A minimal interventive protocol using antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization: A case report.

Molar incisor hypomineralization (MIH) is a qualitative developmental defect of enamel that occurs during the mineralization phase. Patients with MIH have increased risk of caries, hypersensitivity, and restoration failures. The present case report describes the treatment of a 10-year-old patient exhibiting two teeth with atypical carious lesions. A minimal interventive protocol was instituted combining antimicrobial photodynamic therapy and the selective chemical-mechanical removal of the carious tissue using the product Papacárie Duo®. This protocol is promising for the decontamination and control of hypersensitivity in teeth with MIH.

Evaluation of antimicrobial photodynamic therapy and minimal intervention associated with deproteinisation in permanent teeth with molar incisor hypomineralisation: study protocol for a clinical, controlled, blinded trial.

INTRODUCTION: Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel development that occurs in the mineralisation phase. MIH affects one or more permanent molars and, occasionally, permanent incisors. The aim of the proposed study is to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) on permanent teeth with MIH through decontamination and sensitivity control. METHODS AND ANALYSIS: Patients from 8 to 12 years of age with permanent molars will be randomly allocated to three groups. Group 1: selective chemical-mechanical removal of carious dentinal tissue around the walls of the cavity with Papacárie Duo and a curette followed by the application of aPDT and deproteinisation with Papacárie Duo; group 2: selective removal of carious dentinal tissue around the walls of the cavity with a curette, followed by the application of aPDT and deproteinisation with a 5% sodium hypochlorite solution; group 3: selective removal of carious dentinal tissue using a curette. The selected teeth must have a carious lesion in the dentin and posteruptive enamel breakdown on one or more surfaces with an indication for clinical restorative treatment. The teeth will subsequently be restored using a mixed technique with resin-modified glass ionomer cement and bulk-fill composite resin. The data will be submitted to descriptive statistical analysis. Associations with age and sex will be tested using either the χ2 test or Fisher's exact test. Pearson's correlation coefficients will be calculated to determine the strength of correlations between variables. Comparisons of the microbiological results (colony-forming units) will be performed using analysis of variance and the Kruskal-Wallis test. Kaplan-Meier survival analysis will be performed to assess the performance of the restorations. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 61027522.0.0000.5511/approval date: 23 August 2022). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05443035.

Radiolucência intracoronal pré-eruptiva (PECR) de um segundo molar permanente. relato de caso / Pre-eruptive intracoronal radiolucency (PECR) of a permanent second molar. case report

Introdução: A Radiolucência intracoronal pré eruptiva (PECR) é um achado radiográfico, com aspecto de lesão radiolúcida na dentina coronária, adjacente a junção amelodentinária, em dentes não irrompidos. Objetivo: Relatar um caso de possível reabsorção intracoronal pré-eruptiva com destruição extensa de dentina e envolvimento pulpar de um segundo molar permanente recém-erupcionado. Método: Após definição do diagnóstico, optou-se por um tratamento conservador, com a realização de capeamento pulpar direto com a finalidade de manutenção da vitalidade pulpar e término de formação das raízes. Resultado: Após o tratamento, paciente permaneceu assintomática no controle de quinze dias, com teste de vitalidade normal e sem sinais de inflamação. Conclusão: A interpretação cuidadosa do exame radiográfico é crucial para a detecção precoce e manejo adequado dessas lesões.

Pre-eruptive intracoronal radiolucency (PECR) is a radiographic finding, with the appearance of a radiolucent lesion in the coronary dentin, adjacent to the dentinal-enamel junction, in unerupted teeth. Objective: To report a case of possible pre-eruptive intracoronal resorption with extensive dentin destruction and pulpal involvement of a newly erupted second permanent molar. Method: After defining the diagnosis, a conservative treatment was chosen, with direct pulp capping in order to maintain pulp vitality and end root formation. Result: After treatment, the patient remained asymptomatic in the fifteen-day control, with normal vitality test and no signs of inflammation. Conclusion: Careful interpretation of the radiographic examination is crucial for early detection and proper management of these lesions.

Effects of Photobiomodulation in Children with Down Syndrome and Possible Sleep Bruxism: Protocol For A Randomized, Controlled, Blind, Clinical Trial: Study protocol clinical trial (SPIRIT compliant).

