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1.
J Dent ; 147: 105098, 2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38797490

RESUMO

OBJECTIVES: This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions. METHODS: 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis. RESULTS: The caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations. CONCLUSIONS: During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss. CLINICAL SIGNIFICANCE: Both SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants. CLINICALTRIALS REGISTRATION NUMBER: NCT03862014.

2.
BMC Oral Health ; 24(1): 548, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38730438

RESUMO

PURPOSE: To evaluate and compare oral health and behavior scores at the first dental visit and dental treatment need using general anesthesia/sedation (GA/S) of children with systemic diseases (SD) and healthy children. METHODS: Data were obtained from healthy children (n = 87) and children with SD (n = 79), aged 4 to 6 years, presenting to a hospital dental clinic for a first dental examination. The total number of decayed, missing and filled teeth (dmft), dental behavior score using Frankl Scale, and dental treatment need using GA/S were recorded. Chi-square / Fisher's exact test and Mann-Whitney U tests were used for statistical analyses. RESULTS: The patients with SD were diagnosed with cardiac disease (61%), renal disease (9%), and pediatric cancers (30%). The median dmft values of the SD group (3.00) were significantly lower than those of healthy children (5.00) (p = 0.02) and healthy children exhibited significantly more positive behavior (90.8%) than children with SD (73.4%) (p = 0.002). The number of patients needing GA/S for dental treatment did not differ significantly between the two groups (p = 0.185). There was no relationship between dental treatment need with GA/S and dental behavior scores of the patients (p = 0.05). A statistically significant relationship was found between the patients' dmft scores and the need for dental treatment using GA/S; and the cut-off value was found to be dmft > 4 for the overall comparisons. CONCLUSION: The presence of chronic disease in children appeared to affect the cooperation negatively at the first dental visit compared to healthy controls, however, it did not affect the oral health negatively. Having a negative behavior score or SD did not necessitate the use of GA/S for dental treatment.


Assuntos
Índice CPO , Humanos , Pré-Escolar , Criança , Feminino , Masculino , Comportamento Infantil , Neoplasias/psicologia , Cardiopatias , Saúde Bucal , Nefropatias , Cárie Dentária , Anestesia Geral , Anestesia Dentária , Estudos de Casos e Controles , Sedação Consciente
3.
BMC Oral Health ; 23(1): 828, 2023 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-37924021

RESUMO

BACKGROUND: The treatment of young permanent first molars with extensive carious tissue loss may often require restoration with preformed crowns. This study compared the clinical and radiographic performance of stainless-steel crowns (SSCs) and preformed zirconia crowns (ZCs). METHODS: Forty-eight molar incisor hypomineralisation (MIH)- or caries-affected permanent molars in 20 healthy patients between 6-13-year-old were randomly divided into ZC and SSC groups (n = 24 teeth/group) in a split-mouth design. The oral hygiene levels of patients were assessed using Greene and Vermillion simplified oral hygiene index (OHI-S). Plaque accumulation and gingival health were evaluated using the Silness&Löe plaque index (PI) and Löe&Silness gingival index (GI), respectively. Clinical retention, marginal extension level, marginal adaptation of crowns and wear of the antagonist teeth were assessed at baseline, 1, 6, 12 and 18 months. The radiological assessments for evaluating the marginal adaptation of crowns and periapical pathology of crowned teeth were performed at 6 and 12 months. The data were analyzed using Kaplan-Meier analysis, Mann-Whitney U test, and two-way ANOVA. RESULTS: A total of forty teeth in 17 children were evaluated for 18 months. ZCs had significantly lower gingival and plaque index values than teeth restored with SSCs during all evaluation periods (p < 0.05). Neither crown type resulted in clinically-detectable wear on opposing dentition or periapical pathology. One ZC was lost at 13 months, while all SSCs survived in function clinically. The cumulative survival rates of ZCs and SSCs were 95.2% and 100% respectively. CONCLUSIONS: Both ZCs and SSCs showed high clinical retention rates in young permanent molars. ZCs had lower plaque accumulation and better gingival health than SSCs, which were consistently associated with mild gingival inflammation. CLINICAL TRIAL REGISTRATION NUMBER: NCT05049694.


