Erupçäo de molares de decíduos e permanentes: relaçäo com a idade de aplicaçäo de selante oclusal / Eruption of deciduous and permant molars: relation with the age of application the dental sealant

Foram examinadas 609 crianças de 3 a 6 anos para se verificar a presença e as condiçöes clínicas dos primeiros molares permanentes e primeiros e segundos molares decíduos, com a finalidade de se determinar a idade mais adequada para o início de um programa de aplicaçäo de selantes oclusais. A idade de 6 anos para os primeiros molares permanentes e a de 3 anos para os primeiros e segundos molares decíduos säo as recomendadas

Consideraçöes gerais sobre a prevençäo de cárie na primeira infância / General considerations about caries prevention in childhood

A presente revisäo enfatiza a primeira infância como a época ideal para se prevenir a doença cárie. Os hábitos alimentares, higiênicos e outras medidas preventivas säo discutidos, como também a importância da conscientizaçäo e interaçäo de obstetra, pediatra, odontopediatria, pais e responsáveis pelos cuidados da criança

Caries-inhibiting effects of different modes of Duraphat varnish reapplication: a 3-year radiographic study.

One hundred and sixty 11-year-olds were randomly allocated to two experimental groups, one test (group 1) and one control group (group 2), for a 3-year clinical test comparing different modes of fluoride varnish treatment. In the test group, children received Duraphat varnish treatments 3 times a week, once a year. The children in group 2 were treated with Duraphat every 6 months. During the experimental period, children in group 1 received 9 fluoride varnish applications, and in group 2, 6 applications. Four bitewing radiographs were taken in each child each year for the measurements of the incidence and progression of proximal caries. Repeated fluoride varnish treatment with Duraphat, 3 times a week once a year, appears to inhibit proximal caries progression and development since the children in this group showed even a lower caries status, 1.3 +/- 0.3 DS, at the end of the study compared to 1.6 +/- 0.2 DS at the outset. In group 2, the children increased their caries status from 1.7 +/- 0.2 to 2.4 +/- 0.4 DS during the experimental period. The caries difference was statistically significant (p less than 0.05) between the two groups. A health economic comparison of the two modes of application showed 30% lower costs for the children in the test group based on time used for preventive measures and assumed filling therapy.

[Metabolic disorders and their correction in schoolchildren with different forms of caries]. / Metabolicheskie narusheniia i ikh korrektsiia u shkol'nikov s razlichnymi formami kariesa.

Biochemical studies of salivary metabolic disorders in 839 schoolchildren with various forms of caries have revealed salivary pH range to vary from 6.23 +/- 0.02 to 6.80 +/- 0.04, with calcium and inorganic phosphorus levels varying from 4.20 +/- 0.07 to 5.12 +/- 0.11 mg% and from 0.117 +/- 0.05 to 1.041 +/- 0.21 micrograms/ml, respectively. Alkaline phosphatase activity range was found to vary from 107.7 +/- 7.65 to 295.0 +/- 32.3, that of acids from 11.7 +/- 1.81 to 52.5 +/- 4.61 nmol/ml. alpha-ketoglutarate, oxalacetate, phosphoenolpyruvate levels were 3.12 +/- 0.03 to 28.8 +/- 3.41 mumol/ml, fructose diphosphatase content from 2.5 +/- 0.35 to 8.71 +/- 0.72 nmol/s/ml. Use of namacit various dosage forms (5 percent aqueous solution, as a toothpaste component--6 percent, or a component of an adhesive coating) elevated salivary pH level to 7.06. Calcium level remained unchanged, that of inorganic phosphorus increased (p less than 0.001), phosphatase activities grew, as did acid levels and fructose diphosphatase activity, that increased irrespective of the dosage form used (p less than 0.001).

[Comparative study of the fissure sealants Concise and Delton]. / Osszehasonlító vizsgálatok Concise és Delton barázdazáró anyaggal.

In the case of Concise after one year 88.3% and after two years 72.8% caries-prophylactic effect was measured. In case of Delton the same values were 83.8% and 89.4%, respectively.

Dental caries experience in schoolchildren in fluoridated and non-fluoridated communities in Western Australia.

A cross-sectional survey was undertaken in 1987 to measure the difference in caries experience in schoolchildren between a fluoridated (0.8 mg/L F-) and a non-fluoridated region (0.1-0.4 mg/L F-). 3436 children aged 5-15 yr were examined. Children in the non-fluoridated region had a higher caries experience than those in the fluoridated region. Mean differences were 1.06 dfs (95% CI = 0.66 to 1.47, P less than 0.001) and 0.48 DFS (95% CI = 0.23 to 0.72, P less than 0.001). After adjusting for potential confounding factors (fluoride tablet consumption, socioeconomic status, number of fissure-sealed surfaces, and mobility between regions) the relative risk of not being caries-free in the non-fluoridated region compared with the fluoridated region was 1.43 (95% CI = 1.21-1.70, P less than 0.0001) for the primary dentition and 1.39 (95% CI = 1.18-1.63, P less than 0.0001) for the permanent dentition.

Retention and maintenance of fissure sealants over 10 years.