Hypotonia, particularly of the masticatory and oropharyngeal muscles, is 1 of the main characteristics of Down Syndrome (DS), resulting in impaired speech, chewing and swallowing. Moreover, the complete or partial obstruction of the airways during sleep may occur due to hypotonia of the tongue, leading to snoring and sleep disorders, such as obstructive apnea and sleep bruxism. OBJECTIVE:: Analyze salivary levels of dopamine and cortisol and muscle activity before and after treatment with low-level laser therapy administered to acupoints in children with DS. METHODS:: A randomized, controlled, clinical trial will be conducted. Individuals 4 to 17 years of age with a diagnosis of DS and possible sleep bruxism will be screened at the Integrated Health Clinic of Nove de Julho University. We will evaluate orofacial dysfunction (Nordic Orofacial Test - Screening questionnaire), Masseter muscle activity during sleep will be assessed by BiteStrip and the masticatory muscles will be evaluated by electromyography (BTS TMJOINT) head posture as well as salivary cortisol and dopamine. After the evaluations, the participants will be randomized into 2 groups: Grupo 1 - treatment with low-level laser therapy at a wavelength of 808 nm; Group 2 - sham treatment (simulated laser therapy). Treatment will be conducted twice per week for a total of 12 sessions. The data will be tabulated and treated using GraphPad Prism version 7.0. The Kolmogorov-Smirnov test will be used to determine the normality of the data. Variables that fit the Gaussian curve will be expressed as mean and standard deviation. The ANOVA 2-way will be used for comparisons between the groups, with the significance level set to 5% (P < .05).ClinicalTrials registration number: NCT04211870.

The relationship between bruxism, sleep quality, and headaches in schoolchildren.

[Purpose] Present study aimed to evaluate the relationship between sleep bruxism and headache in school children. [Subjects and Methods] This study was conducted with 103 children aged 3-6 years. The exclusion criteria were early tooth loss, dental appliance was used, physical or psychological limitations, chronic disease and continuous medication. Sleep bruxism was diagnosed based on an indication by parents of the occurrence of teeth clenching/grinding and incisor/occlusal tooth wear, following the criteria of the American Academy of Sleep Medicine. Sleep quality was evaluated by a questionnarie, detailing the child's sleep characteristics. [Results] Forty-nine children (47.6%) were diagnosed with sleep bruxism. Those with sleep bruxism were 3.25-fold more likely to present headache. Children whose parents were separated had a significantly greater frequency of sleep bruxism and primary headache. The relative risk of exhibiting primary headache was 13.1 among children with sleep bruxism whose parents were separated. [Conclusion] Children with SB demonstrated a greater risk of having primary headache and those whose parents were separated had a greater chance of having headache. Only sleep bruxism was associated with headache, clenching the teeth during waking hours was not correlated with primary headache.

Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial.

BACKGROUND: Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. METHODS: The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. DISCUSSION: Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. TRIAL REGISTRATION: NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).

Evaluation of electromyographic signals in children with bruxism before and after therapy with Melissa Officinalis L-a randomized controlled clinical trial.

[Purpose] Bruxism is a repetitive muscle activity involving the clenching or grinding of one's teeth during sleep or waking hours. Melissa officinalis L. may be employed as a natural therapy due to the sedative, anxiolytic, anti-inflammatory, and anti-spasm properties of the chemical constituents of the essential oil obtained from its leaves. The aim of the present study was to evaluate electromyographic signals in the temporal muscle using the BiteStrip(®) test on children with sleep bruxism before and after therapy with Melissa officinalis L. [Subjects and Methods] The subjects were randomly allocated to two groups. Group 1 (n = 12) ingested a tincture containing Melissa officinalis L. for 30 days. Group 2 (n = 12) received a placebo solution with the same dose and frequency as Group 1. The Wilcoxon and Mann-Whitney tests were employed for statistical analysis. [Results] The sample was made up of 24 children aged 6 to 10 years. No statistically significant differences were found between initial and final muscle activity in either group or in an intergroup comparison. [Conclusion] Use of the Melissa officinalis L. tincture at the dose employed did not lead to a reduction in muscle activity in children with bruxism.

