Management of an unerupted tooth and odontoma after trauma in predecessor

The purpose of this case report was to describe the surgical exposure and orthodontic management of an unerupted and ectopic maxillary right central incisor after trauma to the primary predecessor. Case report: An 11-year-old girl was referred to the Pediatric Dentistry Clinic due to eruption failure of the maxillary right central incisor. Radiographs showed the impacted central incisor located below the anterior nasal spine and its apex parallel to the palatal plane and the presence of an odontoma. General surgery was performed to remove the odontoma and two perforations in the crown of the impacted tooth were made to carry out orthodontic traction. Correct alignment was achieved after 18 months and no significant clinical or radiographic alterations were founded. Conclusion: The orthodontic management was performed successfully, and a positive esthetic outcome combined with adequate occlusion demonstrated the satisfactory results of this case.

Objetivo: O objetivo deste relato de caso foi descrever a exposição cirúrgica e o tratamento ortodôntico de um incisivo central superior direito ectópico e não irrompido após trauma do predecessor decíduo. Relato do caso: Uma menina de 11 anos de idade foi encaminhada à Clínica de Odontopediatria devido ao atraso na erupção do incisivo central superior direito. As radiografias mostraram o incisivo central impactado localizado abaixo da espinha nasal anterior e seu ápice paralelo ao plano palatino e a presença de um odontoma. A cirurgia para remoção do odontoma foi realizada sob anestesia geral e duas perfurações na coroa do dente impactado foram realizadas para a tração ortodôntica. O alinhamento correto foi alcançado após 18 meses e não foram encontradas alterações clínicas ou radiográficas significativas. Conclusão: O manejo ortodôntico foi realizado com sucesso, e um resultado estético positivo combinado à oclusão adequada demonstrou os resultados satisfatórios deste caso.

Hypnosis in the control of pain and anxiety in Pediatric Dentistry: a literature review / Hipnose no controle da dor e da ansiedade em Odontopediatria: uma revisão de literatura

ABSTRACT This study is a literature review on the physical and mental influence of hypnosis in pediatric patient in controlling anxiety and pain. The objective was to gather the evidence found in the analysis of articles, research and systematic reviews, in the period from 1994 to 2018. For a descriptive review were selected Internet portals as Medicine®, Pubmed, Capes, using keywords like: "hypnosis", "pediatric dentistry", "fear", "anesthesia", "anxiety", "children", "pain". Descriptively and concisely, they presented relevant findings regarding associations between hypnosis and dentistry and their applications in controlling anxiety and pain. It was concluded that hypnosis could increase the cooperation of the child patient and decrease the resistance during painful dental procedures. Despite the promising results observed, hypnosis in pediatric dentistry is still seldom used. This may be due to lack of knowledge about the procedure and the absence of formal education, indicating the importance of including Hypnosis in the healthcare professionals' curriculum and their practices.

RESUMO Este estudo trata de uma revisão de literatura sobre a influência física e mental da hipnose no paciente Odontopediátrico no controle da ansiedade e da dor. Objetivou-se reunir as evidências encontradas em artigos de análise, pesquisa e revisões sistemáticas, compreendendo o período de 1994 até 2018. Para uma revisão descritiva foram selecionados portais na internet como Bireme, Pubmed, Periódicos Capes, por meio de palavras-chave como: "hypnosis", "pediatric dentistry", "fear", "anesthesia", "anxiety", "children" "pain". Foram apresentados de forma descritiva e concisa relevantes achados referentes às associações entre a hipnose e Odontopediatria e suas aplicações no controle da ansiedade e da dor. Concluiu-se que a hipnose pode aumentar a cooperação do paciente infantil e diminuir a resistência durante os procedimentos odontológicos dolorosos. Apesar dos resultados promissores observados, a hipnose em Odontopediatria ainda é pouco utilizada. Isto ocorre devido à ausência de conhecimento sobre o procedimento e a falta de treinamento durante a formação superior, demonstrando a importância da inclusão deste tema nos currículos dos profissionais de saúde e em suas práticas clínicas.

Can the Enterococcus faecalis identified in the root canals of primary teeth be a cause of failure of endodontic treatment?

