Effect of two irrigating solutions on antimicrobial activity and clinical and radiographic success after endodontic treatment in primary teeth: a randomized clinical trial.

OBJECTIVES: This study evaluated the antimicrobial activity, clinical and radiographic outcome of pulpectomy in primary teeth using either 1% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) as irrigants. MATERIALS AND METHODS: A randomized double-blind controlled clinical study in which primary teeth were allocated to 1% NaOCl (n = 20) and 2% CHX (n = 20) groups. Microbiological collections were performed before and after irrigation for agar culture and real-time polymerase chain reaction (qPCR). Clinical and radiographic success was assessed at different times. Data were submitted to descriptive analysis, chi-square, Mann-Whitney, and Wilcoxon tests (p  < .05). RESULTS: For 1% NaOCl, the following clinical and radiographic success rates were observed: 7 days (93%/80%); 30 days, 3 and 6 months (100%). For 2% CHX: 7 days (73%/53%); 30 days (93%); 3 months (100%/93%); 6 months (100%) (p > .05). One percent NaOCl and 2% CHX effectively reduced total microorganisms (p < .05) but not mutans streptococci (p > .05). In qPCR analysis, the solutions promoted a reduction of total bacteria and Streptococcus mutans, and no difference was observed between times and groups (p > .05). CONCLUSIONS: One percent NaOCl and 2% CHX were effective for clinical and radiographic success and antimicrobial activity in primary teeth submitted to pulpectomy. CLINICAL RELEVANCE: Studying the antimicrobial activity and clinical and radiographic outcomes of pulpectomy in primary teeth using NaOCl and CHX as irrigants is clinically relevant because it provides information for optimizing treatment protocols and improving the quality of care for pediatric patients. It contributes to evidence-based practice and can potentially lead to better outcomes, reduced complications, and enhanced patient experiences.

Relationship between cariogenic bacteria and molar incisor hypomineralization in Brazilian schoolchildren.

Background: Teeth with defects in their structure, such as the ones affected by molar-incisor hypomineralization (MIH), are more susceptible to carious lesions. Caries is a complex and multifactorial disease highly prevalent in childhood. The present research evaluated the relationship between the stages of MIH and cariogenic bacteria in children. Methods: After examining 566 schoolchildren, four groups of 10 children each were formed: healthy (G1), mild MIH (G2 and G3), and severe MIH + caries (G4). Dental biofilm was assessed to quantify Streptococcus mutans (SM) and Lactobacillus spp. (LB) using real-time polymerase chain reaction (RT-PCR). Results: LB counting in biofilm samples of healthy children (G1) and those with mild MIH characterized by white opacities (G2) were not significantly different. The same happened when the ones with yellow opacities (G3) were compared with severe MIH + caries (G4) (P>0.05). The post hoc Tukey test proved that G4 had greater levels of SM and LB when compared with G2 (P<0.05); however, the control group did not diverge from the others considering SM (P>0.05). Increased LB enhanced the severity of MIH [rate ratio (RR): 7.706; P=0.035]. Conclusions: LB was influenced by different degrees of MIH and the presence of caries and could guide clinical decisions and patients' recommendations to prevent carious lesions in MIH children.

Clinical management of caries by public and private university dental students / Abordagem clínica da doença cárie segundo a formação universitária

Objective: The aim of this study was to verify the clinical approach knowledge of graduate students from two colleges (public and private) concerning dental caries. Material and Method : A case report containing patient general data, photos, and radiographs were presented for the students, which responded tests and a discursive question. Discursive answers were analyzed according to content analysis technique, and posteriorly dichotomized for statistical analysis. (Chi-square, p<0.05). Result: Response rates (n=72) were 85.71% in the public college, and 92.30% in the private college. After x-rays evaluation and considering the diverse dynamics by which both schools perform their patient care management, it was observed that less than 10% of the public college students would perform conservative procedures in primary teeth, while at least 30% of private college students would decide for conservative procedures for all cases (p<0.001). Concerning the permanent dentition, the majority of the public college students would perform "conservative" approach. "Preventative-conservative practice" was similarly observed amongst public and private college students. Conclusion: Both in public and in private college were similar curative e approaches (primary teeth) and preventative +conservative (permanent teeth).

Objetivo: O objetivo deste estudo foi verificar a abordagem clínica dos formandos de duas instituições de ensino (pública e particular) em relação à doença cárie. Material e Método: Utilizou-se um caso clínico (contendo dados, fotos e radiografias), e questionou-se sobre o plano de tratamento, com questões fechadas e uma questão discursiva. As respostas discursivas foram analisadas pela técnica de análise do conteúdo, e, posteriormente dicotomizadas, assim como as fechadas, para análises estatísticas (Qui-quadrado, p<0,05). Resultado: A taxa de resposta (n=72) foi de 85,71% na faculdade pública e 92,30% na particular. Após a consulta das tomadas radiográficas e considerando a dinâmica de atendimento clínico diferente das faculdades, menos de 10% dos estudantes da faculdade pública realizariam procedimentos conservadores nos dentes decíduos, enquanto pelo menos 30% dos estudantes da faculdade particular optariam por procedimentos conservadores em todos os casos (p<0,001). Quanto aos dentes permanentes, a totalidade dos estudantes da faculdade pública faria tratamento conservador. Conclusão: Tanto na faculdade pública quanto na particular houve semelhança de abordagens curativa (dentes decíduos) e conservadora+preventivista (dentes permanentes).