Assuntos
Placa Dentária , Dente Decíduo , Criança , Humanos , Adolescente , Estudos Prospectivos , Restauração Dentária Permanente/métodos , Aço Inoxidável , Falha de Restauração Dentária , Dente Molar/diagnóstico por imagem , Coroas
4.
Aust Endod J ; 48(1): 197-201, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35262234

RESUMO

Regenerative endodontic treatment (RET) may not be suitable in some necrotic young permanent molars due to coexistent roots with closed and open apices, and/or inadequate apical bleeding in one or more roots. Here, we present a combined treatment approach utilising conventional root canal treatment in the closed-apex roots and RET on the open-apex roots of necrotic young molars. The closed-apex roots of 8 molars received root fillings, and their open-apex roots were treated with a regenerative endodontic procedure. In another molar, the failed RET on one root was retreated by conventional root canal filling, preserving other revitalised roots. After 4-6 years, all teeth showed periapical healing in the absence of clinical symptoms. The combined conventional and regenerative treatment approach can yield favourable healing outcomes in necrotic, young molar roots with different levels of apical closure. Likewise, failed revitalised roots can be retreated separately with conventional root filling.


Assuntos
Periodontite Periapical , Endodontia Regenerativa , Necrose da Polpa Dentária/diagnóstico por imagem , Necrose da Polpa Dentária/terapia , Humanos , Dente Molar/diagnóstico por imagem , Periodontite Periapical/terapia , Tratamento do Canal Radicular/métodos
5.
Spec Care Dentist ; 38(5): 319-323, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29971831

RESUMO

The difficulty in providing stability to the coronal segment makes cervical root fracture one of the most challenging dental traumatic injury. This type of injury is less frequent in children. However, due to their serious consequences and poor prognosis, tooth loss may occur. This report presents the management of a case of cervical root fracture in an 11-year-old patient with epilepsy. The stabilization of the root-fractured tooth with a splint failed due to the recurrent seizures the patient had. Coronal fragment was removed and vital root submergence was performed in order to support the alveolar growth. The natural tooth crown was incorporated into a modified Nance appliance to meet the esthetic and functional requirements of the patient. After 5-year follow-up, this treatment approach has seemed to offer a long-term provisional and satisfactory solution to the consequences of a cervical root fracture injury.


Assuntos
Epilepsia/complicações , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapia , Raiz Dentária/lesões , Criança , Feminino , Humanos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
6.
Clin Oral Investig ; 21(7): 2235-2243, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27900529

RESUMO

OBJECTIVES: To evaluate and compare the clinical retention of a resin-based fissure sealant placed with an intermediate layer of etch-and-rinse (ER) or self-etch (SE) adhesives. MATERIALS AND METHODS: Two hundred twenty-eight sealants were placed in 57 children with previously unsealed, caries-free permanent first molars, employing a split-mouth design. The teeth were randomized into four groups (n = 57 teeth/groups) according to the adhesive system placed under the tested sealant (Delton FS+; Dentsply). Group 1 (control): no bonding agent (conventional acid-etch sealant); group 2: prior enamel etch + ER adhesive (XP Bond; Dentsply); group 3: SE adhesive (Clearfil SE Bond; Kuraray) without prior etching; and group 4: prior enamel etch + SE adhesive (Clearfil SE Bond). Clinical assessments were performed according to modified USPHS criteria at 1, 3, 6, 12, 18, and 24 months. The data were analyzed statistically using Fisher's Exact test, the Kaplan-Meier analysis, and the Log-rank test. RESULTS: At 24 months, sealants bonded with XP Bond and Clearfil SE Bond with prior enamel etching showed similar retention rates (p > 0.05), and these rates were significantly better than the rates of the conventional sealant and Clearfil-SE groups (p < 0.05). There was no significant difference between the retention rates of the latter two groups (p > 0.05). The cumulative survival rates on palatal/buccal surfaces showed similar outcomes as with occlusal surfaces: XP Bond (94%), Clearfil SE Bond + acid-etch (94%), conventional sealant (52%), and Clearfil SE Bond only (37%). CONCLUSIONS: Application of the tested ER adhesive and the SE adhesive with enamel etching significantly improved the clinical retention of Delton-FS over the 24-month period. CLINICAL RELEVANCE: The use of a resin-based fissure sealant placed with ER or SE adhesive with prior acid-etching yielded better retention than the conventional sealant over the 24-month period.


Assuntos
Colagem Dentária/métodos , Adesivos Dentinários/química , Selantes de Fossas e Fissuras/química , Condicionamento Ácido do Dente , Bis-Fenol A-Glicidil Metacrilato/química , Criança , Feminino , Humanos , Masculino , Teste de Materiais , Estudos Prospectivos , Cimentos de Resina/química , Método Simples-Cego , Propriedades de Superfície , Resultado do Tratamento
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