más frecuente (técnica del formocresol 3,03%, técnica de la pasta iodoformada 1,51%). CONCLUSIONES: tanto el formocresol como la pasta iodoformada son materiales que pueden ser empleados para la obturación de pulpotomías en molares primarios. Por tanto, se puede considerar a la pasta iodoformada como una alternativa al uso del formocresol en la terapia pulpar de molares primarios vitales.

PURPOSE: evaluate the clinical and radiographic behaviour of pulpotomy treatments performed with formocresol and iodoform paste in primary molars. MATERIALS AND METHODS: a non probabilistic sample was selected which consisted of 21 children of both sexes ranged in age from 3 to 8 years, who attended to the Pediatric Dentistry Service of the Autonomous Institute Andes's University Hospital, Mérida - Venezuela. Pulpotomy treatments were performed in vital primary molars with carious pulpal exposure. The selected molars were randomly separated according to the material (1st group: formocresol and 2nd group: iodoform paste). The sample was observed into 1, 2 and 3 month after the treatment in stead to evaluate the apparition of clinic and radiographic sings and symptoms of pulpal pathology. RESULTS: the Fisher's exact test showed that there were not statistically significant differences between both materials (p=0,351 y 0,176). It were found a success rates of 81,8% with the formocresol technique and 90,9% with the iodoform paste technique. The clinic and radiographic founds observed during the evaluation period were swelling, fistulation, perifurcal radiolucency, external pathologic radicular resorption, internal radicular resorption. The last one was the most frequently found observed (formocresol technique 3,03%, iodoform paste technique 1,51%). CONCLUSIONS: either formocresol or iodoform paste can be used as obturating materials for pulpotomies in primary molars. Therefore, the iodoform paste can be considered as an alternative to the formocresol use in the primary molar pulpal therapy.

Comparative analysis of the eletronic and radiographic determination of root canal length of primary molars: an ex vivo study

Aim: To evaluate comparatively the radiographic and electronic root canal length determination in primary molars. Methods: 128 canals from 66 primary molars were selected. The root of each tooth was cut open on the occlusal face, and the real tooth length (RTL) was measured and the gold standard working length (WL) was determined by subtracting 1 mm from this measurement. The teeth were then placed in a plastic receptacle holding alginate and saline for the electronic determination of the root length using a Root ZX apex locator. The radiographic determination of the WL was obtained by subtracting 1 mm from the measurement highest cusp to the root apex appearing in the radiography. The data were analyzed statistically by the Chi-square test at a 5% significance level. Results: There was statistically significant difference (p<0.05) between each tested method and the gold standard. The Root ZX apex locator and the radiographic method presented satisfactory results in 75.78% and 54.68% of the cases, respectively. Conclusions: The Root ZX apex locator is a reliable method to determine the WL of primary teeth, since it showed greater accuracy than the radiographic method.

Avaliação Clínica e Radiográfica do emprego do Mineral Trióxido Agregado (MTA) em dentes decíduos pulpotomizados / Evaluation Clinical and Radiografic of the use Mineral Aggregate Trioxide (MTA) in pulpotomizados deciduous teeth

A pulpotomia tem como princípio básico a remoção total da polpa coronária e subsequente dos filetes remanescentes radiculares, em condições de saúde, permitindo que o ciclo biológico do dente decíduo prossiga naturalmente. Muitos são os materiais de escolha para realização desse procedimento. Desta forma, foram selecionados 30 molares decíduos em pacientes atendidos em clínica de Odontopediatria durante o ano de 2006, com indicação clínica e radiográfica para a realização de pulpotomia, utilizando-se o Mineral Trióxido Agregado (MTA) como material de escolha. Após o procedimento fi realizada proservação clínica e radiográfica, com intervalo de 90 a 180 dias, para observar o selamento marginal da câmara pulpar, bem como a preservação das estruturas periodontais e possívelformação de barreira dentinária (ponte de dentina),. Os resultados comprovaram que o MTA pode ser utilizado como material de escolha por ser biocompatível.

The pulpotomy basic principle is the total removal of the coronary pulp and subsequent remaining of pulpa radicularis, in healh conditions, allowin the biological cycle of the primary tooth to continue of course.Formocresol, during much time, has been the material of choice to accomplish this procedure. Of this from, 30 molars deciduos were selected from patients being taken care of during the Course in Pedodontist in the uear of 2006, with clinical and radiographic indication for pulpotomy accomplishment using Mineral Trioxide Aggregate (MTA) as the material of choice. After the procedure had been carriedthough clinical and radiographic accessory in an interval pf 90 and 180 days, to observe the sealing marginal of the chamber pulp, as well as the preservation of the periodontals structures. The results prove that the MTA is a biocompatible material.