[Prevalence of exogenous pigmentations and caries by intake of ferric supplements in primary dentition]. / Prevalencia de pigmentaciones exógenas y caries por ingesta de suplementos férricos en dentición primaria.

Objective: The aim of this study was to determine the prevalence of extrinsic black pigmentation in primary dentition and its relationship with dental caries in children aged 3 to 5 years. Materials and methods: The study design was descriptive, prospective, cross-sectional and observational; The sample of the present study consisted of 79 children who were receiving treatment with ferrous sulfate, who underwent a clinical examination and odontogram. To determine the presence of extrinsic black pigmentation, the Shourie classification was used. Results: A low prevalence of extrinsic pigmentation of 7.6% was found, and children with extrinsic pigmentation had a Ceod of 9.83+-3.601, while those children without the presence of pigmentations had a Ceod of 4.60+-3.248. Conclusions: A significant relationship was found between the Ceod index and extrinsic black pigmentation (p<0.001).

Risk indicators for the severity of erosive wear in deciduous dentition of Mexican schoolchildren aged 5 to 7 years.

The objective of this work was to estimate the prevalence and severity of erosive tooth wear (ETW), and to identify risk indicators of deciduous dentition of a group of schoolchildren from public schools in Tlalnepantla de Baz, State of Mexico. A cross-sectional study was carried out in 352 schoolchildren from 5 to 7 years old. The severity of the ETW was evaluated using the Basic Erosive Wear Examination (BEWE). Risk indicators were evaluated through a survey which included food and beverage consumption, consumption habits, vitamin C consumption, gastroesophageal reflux, heartburn, belching, xerostomia, vomiting and teeth grinding. Multinomial logistic regression models were fitted. The prevalence of ETW was 99.7% (n = 351). Regarding severity, 46.6% were at a null/mild level, 27.3% moderate, and 26.1% severe. Males were more likely to present severe ETW (odds ratio (OR) = 2.23, 95% confidence interval (CI), 1.27-3.93; p = 0.005). The risk indicators for the severity of ETW were the frequent consumption of citrus fruits (OR = 2.09, 95% CI, 1.12-3.89; p = 0.021), fruit juice (OR = 1.99, 95% CI, 1.06-3.75; p = 0.033), processed beverages (OR = 2.15, 95% CI, 1.23-3.78; p = 0.008) and hot sauce (OR = 1.82, 95% CI, 1.03-3.20; p = 0.036). The prevalence of ETW in the deciduous dentition was very high (99.7%) and ~1/3 for severe ETW. The dietary factors associated with severe ETW are part of the regular consumption of Mexican school-age children, which impact their oral health condition. It is important to establish intervention strategies from the infant stage, focused on both children and their caregivers.

Fluorosis dental en la primera infancia: estado del arte

La fluorosis dental se caracteriza por una hipomineralización de la estructura dental causada por ingesta excesiva de flúor sistémico. En la dentición decidua, su diagnóstico precoz es importante, dado que será un predictor para la aparición de lesiones en la dentición permanente. El objetivo de esta revisión fue describir la evidencia científica sobre la fluorosis dental en dentición decidua reportando su etiología y factores relacionados, prevalencia, diagnóstico y tratamiento. Se realizaron búsquedas electrónicas en las bases de datos Pub-Med/Medline, EbscoHost y ScienceDirect (noviembre/2020), utilizando las palabras clave "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". El desarrollo de fluorosis dental en dentición decidua se relacionó con la ingesta de múltiples fuentes de flúor principalmente, agua potable, alimentos de la dieta, fórmulas infantiles, suplementos y uso de dentífricos fluorados en dosis inadecuadas. Algunos factores prenatales, como vivir en terrenos montañosos o de gran altitud y habitar en lugares cercanos a minas de combustión de carbón, también fueron asociados. La prevalencia de fluorosis dental reportada en los estudios varió entre 6,2 y 96,6 %, dependiendo principalmente de la concentración de flúor en agua potable. Para el diagnóstico de la fluorosis dental en la dentición decidua se deben considerar características como la localización, aspecto, extensión y color de la lesión, realizando diagnóstico diferencial con otro tipo de defectos en esmalte y dentina. Así mismo, el tratamiento de las lesiones dependerá de la severidad del defecto y condiciones individuales del paciente.

Dental fluorosis is characterized by a hypomineralization of the tooth structure caused by excessive intake of systemic fluoride. In the deciduous dentition, its early diagnosis is important since it will be a predictor for the appearance of lesions in the permanent dentition. The objective of this review was to describe the scientific evidence on dental fluorosis in deciduous dentition, reporting its etiology and related factors, prevalence, diagnosis and treatment. Electronic searches were conducted PubMed / Medline, EbscoHost and ScienceDirect (November / 2020) databases, using the keywords "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". The development of Dental fluorosis in deciduous dentition was related to the intake of multiple sources of fluoride mainly; drinking water, diet foods, infant formulas, supplements and the use of luoridated toothpastes in inadequate doses. Some prenatal factors such as living in mountainous or high altitude terrain and living in places near coal-burning mines were also associated. The prevalence of dental fluorosis in early childhood reported in the studies varied between 6.2% and 96.6%, depending mainly on the concentration of fluoride in drinking water. For the diagnosis of dental fluorosis in the deciduous dentition, characteristics such as the location, appearance, extension and color of the lesion must be considered, making a differential diagnosis with other types of enamel and dentin defects. Evenly, the treatment of lesions will depend on the severity defects and individual patient conditions.

Splinting in the management of dental trauma in the primary dentition: a systematic review.

