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.

Antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization-controlled clinical trial.

BACKGROUND: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH. METHODS: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied. DISCUSSION: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention. TRIAL REGISTRATION: NCT03904641.

Tratamento Restaurador Atraumático (TRA) e sua aplicabilidade emcomunidades menos assistidas / Atraumatic Restorative Treatment (ART) and their applicability in less assisted communities

O TRA (Tratamento Restaurador Atraumático) surge como aliado à odontologia de mínima intervenção,dispensando os avanços tecnológicos, o enfoque estritamente invasivo e curativo, muitas vezes disponíveis auma pequena parcela da população e não atendendo às camadas sociais menos favorecidas dos países emdesenvolvimento e subdesenvolvidos. O TRA dispensa infraestrutura, técnica e custo monetário complexos,utilizando ações eficazes que visam à multiplicação da saúde bucal. A técnica inclui mínima intervenção emáxima preservação de estruturas dentárias, bem como, o uso de materiais odontológicos biologicamentecompatíveis e agregadores à saúde bucal do paciente. Este artigo tem como finalidade expor em revisãobibliográfica a cerca da utilização do TRA e sua aplicabilidade em comunidades menos assistidas, bem comosuas características e eficácia técnica

The Atraumatic Restorative Treatment (ART) arises as an ally to the minimally invasive Dentistry giving up thetechnology, the approach strictly invasive and healing many times available for a minority, not reaching the lessfavored areas from developed and developing counties. The ART doesn't need infrastructure technique or highcost using effective measures aimed on increase the oral health. The technique includes less intervention andmaximum dental structure preservation, also the correct use of dental materials bringing dental health for thepatient. This article has the goal to expose as a literature review the ART and your applicability in less favoredareas, your efficiency and technical features