The long-term efficacy (retention and caries prevention) of fissure sealants is well documented. However, the effectiveness of contemporary sealants under sometimes less than ideal field conditions is not so well reported, nor are the clinical issues of the long-term extent of partial sealant loss, resealing needs and sealant replacement under such conditions. The results of a 10-year follow-up of 8,340 chemically-cured sealants placed between 1978 and 1985 in selected "high-risk", first permanent molars of children of moderate to severe decay susceptibility are presented. These children were annual participants in the Prince Edward Island Children's Dental Care Program. Complete sealant retention was 89 per cent after one year and 60 per cent after 7-9 years. One year after insertion, 6 per cent of sealants required maintenance resealing; thereafter it was 2 per cent to 4 per cent per year. Sealant removals because of MO amalgam placement or occlusal decay were very low, about 2 per cent and 1 per cent, respectively, in each of the first five years. The overall annual sealant success of 96 per cent after one year and 85 per cent after 8-10 years supports the careful application of chemically-cured sealants under field conditions and the use of annual recalls to allow minimal sealant maintenance.

[The utilization of glass ionomer sealing cements]. / Utilisation de ciments de scellement d'ionomère de verre.

In order to fix the reconstructive work, a luting cement is used. The main task of this cement is to retain the restoration on the tooth and to fill and seal the gap between them. The first glass ionomer luting cement came on the market in 1978. In the beginning, the cement did not perform as expected: high solubility, high viscosity and hypersensitivity, even followed by pulp death, were reported. The glass ionomer luting cement compares now favourably with the traditional non-adhesive cements. Nevertheless, the zinc phosphate cement is still the most commonly used cementing agent in the dental private practice. Studies have shown that the problems of hypersensitivity after the use of glass ionomer luting cements are more dentist related than material related. This article explains how to use the glass ionomer luting cements in order to achieve a successful cementation.

Cotton roll isolation versus Vac-Ejector isolation.

A visible-light-cured, white pit-and-fissure sealant was applied to 523 teeth in school children using either cotton rolls or a VacEjector for isolation. After a minimum of six months, the patients were recalled and the retention of the sealants was evaluated. No significant difference in sealant retention was found between the two isolation methods.

[Resin and glass-ionomer sealants. Indications, mechanism of action, and application technics]. / I sigillanti in resina ed al cemento vetro-ionomerico. Indicazioni, meccanismo d'azione e tecniche di applicazione.

The usefulness and indications to treatment with sealants in pedodontics are examined. Sealants are classified and the action mechanism of sealant resins and the application techniques needed for correct positioning of the material are described. The use of the new glass-ionomer cement sealants, with their advantages and disadvantages, are then discussed and the preventive and economic value of occlusive seals evaluated.

A clinical evaluation of a light-cured fissure sealant (Helioseal).

The clinical success of pit and fissure sealants has been reported by several authors. In this study a white-shaded, visible-light-cured sealant was used; the results of the clinical evaluation confirmed this finding. Concerning retention rate, marginal adaptation, and the presence of secondary caries and air bubbles, good results were obtained. Data indicate that a visible- light-cured sealant (Helioseal) appears to be as good as the self-cured sealants and better than the UV-light-cured products. A comparison was also made between the invasive (PFSI) and non-invasive (PFS) application techniques; with respect to the marginal adaptation and the presence of air bubbles, better results were found for fissures that had been enlarged as a preventive measure. More longitudinal studies over a longer period of time are necessary.

[Criteria for a judicious indication for the application of pit and fissure sealants]. / Critères pour une indication judicieuse du scellement des puits et fissures.

The caries reducing effect of the application of pit and fissure sealants has been demonstrated by several studies. It remains however a matter of debate, if every newly erupted fissure has to be sealed. From this article it becomes clear that the decision for sealing depends on several factors as there are: the general health status of the patient, the socio-economic situation, the responsibility of the child for his/her own hygiene, the motivation of the patient, the caries history of the patient: his/her dietary habits, fluoride-use and regular six-month recalls. The motivation of the practitioner and his/her knowledge of fissure caries (including morphology and caries susceptibility) are also very important. So, an individual application after giving the matter a careful thought is recommended and proposing general rules is not possible. Finally an attempt is made to suggest some guidelines.

A national survey of sealant use by pediatric dentists.

A national survey of pediatric dentists was undertaken to determine their level of sealant use and the factors that affected level of use. A twelve-page mailed questionnaire was completed by 329 practitioners. Decision-making factors, attitudes and knowledge about sealants, sealant awareness, characteristics of sealant use, undergraduate dental school experience with sealants, auxiliary factors, impact of insurance, characteristics of dental practice, interaction with colleagues, and characteristics of patient populations were explored as they related to level of sealant use. Variables significantly associated with sealant use included: availability of insurance, ability to delegate sealant procedures, and patient income and acceptance. Frequent users were more knowledgeable about sealant issues and were more likely to be consulted by their peers.

The retention of fissure sealants using twenty-second etching time: three-year follow-up.

The retention of a self-polymerized fissure sealant applied after twenty seconds etching time was evaluated after three years. From the original 100 molars that were sealed, seventy-one teeth with 105 sites were available. The sealants were totally retained in 91 percent of the cases, after three years. The findings demonstrate that the retention rates of fissure sealants using twenty seconds etching time are comparable to those reported with the more conventional sixty seconds.