PURPOSE: The purpose of this study was to gather existing data on the efficacy of tooth splinting (TS) in patients with traumatized primary teeth, evaluating their overall prognosis and reported complications. METHODS: Electronic searches were performed in seven databases up to Februray/2023. Clinical studies published in the last two decades and presenting the following characteristics were included: (a) reporting on children with traumatized primary teeth; (b) describing the efficacy of splinting those teeth. Studies describing imobilization of dental avulsion were excluded. RESULTS: A total of 163 potentially relevant studies were initially found. After title/abstract screening, and full-text evaluation, three retrospective studies with moderate to high risk of bias were included. The studies described the outcomes of TS in primary teeth with luxation (intrusion, extrusion, lateral displacement), intra-alveolar root fracture, and/or alveolar fracture. High clinical success rate was observed for teeth with root fracture. Benefits of spliting teeth with lateral luxation were not identified, although it may be a reccomended approach. No study was found evaluating TS for alveolar fracture. CONCLUSION: Based on a low level of evidence, the findings highlight a better clinical success rate of the use of TS in the management of deciduous teeth with root fractures.

Reabsorção radicular inflamatória externa em dentes decíduos com traumatismos dentários e fatores associados / External inflamatory root reassorption in primary teeth with dental trauma and associated factors

A reabsorção radicular externa inflamatória vem sendo cada vez mais observada pelos Odontopediatras como consequência do traumatismo dentário na dentição decídua. O prognóstico dessa condição na dentição decídua é desfavorável, de rápida progressão e quando não diagnosticada e tratada, pode prejudicar o desenvolvimento do germe do dente permanente sucessor e levar a perda prematura do dente decíduo. Esse estudo tem como objetivo identificar a frequência e os fatores associados às reabsorções radiculares externas inflamatória em dentes decíduos traumatizados. Trata-se de um estudo transversal retrospectivo que avaliou clinicamente e radiograficamente incisivos decíduos de prontuários de crianças atendidas e acompanhadas por pelo menos um ano no período entre 2007 e 2022 em clínica de referência em traumatismo em dentes decíduos de Belo Horizonte da Faculdade de Odontologia da Universidade Federal de Minas Gerais (FAO UFMG).Acoleta de dados das fichas clínicas foi realizada por dois pesquisadores treinados e a análise das radiografias foi realizada por um pesquisador treinado e calibrado para identificação da reabsorção radicular externa inflamatória. Dois professores experientes em traumatismos dentários e um especialista em radiologia foram responsáveis pelo treinamento e calibração (kappa = 0.7). A variável dependente foi a presença de reabsorção radicular externa inflamatória após traumatismos dentários. As variáveis independentes coletadas através de fichas clínica foram o sexo e a idade da criança, a escolaridade da mãe, de hábito de sucção não nutritiva, higiene bucal, mobilidade, traumatismo de repetição, atendimento imediato e o tipo de traumatismo dentário . No total, 508 dentes foram analisados através dos dados de fichas clínicas e exames radiográficos de 278 crianças com idade entre 6 e 72 meses. A análise estatística foi realizada através do software Statistical Package for Social Science (SPSS) 25.0 e incluiu análise descritiva, teste qui-quadrado e Regressão de Poisson com variância robusta. Dos dentes avaliados 20,9% (n= 106) apresentaram reabsorção radicular externa inflamatória. Foram associadas à reabsorção externa inflamatória, a busca por atendimento 2 horas ou mais após o traumatismo dentário (RP= 1,49; IC=1,03- 2,07; p=0,033),a presença de mobilidade dentária (RP= 2,18; IC=1,49-3,21; p>0,001) e de fratura complicada (RP=1,87; IC=1,10-3,16; p=0,019). Conclui-se que a frequência de reabsorção radicular externa inflamatória em dentes decíduos traumatizados foi moderada/alta e esteve associada ao atendimento tardio, fraturas complicadas e mobilidade dentária.

Inflammatory external root resorption has been increasingly observed by pediatric dentists as a consequence of dental trauma in the primary dentition. The prognosis of this condition in the primary dentition is unfavorable, with rapid progression and, when not diagnosed and treated, can harm the development of the germ of the permanent successor tooth and lead to premature loss of the primary tooth. This study aims to identify the frequency and factors associated with inflammatory external root resorption in traumatized primary teeth. This is a retrospective cross-sectional study that clinically and radiographically evaluated primary incisors from the medical records of children treated and monitored for at least one year between 2007 and 2022 at a reference clinic for trauma to primary teeth in Belo Horizonte at the Faculty of Dentistry of the Federal University of Minas Gerais (FAO UFMG). Data collection from clinical records was carried out by two trained researchers and analysis of radiographs was carried out by a researcher trained and calibrated to identify inflammatory external root resorption. Two professors experienced in dental trauma and a radiology specialist were responsible for training and calibration (kappa = 0.7). The dependent variable was the presence of inflammatory external root resorption after dental trauma. The independent variables collected through clinical records were the child's sex and age, mother's education, non-nutritive sucking habit, oral hygiene, mobility, repeated trauma, immediate care and the type of dental trauma. In total, 508 teeth were analyzed using data from clinical records and radiographic examinations of 278 children aged between 6 and 72 months. Statistical analysis was performed using the Statistical Package for Social Science (SPSS) 25.0 software and included descriptive analysis, chi-square test and Poisson Regression with robust variance. Of the teeth evaluated, 20.9% (n= 106) showed inflammatory external root resorption. They were associated with inflammatory external resorption, seeking care 2 hours or more after dental trauma (RP= 1.49; CI=1.03-2.07; p=0.033), the presence of tooth mobility (RP= 2 .18; CI=1.49-3.21; p>0.001) and complicated fracture (PR=1.87; CI=1.10-3.16; p=0.019). It is concluded that the frequency of inflammatory external root resorption in traumatized primary teeth was moderate/high and was associated with late care, complicated fractures and tooth mobility.

