In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment.

OBJECTIVES: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. MATERIAL AND METHODS: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). RESULTS: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. CONCLUSIONS: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Dental caries in inland Brazilian adolescents and its relationship with social determinants

AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents. RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries...

[Knowledge and practices of oral health on hospitalized children with cancer]. / Conhecimentos e práticas em saúde bucal com crianças hospitalizadas com câncer.

The aim of this study was to evaluate the knowledge and practices of oral health (OH) in hospitalized children with cancer. The sample was composed by the nurse team, caretakers and children. It was applied a questionnaire concerning the general knowledge about OH, methods and instruments used for oral hygiene (OH). According to the results, the responsible of OH of children are the caretakers (90.7%) who receive instructions from the nurse team in 21.4% of cases. As for the oral cavity discomfort, the nurse team reported that all patients exhibited clinical manifestations while the caretakers reported a different number, 62.8% of cases. All participants considered important having a dentist in the oncology sector. According to the results obtained, it was possible to conclude that there is no oral health protocol for hospitalized children with cancer and that the most frequent oral manifestations among patients going through antineoplastic treatment were: mucositis, nausea, vomit, xerostomy and lack of sense of taste.

Conhecimentos e práticas em saúde bucal com crianças hospitalizadas com câncer / Knowledge and practices of oral health on hospitalized children with cancer

O objetivo do estudo foi avaliar os conhecimentos e práticas em saúde bucal (SB) com crianças hospitalizadas com câncer. A amostra foi composta pela equipe de enfermagem, cuidadores e crianças. Foi aplicado um questionário relacionado ao conhecimento geral sobre SB, métodos e instrumentos utilizados para a higiene oral (HO) e dados socioeconômicos. Baseado nos resultados, quem realiza a HO das crianças são os cuidadores (90,7 por cento), que receberam orientações da equipe de enfermagem em 21,4 por cento dos casos. Com relação ao desconforto na cavidade bucal, a equipe de enfermagem reportou que todos apresentaram manifestações clínicas, enquanto apenas 62,8 por cento dos cuidadores reportaram casos. Todos os participantes consideram importante haver um CD no setor de oncologia. Pôde-se concluir que não existe um protocolo de cuidados com a higiene bucal de crianças hospitalizadas com câncer e que as manifestações bucais mais frequentes entre os pacientes em tratamento antineoplásico foram: mucosite, enjoos, vômitos, xerostomia e ausência de paladar.

The aim of this study was to evaluate the knowledge and practices of oral health (OH) in hospitalized children with cancer. The sample was composed by the nurse team, caretakers and children. It was applied a questionnaire concerning the general knowledge about OH, methods and instruments used for oral hygiene (OH). According to the results, the responsible of OH of children are the caretakers (90.7 percent) who receive instructions from the nurse team in 21.4 percent of cases. As for the oral cavity discomfort, the nurse team reported that all patients exhibited clinical manifestations while the caretakers reported a different number, 62.8 percent of cases. All participants considered important having a dentist in the oncology sector. According to the results obtained, it was possible to conclude that there is no oral health protocol for hospitalized children with cancer and that the most frequent oral manifestations among patients going through antineoplastic treatment were: mucositis, nausea, vomit, xerostomy and lack of sense of taste.

Restaurações adesivas indiretas opção clínica para molares decíduos em infra-oclusão / Indirect adhesives restorations clinical option for infraoccluded primary molars

A infra-oclusão de molares decíduos é uma situação clínica que pode ser encontrada em dentes com anquilose dento-alveolar, e pode causar prejuízos ao desenvolvimento da oclusão. Este artigo apresenta uma revisão de literatura sobre etiologia, diagnóstico e seqüelas da anquilose e conseqüente infra-oclusão de molares decíduos, e um relato de caso clínico utilizando restaurações adesivas indiretas como uma possibilidade de manejo desta situação, proporcionando funcionalidade e buscando evitar a instalação de desarmonias oclusais. No relato são apresentadas as etapas clínicas e laboratoriais envolvidas na confecção das restaurações.

Clinical evaluation of composite and compomer restorations in primary teeth: 24-month results.