OBJECTIVE: This study investigated the presence of Enterococcus faecalis in primary teeth with primary root canal infections and related to the possible failure of pulpectomy outcome after 36 months. MATERIAL AND METHODS: Root canal samples were obtained from 25 out of 244 patients using the sterile paper cone method. The identification of E. faecalis was done with culture and molecular tests using species-specific 16S rRNA gene-based polymerase chain reaction (PCR). After 36 months, the pulpectomy outcome was evaluated. RESULTS: Enterococcus faecalis was found in five (20%) samples, and dental caries were the cause of primary infection in all of them. Pulpectomy outcome was evaluated only in teeth that completed the entire clinical protocol and were followed up to 36 months (n = 8). From these, 75% (n = 6) were successful and 25% (n = 2) failed. E. faecalis was present in 50% of both successful and failed cases. CONCLUSIONS: Enterococcus faecalis was not related to the failure of endodontic treatment of primary teeth.

Management of an unerupted dilacerated maxillary central incisor after trauma to the primary predecessor.

The most common cause of permanent maxillary incisor dilaceration is usually trauma to the primary predecessor, such as avulsions, intrusions, or gross displacement of primary incisors. The purpose of this case report was to describe the surgical exposure and orthodontic traction of an unerupted dilacerated permanent maxillary central incisor performed on a young girl. During the surgical exposure, a hole was placed in the tooth crown, and elastic chains, inserted though the hole, were used for traction. The alignment and leveling of the impacted incisor were performed with sequential stainless steel wires. Good periapical and periodontal health, combined with adequate occlusion and a positive esthetic outcome, demonstrated the satisfactory results of this case.

The influence of smear layer removal on primary tooth pulpectomy outcome: a 24-month, double-blind, randomized, and controlled clinical trial evaluation.

BACKGROUND: The effect of smear layer (SL) removal on primary tooth pulpectomy outcome has not been well elucidated. AIM: To determine the effect of SL removal on primary tooth pulpectomy outcome. METHODS: This is a double-blind, randomized, and controlled clinical trial. Forty-eight patients were randomly divided into SL removal (G1 = 40 teeth) or smear layer nonremoval (G2 = 42 teeth) groups. Following the chemomechanical preparation with K-files and 2.5% sodium hypochlorite (NaOCl), teeth were irrigated with either 6% citric acid and 0.9% physiologic solution (G1) or only 0.9% physiologic solution (G2). Camphorated paramonochlorophenol was used as intracanal medication. At the second appointment, 1 week after, root canals were filled with zinc oxide-eugenol paste. Clinical and radiographical baseline criteria were stipulated equally for both groups. RESULTS: The success rate (G1 = 91.2%; G2 = 70.0%) was statistically different (P = 0.04) between the groups. In G2, the outcome was affected significantly by pulpal necrosis (P = 0.02), pre-operatory symptoms (P = 0.02), and periapical/inter-radicular radiolucency (P = 0.04). CONCLUSION: The pulpectomy outcome was improved by smear layer removal. The outcome for teeth with pulpal necrosis, pre-operatory symptoms, or periapical/inter-radicular radiolucency was significantly improved by removal of the smear layer.

Long-term outcomes of primary tooth pulpectomy with and without smear layer removal: a randomized split-mouth clinical trial.

PURPOSE: The aim of this study was to evaluate, via clinical and radiographic assessment, pulpectomy outcomes performed on primary anterior teeth both with and without a citric acid solution to enhance smear layer removal. METHODS: Patients with a matched pair of primary incisors (split-mouth design) with irreversible pulp changes were selected. A total of 36 teeth (18 children) received pulpectomies and were followed for 36 months. Pulpectomies were performed using sodium hypochlorite and saline solution as canal irrigants; during the last irrigation, the tooth was randomly selected to receive ( Group 1) or not receive (Group 2) the citric acid solution for smear layer removal. The roots were filled with ZOE paste. RESULTS: Overall pulpectomy success was 90.6%. Cases with smear layer removal were successful 82.3% of the time; those without smear layer removal, 88.2%, and there were no statistical differences (P=1.00). CONCLUSION: Pulpectomy with smear layer removal in primary incisors exhibited, after 36 months, a high success rate; however, comparable results were obtained when the smear layer was not removed.