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study / Lesões dentárias traumáticas na dentição decídua e sequelas na dentição permanente: um estudo retrospectivo de 7 anos

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can cause sequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primary dentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil. Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental records over 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-two patients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and in the 2 to 4-year age group (44.10%); most injuries occurred from fall from the child's own height (40.30%) and at home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinical and radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding the permanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion:According to this study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The major type of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is important to the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.(AU)

Objetivo: Lesões dentárias traumáticas (TDIs) afetam a estética e a função dos dentes decíduos e podem causar sequelas em sucessores permanentes. Este estudo avaliou a distribuição das TDIs e sequelas na dentição decídua e sua respectiva dentição permanente em crianças atendidas no Centro de Trauma Odontológico no Brasil. Material e Métodos: Trata-se de um estudo transversal realizado por meio da coleta de dados de 256 prontuários odontológicos ao longo de 7 anos. Foram utilizadas análises estatísticas descritivas e teste exato de Fisher (p <0,05). Resultados:Sessenta e dois pacientes apresentaram trauma na dentição decídua. As TDIs foram observadas principalmente em meninos (64,50%) e na faixa etária de 2 a 4 anos (44,10%); a maioria das lesões ocorreu por queda da própria altura (40,30%) e em casa (71,20%). O tipo de trauma mais comum foi a subluxação (22,90%). As sequelas clínicas e radiográficas mais prevalentes foram mobilidade (45,60%) e lesão periapical (31,80%), respectivamente. Em relação à dentição permanente, a sequela mais frequente foi a hipomineralização (33,30%). Conclusão: De acordo com este estudo, as TDIs em dentes decíduos foram de 29,24% de todos os casos do Programa de Trauma Dental. O principal tipo de trauma em crianças foi a subluxação, com sequelas em ambas as dentições. O acompanhamento após o trauma é importante para a manutenção da dentição decídua e para prevenir e tratar possíveis sequelas na dentição permanente. (AU)

Very early orthodontic treatment: when, why and how?

ABSTRACT Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.

RESUMO Introdução: Vários problemas ortodônticos devem ser tratados já em idade precoce, para evitar a necessidade de procedimentos futuros de maior complexidade e custo. A evidência científica sugere que as seguintes más oclusões podem se beneficiar de terapias interceptivas simples mas eficientes: mordidas cruzadas posteriores, Classe III leve a moderada, certas más oclusões de Classe II, mordidas abertas e discrepâncias no tamanho das arcadas. Objetivo: Resumir a evidência científica existente sobre o tratamento ortodôntico precoce e ilustrar sua aplicação e efetividade, por meio da exposição de múltiplos casos clínicos. Conclusão: O tratamento ortodôntico interceptivo precoce de curto prazo com aparelhos simples na fase da dentição decídua ou início da dentição mista pode corrigir eficientemente certas más oclusões e ajudar a reduzir a complexidade ou, até mesmo, evitar a necessidade de procedimentos complexos e onerosos durante a puberdade. Para certos pacientes com discrepância significativa no comprimento das arcadas, o conceito de extrações seriadas deve fazer parte do arsenal de recursos ortodônticos.

Prevalência de maloclusão em dentição decídua nos alunos do ensino pré-escolar do concelho de porto de mós (portugal) / Prevalence of malocclusion in deciduous dentition in preschool students in the municipality of Porto de Mós (Portugal) / Prevalencia de maloclusión en dentición temporal en preescolares del municipio de Porto de Mós (Portugal)

Introdução:A maloclusão é considerada a segunda doença oral mais comum em crianças e jovens adultos. É importante saber identificar estas alterações de forma a permitir um adequado desenvolvimento da oclusão.O diagnóstico de um desenvolvimento anormal na dentição decídua é relevante para a prevenção e quando necessáriouma intervenção precoce. Objetivo:O objetivo deste estudo transversal foi avaliar a prevalênciade maloclusão em crianças com dentição decídua e relacionar com diferentes parâmetros.Metodologia:Observaram-se 300 crianças de ambos os sexos, com idades compreendidas entre os 3 e os 6 anos. A recolha de dados foi realizada a partir do exame clínico comkits de observação(espelho bucal básico descartável,sonda descartável, babador,luvas e sacos descartáveis), sob luz natural e na cadeira escolar, no Agrupamento de Escolas de Porto de Mós, Distrito Sanitário de Leiria. Analisaram-se as seguintes características: Tipo de arco de Baume, espaços primatas, diastemas, apinhamento, relação distal dos segundos molares decíduos, relação canina, sobremordida e sobressaliência, mordida anterior e posterior.Resultados:A prevalência de maloclusão registradafoi de 67,7%, verificando-se ser mais baixa aos seis anos, sem apresentar diferenças significativas em ambos os sexos. A sobressaliência foi a maloclusão mais prevalente (42,7%) nas crianças observadas, seguida da mordida aberta anterior (23,3%). Registrou-seumaelevada prevalência de maloclusão nas crianças com arco de Baume tipo II, sem diastemas ou espaços primatas, com apinhamento, degrau distal, classe II canina ou desvio da linha média para a direita.Conclusões:Verificou-se existir uma elevada prevalência de maloclusão nas crianças do agrupamento de escolas do Concelhode Porto de Mós, estando relacionada com diferentes parâmetros oclusais (AU).

Introduction:Malocclusion is considered a second mostcommon oral disease in children and young adults. It is important to know how to identify these changes in order to allow proper development of the occlusion.The diagnosis of anabnormal development in primary dentition is relevant for prevention and when necessary, early intervention.Objective:The aim of this cross sectional study was to evaluate the prevalence of malocclusion in children with deciduous dentition and relate this prevalence with sex, age and with different occlusal parameters.Methodology:300 children of both sexes, aged between 3 and 6 years were observed. Data collection was carried out from the clinical examination using observation kits, in schools, in the Group of schools of Porto de Mós, Health District of Leiria. The following characteristics were analyzed: Baume arc Type, spaces, diastemas, crowding, the deciduous second molars distal relation, canine relationship, Overbite and overjet, anterior and posterior bite.Results:The recorded prevalence of malocclusion was 67.7%, was lower at six years old, without any differences in both sexes. The overjet was the most prevalent malocclusion (42.7%) in the observed children. There was a high prevalence of malocclusion in children with type II Baume arch, without spaces or primate spaces, with distal step, canine class II or with the middle line shifted to the right.Conclusions:There there was a high prevalence of malocclusion in children of the schools in the municipality of Porto de Mós, and is related to the different occlusal parameters (AU).