Avaliação dos ruídos da articulação temporomandibular em crianças com bruxismo / Assessment of temporomandibular joint sounds in children with bruxism

OBJETIVO: avaliar se há relação entre bruxismo e presença de ruídos articulares em crianças. MÉTODOS: participaram do estudo 48 crianças entre 6 e 9 anos atendidas na Clínica Infantil da Faculdade de Odontologia da Universidade Nove de Julho. Foram selecionadas 21 crianças com bruxismo e 27 crianças no grupo controle. Um único examinador previamente treinado e "cego" em relação aos grupos realizou exame de palpação manual e auscultação bilateral das Articulações Temporomandibulares com a utilização de estetoscópio, extra-auricular lateral e dorsal para a análise dos ruídos articulares, diferenciando-os em crepitação e estalidos. Foi realizado o número mínimo de 3 repetições nas mensurações dos ruídos para cada criança. Foram realizadas as análises descritivas de todas as variáveis e o teste qui-quadrado foi utilizado para avaliar a associação entre as variáveis, adotando-se um nível de significância de 5%. RESULTADOS: em relação à presença de ruído 37,5% (n=18) apresentaram algum tipo de ruído articular, sendo que 72,2% (n=13) apresentaram estalido e 27,8% (n=5) apresentaram crepitação. Das 18 crianças que apresentaram algum tipo de ruído, 66,7% (n=12) também eram bruxistas. Foi observada associação estatisticamente significante entre a presença de ruído e bruxismo. Ao analisar a associação entre ruído e as variáveis gênero e idade, o grupo estudado não houve associação entre ruído e gênero, porém em relação à idade, houve uma maior porcentagem de crianças sem a presença de ruído articular aos 6 anos de idade, sendo estatisticamente significante. CONCLUSÃO: os dados do presente estudo mostraram associação entre bruxismo e ruídos articulares em crianças. .

PURPOSE: the aim of the present study was to determine whether bruxism is associated with joint sounds in children. METHODS: children aged six to nine years were recruited from the pediatric clinic of the School of Dentistry of University Nove de Julho (Brazil). Twenty-one children with bruxism and 27 children without this condition (control group) were selected. The evaluation was performed by a previously trained examiner who was blinded to the allocation of the groups and involved manual palpation as well as lateral and dorsal extra-auricular auscultation of the temporomandibular joints with the aid of a stethoscope for the determination of joint sounds, differentiating a click/pop from crepitus. At least three readings were performed on each child. Descriptive statistics were conducted and the chi-square test was used to test associations among the variables, with the level of significance set to 5% (p < 0.05). RESULTS: a total of 37.5% (n = 18) of the sample exhibited some type of joint sound. Among these children, 72.2% (n = 13) exhibited a click/pop and 27.8% (n = 5) exhibited crepitus. Among the 18 children with joint sounds, 66.7% (n = 12) also had bruxism. A statistically significant association was found between joint sounds and bruxism. No association was found between joints sounds and sex. However, a significant association was found with regard to age, as a greater percentage of children at six years of age had no joint sounds. CONCLUSION: the present findings demonstrate an association between bruxism and joint sounds in children. .

Tooth whitening with hydrogen peroxide in adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Technological innovations in dental materials have been fueled by the desire of patients to improve the esthetics of their teeth. This emphasis on esthetics has led dentists to seek resources that respect the standards established by society, but without compromising the integrity of the teeth. METHODS/DESIGN: The aim of the proposed controlled clinical trial will be to assess colorimetric changes and increased dental sensitivity in adolescent patients submitted to tooth whitening with 6% and 7.5% hydrogen peroxide using home kits with whitening strips. Adolescents aged 12 to 20 years will be allocated to different groups based on treatment (n = 16 per group): (1) placebo; (2) 6.0% hydrogen peroxide (White Class with Calcium, FGM); (3) 7.5% hydrogen peroxide (White Class with Calcium, FGM); and (4) 7.5% hydrogen peroxide (Oral B 3D White, Oral-B). After the whitening procedures, the participants will be evaluated using a visual analog scale for tooth sensitivity and digital spectrophotometry to measure changes in color. Descriptive analysis of the data will be performed. Either the chi-squared test or Fisher's exact test will be used for the determination of associations among the categorical variables. Student's t-test and analysis of variance will be used to compare mean colorimetric data. Pearson's correlation coefficients will be calculated to determine the strength of correlations among the continuous variables. DISCUSSION: This randomized trial will provide an opportunity to evaluate products such as whitening strips in comparison to other self-administered methods, especially in adolescents. TRIAL REGISTRATION: The protocol for this study was submitted to Clinical Trials in November 2013 with registration number NCT01998386.