Ectopic eruption of permanent incisors after predecessor pulpectomy: five cases.

Pulpectomy in primary teeth is a common technique that preserves teeth in the oral environment and maintains or recovers periapical tissues to a healthy condition. This article describes the ectopic eruption of permanent incisors whose primary predecessors underwent pulpectomy using ZOE filler paste. In a group of 135 teeth that received pulpectomy therapy due to caries, 10 primary maxillary incisors had overretention and were followed for at least 3.5 years (mean time of 4.2 years), both clinically and radiographically, until the permanent teeth erupted. The proposed treatment included extraction of the overretained primary incisors based on permanent successor eruption chronology and contralateral eruption. Seven permanent teeth erupted ectopically. Autocorrection of the permanent tooth positions was observed in five cases. It can be concluded that periodic clinical and radiographic assessments are essential to verify radicular and filling paste resorptions and to avoid overretention and any subsequent malocclusion.

Pulpectomias com Remoção de Smear-Layer em Dentes Decíduos Anteriores: Cinco Anos de Acompanhamento / Pulpectomies with Smear Layer Removal in Primary Anterior Teeth–Five Years of Follow Up

Objetivo: Avaliar a eficácia de pulpectomias com remoção de smear layer em dentes decíduos anteriores e as condições clínicas dos sucessores permanentes após cinco anos de acompanhamento clínico e radiográfico.Método: Foram selecionadas crianças com idade entre três a cinco anos, clinicamente saudáveis, com necessidade de tratamento do canal radicular em dentes anteriores decorrente de cárie e/ou traumatismo dento-alveolar. O preparo químico-mecânico consistiu da instrumentação com limas K e hipoclorito de sódio 1,0% e na irrigação final, o ácido cítrico a 6,0% foi utilizado para remoção da smear layer. Os condutos foram obturados com o cimento de OZE e todos os dentes restaurados com compósito fotopolimerizável. A avaliação clínica e/ou radiográfica ocorreu no primeiro mês e sucessivamente durante seis meses até cinco anos pós-tratamento ou até a erupção do sucessor permanente.Resultados: O índice de sucesso observado foi de 91,5%. Após cinco anos de acompanhamento, trinta e oito dentes permanentes sucessores (80,9%) estavam erupcionados. Destes, cinco (10,6%) elementos apresentaram erupção ectópica e cinco (10,6%) apresentaram opacidades no esmalte. Não foi observada associação entre o desfecho do tratamento (sucesso ou insucesso) e determinadas variáveis observadas, como o motivo da alteração pulpar, diagnóstico pulpar, presença de lesão periapical e extensão da obturação. Conclusão: Após cinco anos de acompanhamento, as pulpectomias de dentes decíduos anteriores com remoção de smear layer apresentaram alto índice de sucesso sugerindo que o uso do ácido cítrico favoreceu o desempenho da terapia. Foi observado um número reduzido de opacidades do esmalte e de erupção ectópica nos permanentes sucessores.

A partir dos resultados observados, recomenda-se a realização de novos estudos clínicos, preferencialmente controlados e randomizados, utilizando o mesmo protocolo e incluindo molares, a fim de comprovar a efetividade da remoção de smear layer nas pulpectomias de dentes decíduos

Objective: To evaluate the efficacy de pulpectomies with removal of smear layer in primary anterior teeth and the clinical conditions of the permanent successors after five years of clinical and radiographic follow up.Method: Clinically healthy children aged 3 to 5 years requiring root canal treatment in anterior teeth due to caries and/or dentoalveolar trauma were selected. The chemomechanical preparation consisted of instrumentation with K files and 1.0% sodium hypochlorite and final irrigation with 6.0% citric acid for removal of smear layer. The canalswere filled with ZOE and all teeth were restored with photoactivated composite resin. Clinical and/or radiographic evaluation was carried out in the first month and then successively during six months up to five years posttreatment or up to eruption of the permanent successor.Results: The success rate was 91.5%. After five years of follow up, 38 permanent successors (80.9%) had erupted. From these, 5 (10.6%) teeth erupted ectopically and five (10.6%) presented enamel opacities. There was no association between treatment outcome (success or failure) and certain factors, such as pulpal alteration, pulpal diagnosis, presence of periapical lesion and apical limit of obturation. Conclusion: After five years of follow up, the pulpectomies in primary anterior teeth with removal of smear layer presented a high success rate, suggesting that the use of citric acid was favorable to the therapy. There was a small number of enamel opacities and ectopic eruptions of the permanent successors. Based on the obtained results, it is recommended the development of new clinical studies, especially controlled and randomized trials, using the same protocol and including molars, in order to confirm the effectiveness of smear layer removal in the pulpectomies of primary teeth

Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus.