Introducción: La maloclusión se considera la segunda enfermedad bucal más común en niños y adultos jóvenes. Es importanteidentificar estos cambios para llograr un adecuado desarrollo de la oclusión. El diagnóstico precoz deldesarrollo anormal en la dentición temporal es relevante para la prevención y cuando sea necesario una intervención temprana. Objetivo: El objetivo de este estudio transversal fue evaluar la prevalencia de maloclusión en niñoscon dentición temporal y relacionarla con diferentes parámetros. Metodología: Fueran observados 300 niños de ambos sexos, con edadesentre los 3 y los 6 años. La recogida de datos del examen clínico se realizó mediante kits de observación, en un entorno escolar, en el Grupo Escolar dePorto de Mós, Distrito Sanitariode Leiria. Se analizaron las siguientes características: tipo de arco de Baume, espaciosprimates, diastemas, apiñamientos, relación distal de los segundos molares deciduos, relación canina, sobremordida horizontal y vertical, mordida anterior y posterior. Resultados: La prevalencia de maloclusión registrada fue de 67,7%, la cual resultó ser menor a los seis años, sin mostrar diferencias significativas en ambos sexos. El overjet fue la maloclusión más prevalente (42,7%) en los niños observados, seguida de la mordida abierta anterior (23,3%). Hubo una alta prevalencia de maloclusión en niños con arco de Baume tipo II, sin diastemas ni espacios de primates, con apiñamiento, paso distal, canino clase II o desviación de la línea media hacia la derecha.Conclusiones: Se encontró que hayuna alta prevalencia de maloclusión en niños dela comunidad escolar del municipio de Porto de Mós, y que se relaciona,con diferentes parámetros oclusales (AU).

Maximum length of deciduous dentition as an indicator of age during the first year of life: Methodological validation in a contemporary osteological collection.

Out of all the available methods for estimating age at death from immature human skeletal remains, those based on odontometric variables of deciduous dentition have proved to be one of the most accurate. The development of odontometric methods has been improved through the creation of documented human osteological collections, allowing their validation in different populations. The present study aims to test the regression equations for age estimation proposed by Liversidge et al. 1993, Irurita Olivares et al. 2014, and Cardoso et al. 2019, on the basis of the maximum length of deciduous teeth in an Argentinian sample of 35 infants of known age at death. The results showed that the absolute mean difference between estimated and chronological age was 5.76±6.33 weeks for Liversidge's method, 5.71±6.41 weeks for Irurita Olivares's method, and 6.79±5.80 for Cardoso's method. It was also found that, for Liversidge's method, the canines provided the most accurate and the least biased estimations. For Irurita Olivares's method, mandibular anterior teeth were the most accurate, while the first mandibular molars offered the least biased estimations. For Cardoso's method, the canines presented the most accurate estimations, while the lateral incisors the least biased ones. Finally, 95% confidence intervals of estimated ages were calculated for each method, finding that Irurita Olivares's method provided the most reliable age estimations when using mandibular central incisors and mandibular first molars.

Evaluación de desgaste oclusal en dentición decidua en escolares de seis años de edad en una comunidad rural de Yucatán / Evaluation of occlusal faceting in deciduous dentition in 6 year-old children in a rural community of Yucatan

RESUMEN El desgaste oclusal se ha determinado como un signo de parafunción en edad adulta; sin embargo, es frecuente encontrar dichos desgastes en la dentición decidua considerándose un rasgo fisiológico. Objetivo: Determinar la prevalencia de desgaste dental en piezas temporales en escolares de seis años en una población mexicana. Métodos: Se evaluaron 52 modelos de yeso de niños de seis años, en los cuales se registraron las facetas encontradas en las piezas dentarias deciduas, al igual que los planos terminales. Se usaron las pruebas estadísticas t-Student y ji cuadrada. Resultados: En los niños resultó significativamente mayor el número de piezas desgastadas que en las niñas. Difirió signifi ativamente el número de piezas facetadas por tipo de diente en cada género. El promedio de piezas infantiles facetadas no difirió significativamente entre el plano terminal recto y el mesial. Sin embargo, se obtuvo tendencias (p < 0.10) a un mayor número de piezas facetadas en el plano mesial (13.71 ± 2.46; n2 = 14) que en el plano terminal recto (11.68 ± 4.30; n1 = 19). Conclusión: La evaluación del desgaste oclusal en dentición decidua en la población infantil afecta en igual forma a ambos géneros. Por movimientos masticatorios hay mayor prevalencia de desgastes en ciertas piezas dentarias y diferencia con respecto al género.

ABSTRACT The occlusal faceting has been determined as a sign of parafunction during adulthood, but it´s common to find such worn on the deciduous dentition considered as a physiological trait. Objective: To determine the prevalence of occlusal worn on the deciduous dentition of 6 years old students in a determined Mexican population. Methods: 52 plaster models of 6 years old children were assessed, on which the facets found in deciduous teeth, as terminal planes were registered. The Student t-test statistics and Chi-square test were used for data analysis. Results: The number of worn pieces was significantly higher in male than female children. The number of faceted parts by tooth type in each gender differed signifi cantly. The faceted infant pieces average did not differ signifi cantly between straight and mesial terminal plane. Nevertheless, trend (P<0.10) was obtained at a greater number of parts in the mesial faceted plane (13.71 ± 2.46; n2=14) than in the straight terminal plane (11.68 ± 4.30; n1=19). Conclusion: The evaluation of occlusal worn in the deciduous dentition in children affects equally both genders. There is a greater prevalence of worn by chewing movement on certain teeth and it differs according to gender.