PURPOSE: This split-mouth, blind study evaluated the clinical performance of Dyract AP, F2000, and Heliomolar placed in primary molars of 30 children (mean age, 6 years and 2 months). MATERIALS AND METHODS: From a total of 79 restorations accomplished, 27 were built with Heliomolar (18 Class I, and 9 Class II), 30 were with F2000 (21 Class I and 9 Class II), and 22 were built with Dyract AP (14 Class I and 8 Class II). All of teeth restored had primary caries lesions. At 6, 12, 18 and 24 months, 60 restorations (75%) were evaluated using USPHS criteria for: color match (CM), marginal adaptation (MA), marginal discoloration (MD), anatomic form (AF) and secondary caries (SC) by three calibrated operators. The Alpha+Bravo score percentage was considered as clinical success. The data were subjected to statistical analysis by Mann-Whitney and Kruskal-Wallis tests (p<0.05). RESULTS: Heliomolar showed the smallest success clinical at 12 months for marginal adaptation and secondary caries, and at 18 months for marginal discoloration. Regarding color match and anatomic form, no significant differences were found among the groups at each evaluation period. When materials were compared, Heliomolar did not show a significant difference among the evaluated periods for any criteria, remaining with the lowest scores. Significant differences were observed at 12 months for F2000 (marginal adaptation), and at 24 months for Dyract AP (marginal discoloration and secondary caries) and for F2000 (color match and marginal discoloration). CONCLUSIONS: It was concluded that Dyract AP and F2000 showed the best clinical performance over 24 month-evaluations for marginal discoloration and secondary caries, and color match and marginal adaptation, respectively. The use of the resin composite Heliomolar in Class I/II restorations in primary molars should be carefully considered.

An alternative aesthetic restoration for extensive coronal destruction in primary molars: indirect restorative technique with composite resin.

The indirect restorative technique with composite resin has presented efficient results when used in primary teeth. This technique enables the oral rehabilitation. Based on the results presented in the literature concerning clinical performance, this technique is presented as an alternative treatment to the primary teeth with extensive decay by showing a case of rehabilitation of primary molars. The oral rehabilitation using indirect resin composite restoration showed an important concept to be applied in primary dentition due to feasible, low cost, and lower chairside time.

Etching time evaluation on the shear bond strength of two adhesive systems in primary teeth

Objetivo: avaliar o efeito do tempo de condicionamento ácido e sistemas de união na resistência ao cisalhamento (RUC) em dentes decíduos. Metodologia: 48 molares decíduos, hígidos, doados pelo Banco de dentes da USP, foram seccionados longitudinalmente (mésio-distal) e embutidos em resina epóxica, deixando as superfícies V ou L expostas. As amostras foram lixadas até a obtenção de uma superfície plana em dentina e distribuídas em 3 grupos de acordo com o tempo de condicionamento ácido (7, 15 ou 20 s) e sistemas de união (Scotchbond Multipurpose Plus -SBMP e Prime & Bond 2.1-PB): G1 - 7 s + SBMP; G2 - 15 s + SBMP; G3 - 20 s + SBMP; G4 - 7 s + PB; G5 - 15 s + PB; G6 - 20 s + PB. Confeccionou-se restaurações com compósito Z100, sendo armazenados em água destilada a 37oC, por 72h. Os corpos-de-prova foram submetidos ao ensaio de RUC (Instron - 0,5 mm/min). Os sítios de fratura foram analisados em Microscópio Estereoscópico e MEV e os resultados submetidos à análise estatística ANOVA e Teste de Tukey (p<0,05). Resultados: os maiores valores de RUC foram obtidos por G1 e G4. Não houve diferença estatística entre G1 e G2, enquanto o G4 apresentou maiores valores em relação aos G1 e G2 (p<0,05). A falha adesiva foi a mais freqüente (86,5%). Conclusões: 1 - A interação material*tempo de condicionamento demonstrou que para o SBMP o desempenho do sistema não diferiu em relação do tempo de condicionamento ácido, enquanto que para o PB os melhores resultados foram observados para os menores tempos de condicionamento ácido; 2 - A análise dos sítios de fratura demonstrou que a falha mais freqüentemente observada foi a do tipo adesiva (86,5 por cento); 3 - Quando maior o tempo de condicionamento ácido, menor os valores de resistência da união para o sistema adesivo PB.(au)

Management of severe partial hypodontia: case report.

Hypodontia is characterized by partial or total congenital missing of one or more teeth, on one or both dentitions. Heredity is the main etiological factor and the principal clinical features are reduction on number, size and form of teeth, and late eruption. Removable partial prosthesis, fixed prosthesis, overdentures and adhesive prosthesis are alternative treatments; and the indication is type dependent. The aim of this study was to describe the clinical case of an eleven-year-old child with eight missing permanent teeth of idiopathic etiology. The patient had facial and skeletal symmetry, normal development and was not related to any syndrome. Clinical characteristics: permanent teeth with good periodontal conditions (16, 12, 11, 21, 22, 26, 36, 31, 42, 46), primary teeth (53, 63, 64, 73, 83); overbite and microdontia on teeth 12 and 22. The treatment plan was done initially by documenting of the case for teeth analysis (study casting models, periapicals and panoramic x-rays, and photographs), and followed by the exodontics of teeth 73 and 83. A removable appliance in autocured acrylic resin, using teeth in acrylic for maintenance of functional space and occlusion was planned and carried out. An anterior track for vertical dimension gain was used because of his accentuated overbite. The patient will be monitored until the end of the craniofacial growth, when it will be again evaluated and forwarded for the final oral rehabilitation. Hypodontia diagnosis and management should be performed as early as possible not to interfere with the craniofacial development of the child.