Evaluation of Cranio-cervical Posture in Children with Bruxism Before and After Bite Plate Therapy: A Pilot Project.

[Purpose] The aim of the present study was to evaluate the effect of a biteplate on the cranio-cervical posture of children with bruxism. [Subjects and Methods] Twelve male and female children aged six to 10 years with a diagnosis of bruxism participated in this study. The children used a biteplate during sleep for 30 days and were submitted to three postural evaluations: initial, immediately following placement of the biteplate, and at the end of treatment. Posture analysis was performed with the aid of the Alcimagem(®) 2.1 program. Data analysis (IBM SPSS Statistics 2.0) involved descriptive statistics and the Student's t-test. [Results] A statistically significant difference was found between the initial cranio-cervical angle and the angle immediately following placement of the biteplate. However, no statistically significant difference was found between the initial angle and the angle after one month of biteplate usage. [Conclusion] No significant change in the cranio-cervical posture of the children was found one month of biteplate usage. However, a reduction occurred in the cranio-cervical angle when the biteplate was in position.

Association between respiratory problems and dental caries in children with bruxism.

CONTEXT: Bruxism is the habit of clenching or grinding one's teeth in non-functional activities and affects both children and adults alike. Respiratory problems, such as asthma and upper airway infections, are reported to be the etiological factors of bruxism. AIMS: The aim of the present study was to determine whether there is an association between respiratory problems and dental caries in children who exhibit the habit of bruxism. SETTING AND DESIGN: An observational cross-sectional study was carried out. MATERIALS AND METHODS: Patient histories were taken and clinical exams were performed on 90 children for selection and allocation to one of two groups. For the determination of bruxism, a questionnaire was administered to parents/guardians and an oral clinical exam was performed based on the criteria of the American Academy of Sleep Medicine. Thirty-three male and female children between 4 and 7 years of age participated in the study - 14 children with bruxism and 19 children without bruxism. STATISTICAL ANALYSIS: The data were statistically analyzed using the chi-square test, with level of significance set at 5% (P < 0.05). RESULTS: Mean age of the participants was 5.73 years. The male gender accounted for 45.5% (n = 15) of the sample and the female gender accounted for 54.5% (n = 18). A statistically significant association was found between respiratory problems and dental caries among the children with bruxism. Seventy-seven percent of the children with bruxism had caries and 62.5% the children with respiratory problems exhibited the habit of bruxism. CONCLUSIONS: There seems to be an association between bruxism, respiratory problems, and dental caries in children.

Influence of acid etching on shear strength of different glass ionomer cements

Aim: To assess the influence of dental etching on the shear strength of different glass ionomer cements. Methods: The crown of 60 bovine incisors was prepared to obtain a flat, smooth surface, were attached to a PVC tube and randomly divided into six groups: Group 1 – Riva Self Cure without etching; Group II – Riva Self Cure with pre-etching; Group III – Maxxion R without etching; Group IV – Maxxion R with pre-etching; Group V – Ketac™Molar Easymix without etching; and Group VI – Ketac™Molar Easymix with pre-etching. Etching was performed with 10% polyacrylic acid for 30 s. A standardizing device was used for preparation of the test specimens (SBS Test Method). Following preparation, the specimens were stored in distilled water at 37º Cfor 24 h. The shear test was performed on a Kratos universal testing machine at a crosshead speed of 0.5 mm/min. The specimens were then viewed under a stereomicroscope at a magnification of x90 for analysis of fractures. Results: The results revealed that pre-etching increased the shear strength of Riva glass ionomer cement (SDI) alone, where as no statistically significant differences were found with regard to the other materials tested. Conclusions: Pre-etching with 10% polyacrylic acid for 30 s increased the shear strength of Riva glass ionomer cement.