In vivo Comparison of the Duration between two Endodontic Instrumentation Techniques in Deciduous Teeth

Objective:To make an in vivo comparison of the amount of time required for root canal instrumentation of inferior deciduous molars either using rotary or manual techniques, and root canal filling of the same teeth.Material and Methods:Eight participants ranging from six to eight years of age that presented mandibular deciduous molars with root canal treatment indication were selected. Manual instrumentation with stainless steel K-files was performed in group I, and rotary instrumentation with Pro Taper rotary system was performed in group II.Results:T-test was used to determine mean value differences for the mesiolingual (ML) and distal (D) canals, showing no statistically significant differences (p = 0.912 and p = 0.366, respectively). The Mann-Whitney test was performed to detect mesiobuccal canal (MB) mean value differences, which were not statistically significant (p = 0.200). As to mean time required to perform canal filling for each group (manual and rotary) no statistically significant differences (p = 0.715) were found. Conclusion:Root canal preparation with rotary nickel-titanium instruments can be an alternative to mechanical instrumentation, although instrumentation and obturation time was not reduced

Anticaries effect of low-fluoride dentifrices with phosphates in children: A randomized, controlled trial.

UNLABELLED: Low-fluoride dentifrices (LFD) have been recommended for young children aiming to minimize excessive fluoride intake during tooth brushing. Given the uncertainties surrounding the clinical efficacy of such formulations, alternatives to increase their anticaries effect have been investigated. OBJECTIVES: This double-blind, randomized controlled trial assessed the clinical efficacy of LFDs supplemented with Calcium Glycerophosphate (CaGP) or Sodium Trimetaphosphate (TMP) on the progression of dental caries in the deciduous dentition. METHODS: Children (average age 48 months old) from two Brazilian cities (Araçatuba and Fernandópolis) were randomly assigned into 3 groups, according to the dentifrice to be used: 500ppm F plus 1% TMP ("500TMP", n=206), 500ppm F plus 0.25% CaGP ("500CaGP, n=201) and 1100ppm F ('1100F', n=193). Clinical exams (dmfs) were performed at baseline and 18 months after dentifrices started to be used, and the increment in the number of carious lesions (final dmfs - initial dmfs) was calculated. Data were analyzed by multivariate linear regression analysis to verify the influence of city, gender, previous caries experience and type of dentifrice on dmfs increment (p<0.05). RESULTS: Mean caries increment observed for 500TMP (0.26) was significantly lower when compared with 1100F (0.74), while values found for 500CaGP (0.54) were not significantly different from 1100F. Caries increment was significantly higher in children from Araçatuba and in those with previous caries experience. CONCLUSION: The results indicate that clinical efficacy of LFDs supplemented with TMP is superior to that observed for a conventional formulation (1100F), while the addition of CaGP leads to similar efficacy when compared to 1100F. CLINICAL SIGNIFICANCE: Children brushing with 500ppm F toothpastes containing phosphate salts developed fewer caries lesions when compared with those using a 1100ppm F dentifrice. The tested toothpastes can be regarded as a safe alternative to conventional formulations for children under 6 years of age, based on risk-benefit considerations.

Is It Possible to induce Artificial Caries-affected Dentin using the Same Protocol to Primary and Permanent Teeth?

AIM: This in vitro study compared the mineral loss of natural and artificially-created caries-affected dentin in primary and permanent teeth using the same protocol to induce caries lesions. MATERIALS AND METHODS: Twenty molars presenting natural occlusal dentin caries lesions (10 primary-PriC and 10 perma-nent-PermC; control group), and 20 sound molars (10 primary -PripH and 10 permanent-PermpH; experimental group), were selected. Occlusal cavities were prepared in teeth of the experimental group that were submitted to pH-cycling for 14 days to simulate caries-affected dentin. All specimens were longitudinally sectioned and prepared in order to obtain Knoop micro-hardness values from 15 to 250 urn depth, starting in bottom of center of natural lesions or cavities. The microhardness (KHN) data were submitted to three-way repeated measures analysis of variance (ANOVA) and Tukey's tests (α = 0.05). RESULTS: Considering all depths, there was no statistically significant differences (p > 0.05) between the mineral loss of the control (PriC = 30.9 ± 6.4 and PermC = 40.8 ± 8.6) and experimental (PripH = 27.3 ± 11.1 and PermpH = 35.5 ± 14.0) groups, neither between primary and permanent teeth. CONCLUSION: The mineral loss of the artificially-created caries-affected dentin is similar to that from naturally developed dentin caries lesions. CLINICAL SIGNIFICANCE: The pH-cycling model may be a suitable method to simulate caries-affected dentin in both permanent and primary teeth.

A comparison of methods used to determine chewing side preference in deciduous, mixed and permanent dentitions / Comparação dos métodos usados para determinar o lado preferencial mastigatório nas dentições decídua, mista e permanente

Objective: This study determined whether ‘chewing side preference’ (CSP) is correlated to ‘chewing side preference during the first chewing cycle’ (CSP1ºC) in the deciduous, mixed and permanent dentitions. Methods: Three-hundred subjects were divided in 3 groups: Group 1 – 100 children 3-5 years old, primary dentition; Group 2 – 100 children 6-12 years old, mixed dentition; Group 3 – 100 subjects 18-47 years old, permanent dentition. CSP was determined using a method developed by McDonnell et al. Subjects were given a piece of gum and the position of the chewing gum was recorded 7 times as right or left. Subjects were classified as ‘observed preferred chewing side’ (OPCS) when they performed 5/7, 6/7 or 7/7 strokes on the same side. OPCS corresponded to the CSP. CSP1ºC was determined using a method developed by Hoogmartens and Caubergh (1987). Subjects were given five pieces of gum and five pieces of bread and the position of the chewing gum at first chewing cycle was recorded as right or left. For each subject, an index (I) was performed. Chi-square (X2) and phi correlation (r) tests were used to investigate significant correlations between CSP and CSP1ºC. Results: There was a strong positive and significant correlation between CSP and CSP1ºC for primary dentition (p= 0.000; r = 0.82), for mixed dentition (p = 0.000; r = 0.81) and a very strong positive and significant correlation for permanent dentition (p = 0.000; r = 0.90). Conclusion: CSP can be significantly correlated to CSP1ºC for primary dentition, mixed dentition and permanent dentition, and these are strong positive relationships for primary and mixed dentitions and very strong positive relationship for permanent dentition.