The present study evaluated the antimicrobial activity of three root canal irrigants against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. These microorganisms were incubated in the presence of citric acid (6 and 10%), EDTA (17%), and NaOCl (0.5, 1.0, 2.5, and 5.25%). Agar diffusion tests were performed and redox indicator resazurin was used to evaluate the inhibitory effect of the irrigants on the metabolic activity of these microorganisms. The mean diameters of the inhibition zones for the C. albicans cultures were 11.6 mm (17% EDTA), 5.5 mm (0.5% NaOCl), 12.9 mm (1% NaOCl), 22.1 mm (2.5% NaOCl), and 28.5 mm (5.25% NaOCl). The mean diameters of the inhibition zones for E. faecalis were 2.8 mm (1% NaOCl), 5.4 mm (2.5% NaOCl), and 8.3 mm (5.25% NaOCl). For S. aureus, the mean values were 8.0 mm (17% EDTA), 3.0 mm (1% NaOCl), 8.8 mm (2.5% NaOCl), and 10.0 mm (5.25% NaOCl). Most of the irrigant solutions presented effective antimicrobial activity against C. albicans. A high inhibitory effect on the metabolic activity of E. faecalis was detected when the microorganisms were incubated with 17% EDTA. The same result was reached when S. aureus was incubated in the presence of > 2.5% NaOCl. Altogether, these results indicate that 2.5% and 5.25% NaOCl are microbicides against S. aureus while 0.5% and 1% NaOCl are only microbiostatic against the tested bacteria. The 6% and 10% citric acid as well as 17% EDTA did not affect the viability of any of the assayed microorganisms.

Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus

The present study evaluated the antimicrobial activity of three root canal irrigants against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. These microorganisms were incubated in the presence of citric acid (6 and 10 percent), EDTA (17 percent), and NaOCl (0.5, 1.0, 2.5, and 5.25 percent). Agar diffusion tests were performed and redox indicator resazurin was used to evaluate the inhibitory effect of the irrigants on the metabolic activity of these microorganisms. The mean diameters of the inhibition zones for the C. albicans cultures were 11.6 mm (17 percent EDTA), 5.5 mm (0.5 percent NaOCl), 12.9 mm (1 percent NaOCl), 22.1 mm (2.5 percent NaOCl), and 28.5 mm (5.25 percent NaOCl). The mean diameters of the inhibition zones for E. faecalis were 2.8 mm (1 percent NaOCl), 5.4 mm (2.5 percent NaOCl), and 8.3 mm (5.25 percent NaOCl). For S. aureus, the mean values were 8.0 mm (17 percent EDTA), 3.0 mm (1 percent NaOCl), 8.8 mm (2.5 percent NaOCl), and 10.0 mm (5.25 percent NaOCl). Most of the irrigant solutions presented effective antimicrobial activity against C. albicans. A high inhibitory effect on the metabolic activity of E. faecalis was detected when the microorganisms were incubated with 17 percent EDTA. The same result was reached when S. aureus was incubated in the presence of > 2.5 percent NaOCl. Altogether, these results indicate that 2.5 percent and 5.25 percent NaOCl are microbicides against S. aureus while 0.5 percent and 1 percent NaOCl are only microbiostatic against the tested bacteria. The 6 percent and 10 percent citric acid as well as 17 percent EDTA did not affect the viability of any of the assayed microorganisms.

Mechanical properties of one and two-step fluoridated orthodontic resins submitted to different pH cycling regimes.