The influence of grain size coating and shaft angulation of different diamond tips on dental cutting.

OBJECTIVES: To evaluate the influence of the grain size coating and shaft angulation of ultrasonic and high-speed diamond burs on the dental cutting effectiveness. MATERIALS AND METHODS: For the grain size evaluation, cavities were prepared on 40 incisors using high-speed (1092 and 1093F KG Sorensen(®)) and ultrasonic tips (8.2142 and 6.2142-CVDentus(®)). For the shaft angulation evaluation, cavities were prepared on 40 incisors using uniangulated (T1-CVDentus(®)) and biangulated (T1-A CVDentus(®)) ultrasonic tips. The cavities were bisected and examined at ×50 magnification. The width and depth of cavities were measured by Leica QWin software. Kruskal-Wallis non-parametric test was used for analysis. RESULTS: The grain size did not affect the cutting effectiveness, but the high-speed burs promoted deeper and wider cavities than the ultrasonic tips. The shaft angulation did not affect the cutting effectiveness; both the angulated and biangulated tips had greater cutting efficiency in dentin than in enamel. CONCLUSIONS: Ultrasonic tips promoted more conservative preparations and seemed promising for cavity preparation.

Atividade antimicrobiana de um novo biomaterial utilizado na remoção químico-mecânica da cárie / Antimicrobial activity of a new biomaterial used for chemomechanical caries removal

O objetivo deste trabalho foi avaliar, in vitro, a capacidade antimicrobiana doPapacárie®, para Streptococcus mutans e Lactobacillus acidophilus, por meio da técnica de difusão em agar. Trezentos microlitros de Streptococcus mutans foram inseridos em 15 mL de meio decultura BHI-ágar e dispensados em seis placas de Petri. O mesmo procedimento foi realizado para Lactobacillus acidophilus. Após endurecimento do meio, foram confeccionados seis poços por placa, sendo o material experimental inserido alternadamente com gel de gluconato de clorexidinaa 1% (controle positivo). As placas foram mantidas à temperatura ambiente por duas horas para pré-difusão do material e posteriormente incubadas a 37°C por 24 horas em microaerofilia. Após esse período, o halo de inibição formado ao redor do poço foi medido com o auxílio de paquímetrodigital. A análise dos dados obtidos revelou que o Papacárie® não apresentou propriedades antimicrobianas para Streptococcus mutans e Lactobacillus acidophilus.

The aim of this in vitro study was to evaluate the antimicrobial potential of Papacárie®, for Streptococcus mutans and Lactobacillus acidophilus, with the agar diffusiontest. Three hundred microliters of Streptococcus mutans were introduced in 15 mL of BHI-ágarculture media and transferred to six Petri plates. The same procedure was done for Lactobacillus acidophilus. After the culture media set, six wells per plate were done and the experimental material was inserted alternately with 1% gluconate chlorhexidine gel (positive control). The plates were maintained at room temperature during two hours for pre-diffusion of the material, and then incubated at 37°C for 24 hours in candle jars. After this period, the inhibition halo formed around the wells was measured with a digital calipter. The data analysis revealed that Papacárie® did not present antimicrobial properties for Streptococcus mutans and Lactobacillus acidophilus.

Eficiência do Papacárie® na remoção químico-mecânico de dentina cariada / Papacarie® efficiency on chemo-mechanical removal of caries dentin

O objetivo deste trabalho foi avaliar a eficiência do Papacárie® na remoção químico-mecânica do tecido cariado. Foram utilizados dez terceiros molares humanos com a superfície dentinária artificialmente cariada. Os espécimes foram divididos em dois grupos: no primeiro, a dentina cariada foi removida utilizando-se o Papacárie®; e, no segundo, a fresa em baixa rotação. O tempo de trabalho foi cronometrado, obtendo-se uma média de 22 segundos para fresa em baixa rotação e de 119,9 segundos para o Papacárie®. Concluindo-se que a remoção químico-mecânica requereu um maior tempo para remoção de dentina cariada.