Objetivo: Este estudo determinou se o ‘lado preferencial mastigatório’ (LPM) é correlacionado com o ‘lado preferencial no primeiro ciclo mastigatório’ (LP1ºCM) nas dentições decídua, mista e permanente. Métodos: Trezentos indivíduos foram divididos em 3 grupos: Grupo 1 – 100 crianças de 3-5 anos, dentição primária; Grupo 2 – 100 crianças de 6-12 anos, dentição mista; Grupo 3 – 100 indivíduos de 18-47 anos, dentição permanente. O LPM foi determinado usando o método desenvolvido por McDonnell et al. Indivíduos recebiam um pedaço de goma de mascar e, durante a mastigação, foi anotado o lado (esquerdo ou direito) por 7 vezes. Os indivíduos foram classificados como ‘lado preferencial mastigatório observacional’ (LPMO) quando realizavam 5/7, 6/7 ou 7/7 mordidas do mesmo lado, correspondendo, portando, ao LPM. O LP1ºCM foi determinado usando o método desenvolvido por Hoogmartens e Caubergh. Os indivíduos recebiam 5 pedaços de goma de mascar e 5 pedaços de torrada, e a posição da primeira mordida foi anotada (esquerdo ou direito). Cada indivíduo recebeu um index (I). Os testes Qui-quadrado (X2) e Correlação de Phi (r) foram utilizados para avaliar as correlações significantes entre LPM e LP1ºCM. Resultados: Houve forte e positiva correlação significante entre LPM e LP1ºCM para as dentições decíduas (p = 0,000; r = 0,82), para dentição mista (p = 0,000; r = 0,81) e muito forte e positiva para dentição permanente (p = 0,000; r = 0,90). Conclusão: LPM pode ser significantemente correlacionado com LP1ºCM para todas as dentições, e essas correlações são fortes e positivas para as dentições decídua e mista e muito forte e positiva para a dentição permanente.

Association between nonnutritive sucking habits and anterior open bite in the deciduous dentition of Japanese-Brazilians

OBJECTIVE: Assess the association between nonnutritive sucking habits and anterior open bite in the deciduous dentition of Japanese-Brazilian children. METHODS: 410 children of Japanese origin were assessed, 206 boys and 204 girls, between 2 and 6 years of age, in schools in São Paulo State, Brazil. Questionnaires concerning their nonnutritive sucking habits were sent to their legal guardians. Chi-square tests (p<0.05) were applied to assess the association between nonnutritive sucking habits and anterior open bite, and the logistic regression test to obtain the relative risk. RESULTS: The prevalence of sucking habits found in the sample was of 44.6% and for the anterior open bite, 4.4%. There was a statistically significant association between anterior open bite and sucking habits (O.R.=10.77), persistence of sucking habits from 2 to 4 years old (O.R.=22.06), and the persistence of sucking habits from 4 to 6 years old (O.R.=17.31). As for the interruption period of the habit, the group that had interrupted the habit for a period equal or inferior to six months showed an increased prevalence of open bite compared to the group without this habit or in which the habit was interrupted for more than six months. CONCLUSION: Japanese-Brazilian children that had sucking habits have greater chance of acquiring anterior open bite in the deciduous dentition.

Avaliação clínica da saúde bucal de pré-escolares do município de Alfenas e Areado - MG / Clinical evaluation of oral health of preeschool the Alfenas and Areado MG

A CPI ainda é considerada um sério problema de saúde bucal. A identificação do risco ao desenvolvimento à cárie em criança baseia-se em informações sobre uma combinação de fatores sóciodemográfico, dietético, higiene bucal e classe social. Sabe-se que estudos epidemiológicos são necessários para se obter dados, a fim de se planejar, executar e avaliar de forma melhor os serviços de atenção odontológica baseada em promoção de saúde. A elaboração de um programa preventivo voltado para a população pré-escolar é de fundamental importância, visto que, são poucos os estudos voltados para esta faixa etária. Portanto, este trabalho, teve como objetivo avaliar clinicamente a saúde bucal de 447 pré-escolares (0 a 71 meses de idade), dos Municípios de Alfenas e Areado MG, pertencentes a escolas públicas e privadas, com e sem assistência odontológica através dos índices de cárie ceos, de biofilme visível (IPV) e, de sangramento gengival (ISG). Além disso, foram coletados os dados indicadores de risco à cárie da amostra envolvida através da aplicação de um questionário. Houve um maior número de crianças na rede pública. Observou-se o fenômeno da polarização e o predomínio de CPI na região posterior. O ISG foi igual a 0 para os dois municípios. O teste t de Student mostrou que o ceos (p=0,0326), e o IPV (0,0000) entre os dois municípios foram significantes. O IPV entre as crianças com e sem assistência odontológica (p=0,0000) e entre as crianças de escolas públicas e privadas de Areado (p=0,023) foram significantes. O teste do qui-quadrado mostrou que o gênero masculino (p=0,00529) e a freqüência das visitas ao Cirurgião Dentista (p=0,0000) influenciaram a experiência de CPI significantemente. A Análise de Regressão Linear Múltipla, com um p=0,000 e R2=26%, mostrou significância entre as variáveis independentes: gênero masculino (p=0,0013), freqüência de escovação...

ECC (Early Childhood Caries) is still considered a serious oral health problem. A child caries development risk is identified based on a combination of factors as social-demographic, dietetic, oral hygiene and social class status. Its known that epidemiological studies are necessary to better plan, execute and evaluate services related to deontological health promotion. The elaboration of a preventive program, targeted for preschool is very important as little studies are dedicated to this population. Thus, this work aimed to clinically evaluate the oral health of 447 preschool (from 0 to 71 months old), in the towns of Alfenas and Areado/MG, from public and private schools, with and without deontological assistance. Study was based on dental caries (DMFS), visible plaque (VPI) and gingival bleeding (GBI) indexes. Besides, data collection on caries risk indicators was obtained through a questionary applied to the involved sample. There was a higher number of children from public schools. Polarization phenomenon and the predominance of ECC in the posterior zone were observed. The GBI was equal to 0 for both towns. The t-Student test showed that the dmfs (p=0,0,26) and the VPI (p=0,0000) between the two towns, were significant. In Areado, the VPI among children with and without dental assistance (p=0,0000) and among children from public and private schools (p=0,023), were also significant. The chi-square test showed that male gender (p=0,00529) and the frequency of visits to the dentist (p=0,0000) significantly influenced the ECC experience. The Multiple Linear Regression Analysis with p=0,000 and R² = 26%, was significant between the dependent variable (ECC) and independent variables: male gender (p=0,0013), dental brushing frequency (p=0,0000), dental floss usage (p=0,0485), presence of smokers (p=0,0020) and, social-economic status (p=0,0187). Based on sample analysis of a children group from 37 to 71 months of age, for both towns together...

Correlación de diez rasgos morfológicos dentales coronales entre molares deciduos y permanentes en tres grupos étnicos colombianos / Correlation of ten non-metric dental traits between deciduous and permanent molars of three ethnic colombian groups

Objetivos: Determinar la correlación de diez Rasgos Morfológicos Dentales Coronales RMDC (Carabelli, hipocono, puente de esmalte, metacónulo, protostílido, pliegue acodado, patrón cuspídeo, numero de cúspides y cúspide 6 y 7) entre los segundos molares deciduos superiores (um2) e inferiores (lm2), los primeros molares permanentes superiores (UM1) e inferiores (LM1) y los segundos molares permanentes superiores (UM2) e inferiores (LM2). Materiales y métodos: Este es un estudio descriptivo transversal para determinar la correlación de diez RMDC mediante su frecuencia y variabilidad, observados en 201 modelos de yeso de mestizos caucasoides de Cali, 84 modelos de yeso de afrocolombianos de Puerto Tejada y 60 modelos de yeso de indígenas del Amazonas. Resultados: Los indígenas del Amazonas entre um2/UM1 presentan correlación alta en Carabelli y número de cúspides; y muy alta en metacónulo y patrón cuspídeo. Los mestizos caucasoides entre um2/UM1 moderada en Carabelli, pliegue acodado y patrón cuspídeo; y alta en cúspide 6; y entre UM1/UM2/LM1/LM2 moderada en pliegue acodado, y alta en protostílido, patrón cuspídeo y cúspide 6. Los afrocolombianos entre UM1/UM2/LM1/LM2 moderada en pliegue acodado; y alta en protostílido, patrón cuspídeo y cúspide 6. Conclusiones: Los hallazgos soportan lo propuesto por la teoría de los campos morfogenéticos, la cual manifiesta que el diente gradiente de los molares deciduos y permanentes es um2/lm2, dado que retiene la configuración básica del patrón de contacto y el número de cúspides, Por tanto UM1/UM2/LM1/LM2 variarán de acuerdo al origen étnico y a la influencia ambiental de cada una de los tres grupos estudiados.

Aim: To determine correlations of ten non-metric dental crown traits NMDCT (Carabelli, hipocon2, enamel bridge, metaconule, protostylid, deflecting wrinkle, pattern cusp, cusp number and 6 and 7 cusp) between deciduous second upper (um2) and low (lm2) molars, permanent first upper (UM1) and lower (LM1) molars and permanent second upper (UM2) and lower (LM2) molars were studied. Materials y methods: This descriptive study determines the correlation of ten NMDCT through of the frequency and variability, observed on 201 dental casts of Cali racially mixed population, 84 dental casts of Puerto Tejada African-Colombian population and 60 dental casts of Colombian Amazons natives. Results: The Colombian Amazon natives showed high correlation in Carabelli and cusp number between um2/UM1; and very high in metaconule and pattern cusp. Cali racially mixed population showed moderated correlation in Carabelli, deflecting wrinkle and pattern cusp between um2/UM1; and high in 6 cusp. And between UM1/UM2/LM1/LM2 moderate in deflecting wrinkle; and high in protostylid, pattern cusp and 6 cusp. Puerto Tejada African-Colombian population showed moderated correlation between UM1/UM2/LM1/LM2 in deflecting wrinkle; and high in protostylid, pattern cusp and 6 cusp. Conclusions: Findings support the proposal of morphogenetic field theory, which exposes that the key tooth in deciduous and permanent molars is um2/lm2 because it retains the basic configuration of contact and number of cusps pattern, so UM1/UM2/LM1/LM2 will vary according to ethnic origin and to the environmental influence of each of three studied ethnic groups.

Aplicação de gabaritos na análise da dentadura decídua / Diagrams application in the deciduous dentition analysis

INTRODUÇÃO: foram indicados, recentemente, gabaritos para analisar se a dentadura decídua encontra-se normal ou alterada. OBJETIVO: o presente estudo propôs aplicar os gabaritos desenvolvidos por Long em 59 modelos de dentaduras decíduas normais (grupo A) e 139 alteradas (grupo B), para avaliar sua eficiência clínica, à luz dos critérios clínicos conhecidos, que caracterizam uma oclusão normal e uma má oclusão. METODOLOGIA: o grupo A, com 118 modelos de estudo de pacientes com oclusão normal, foi estratificado em 42 modelos de arcos superiores e 36 inferiores tipo I de Baume, e 17 modelos superiores e 23 inferiores de arcos tipo II. O grupo B, com 278 modelos de estudo com más oclusões diversas, foi composto por 78 arcos superiores e 75 inferiores tipo I, e 61 arcos superiores e 64 inferiores do tipo II. Examinou-se um total de 396 modelos. RESULTADOS: os resultados do teste de Kappa entre as variáveis gabarito e critérios clínicos revelaram baixa concordância entre diagnóstico de normalidade e anormalidade da dentadura, independentemente do tipo de arco avaliado. Os gabaritos discordaram em 78 por cento dos casos diagnosticados clinicamente como normais e em 20 por cento dos diagnosticados com erros morfológicos. CONCLUSÃO: os gabaritos propostos não se aplicam à avaliação da dentadura decídua.

INTRODUCTION: Recently, diagrams have been developed in order to analyze normality and malocclusion in the deciduous dentition. AIM: The aim of this study is to apply the diagrams developed by Long in 59 cast models of normal dentitions (group A) and 139 abnormal (group B), in order to evaluate its clinical efficiency before the known clinical criteria, which characterizes normal occlusion and malocclusion. METHODS: Group A, with 118 casts of patients with normal occlusion, was stratified in 42 models of superior arches and 36 of inferior ones of type I of Baume; 17 superior casts and 23 inferior ones of arches of type II. Group B, with 278 casts with different types of malocclusions, was composed of 78 superior arches and 75 inferior ones of type I; 61 superior arches and 64 inferior ones of type II. A total of 396 casts were examined. RESULTS: The Kappa test between diagrams and clinical criteria demonstrated low concordance between diagnosis of normality and abnormality of the dentition, regardless of the type of arch evaluated. The diagrams disagree in 78 percent of the cases clinically diagnosed as normal and in 20 percent of those with morphological errors. CONCLUSION: the proposed diagrams don't apply to the primary dentition evaluation.

Manifestações bucais em crianças com dentição decídua expostas passivamente ao tabaco / Oral manifestations in children with deciduous dentition passively exposed to tobacco

A exposição passiva ao tabaco é um problema médico e social que leva o não fumante a sofrer uma série de doenças, tanto sistêmicas como de repercussão bucal. Este trabalho apresenta uma revisão da literatura que relaciona o tabagismo passivo com o risco de cárie dental e alterações gengivais na dentição decídua, com o propósito de levar ao conhecimento do profissional cirurgião-dentista um tema não muito difundido e instruí-lo na sua prevenção.

Prevalência da perda precoce de dentes decíduos em escolares assistidos pelo instituto Ana Rosa em São Paulo, capital / Prevalence of early loss of deciduous teeth in school children assisted by Ana Rosa Institute in São Paulo, capital

Com base na importância da manutenção da integridade da dentadura decídua e na busca por uma melhor compreensão dos agentes etiológicos e dos fatores associados ao desenvolvimento das maloclusões na dentadura permanente, o presente trabalho verificou a prevalência de perdas precoces de dentes decíduos, bem como as possíveis causas e a região mais afetada, em escolares matriculados no Instituto Ana Rosa, com idade entre dois e nove anos de idade, na cidade de São Paulo, capital. A amostra constou de 443 crianças de ambos os gêneros, que foram submetidas a um exame clínico para identificar a perda prematura de algum elemento dentário, bem como a análise dos prontuários odontológicos, para que fosse identificada a possível causa da perda do dente decíduo. Diante dos resultados obtidos, foi possível concluir que de um total de 443 crianças, 21 apresentaram perda precoce de dente decíduo (4,7%). Não houve diferenças estatisticamente significantes entre a quantidade de dentes perdidos precocemente em relação às regiões maxilar ou mandibular (Qui-Quadrado-Correção de Yates, p=0,5023) e nem entre anterior e posterior dos arcos dentários (Qui-Quadrado-Correção de Yates, p=0,8231). Da mesma forma, não houve diferenças entre o número de perdas entre os diferentes dentes decíduos (teste de Lillifords, p>0,05). Foram observadas diferenças (Teste t, p=0,0002) entre as idades das crianças que perderam precocemente dentes decíduos ou não, sendo que a incidência da perda precoce aumentou conforme a idade. E finalmente, não houve diferenças entre os gêneros em relação à perda precoce dos dentes decíduos (Qui-Quadrado, p=0,725). Foi possível observar que a cárie foi à causa mais comum das perdas precoces de dentes decíduos.

Based on the importance of the integrity of the deciduous dentition and searching for a better understanding of the etiologic agents or the factors associated to the development of malocclusions in the permanent dentition, the present worked verified the prevalence of early loss of deciduous teeth, as well as the possible causes, the most affected area, age and gender in school children enrolled at Instituto Ana Rosa, aged from two to nine, in the city of Sao Paulo, Brazil. The studied sample was composed by 443 children who were submitted to a clinical examination aiming to identify the children who presented premature loss of any dental element. The analysis of the dental forms was carried out to identify the cause of the loss of the deciduous tooth. Before the results obtained, it was possible to conclude that from a total of 443 children, 21 presented early loss of deciduous tooth (47%). There were no statistically significant differences between the amount of early losses in the maxilla and mandible (Chi-Square – Yates correction, p=0.5023) neither on anterior and posterior regions in the dental arches (Chi-Square – Yates correction, p=0.8231). Equally, there were no differences between the number of losses among the different deciduous teeth (Lillifords test, p>0.05). Significant differences were observed among the ages of the children that had an early loss of deciduous teeth (T-Test, p=0.0002), and the incidence of early loss increased according to the age. There were no differences between the genders related to early loss of deciduous teeth (Chi- Square, p=0.725), that is, gender has not influence the incidence of early loss of those teeth. It was possible to observe that caries appeared more frequently as the most common cause for early loss of deciduous teeth.