The aim of this study is to assess the in vitro shear bond strength and adhesive remnant index (ARI) of one and two-step fluoridated orthodontic resins under conditions that simulate high cariogenic challenge. Edgewise brackets for maxillary central incisors were randomly bonded to 80 bovine incisors, using either Transbond Plus Color Change orthodontic resin and a self-etching primer adhesive (G1; n = 40) or Orthodontic Fill Magic with a conventional acid-etch technique (G2; n = 40). Each group of resin (n = 10) was divided into: immediate shear (A- pre-cycling control), immersion in artificial remineralizing saliva (neutral saliva) for 14 days (B- post-cycling control) and pH cycling with high cariogenic challenge (C- acid saliva with pH 5.5 and D- acid saliva with pH 4.5). After 14 days of pH cycling, the shear bond strength and ARI were evaluated. Considering the shear bond strength, Transbond Plus Color Change resin was stronger than Orthodontic Fill Magic when it was submitted to high cariogenic challenge (p < 0.05). Also Transbond Plus Color Change resin showed better adhesion to enamel than Orthodontic Fill Magic, in all situations evaluated (p < 0.05). It could be concluded that Transbond Plus Color Change resin presented better shear bond strength and adhesive remnant index when submitted to high cariogenic challenge, in comparison with Orthodontic Fill Magic.

Mechanical properties of one and two-step fluoridated orthodontic resins submitted to different pH cycling regimes

The aim of this study is to assess the in vitro shear bond strength and adhesive remnant index (ARI) of one and two-step fluoridated orthodontic resins under conditions that simulate high cariogenic challenge. Edgewise brackets for maxillary central incisors were randomly bonded to 80 bovine incisors, using either TransbondTM Plus Color Change orthodontic resin and a self-etching primer adhesive (G1; n = 40) or Orthodontic Fill Magic with a conventional acid-etch technique (G2; n = 40). Each group of resin (n = 10) was divided into: immediate shear (A- pre-cycling control), immersion in artificial remineralizing saliva (neutral saliva) for 14 days (B- post-cycling control) and pH cycling with high cariogenic challenge (C- acid saliva with pH 5.5 and D- acid saliva with pH 4.5). After 14 days of pH cycling, the shear bond strength and ARI were evaluated. Considering the shear bond strength, TransbondTM Plus Color Change resin was stronger than Orthodontic Fill Magic when it was submitted to high cariogenic challenge (p < 0.05). Also TransbondTM Plus Color Change resin showed better adhesion to enamel than Orthodontic Fill Magic, in all situations evaluated (p < 0.05). It could be concluded that TransbondTM Plus Color Change resin presented better shear bond strength and adhesive remnant index when submitted to high cariogenic challenge, in comparison with Orthodontic Fill Magic.

Orthodontic concerns of Brazilian children and their parents compared to the normative treatment need.

The objective of the present study was to evaluate the interest of both children and parents towards orthodontic treatment and compare it to the normative treatment need as well as to determine the factors related to such an interest. The sample consisted of 407 schoolchildren aged between 9 and 12 years and their parents from Nova Friburgo (Rio de Janeiro), Brazil. The orthodontic concern expressed by children and parents was obtained by means of a questionnaire. The normative need was evaluated using two components of the Index of Orthodontic Treatment Need (IOTN). Data analysis involved multiple logistic regression. Normative treatment need was greater than the children's self-perceived treatment need. The parents expressed more interest towards orthodontic treatment of their children than the children themselves. The orthodontic concern expressed by both groups was greater than the normative need for orthodontic treatment, and such a finding was associated with gender of the children (female) and self-perceived treatment need expressed by them. The lack of a relationship between the normative treatment need and the orthodontic concern of children and parents shows that such assessments should be performed when orthodontic treatment is indicated, particularly in terms of public health, as the demand is greater than the services supplied.

Preventive effect of fluoridated orthodontic resins subjected to high cariogenic challenges.

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.

Preventive effect of fluoridated orthodontic resins subjected to high cariogenic challenges

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.

O objetivo do presente estudo foi avaliar in vitro o efeito preventivo a cárie de resinas ortodônticas fluoretadas submetidas à ciclagem de pH utilizando dois tipos de saliva desmineralizadora. Bráquetes de incisivos centrais foram colados em 60 incisivos bovinos, utilizando a resina ortodôntica Transbond Plus Color Change (n=30) ou Fill Magic (n=30). Cada grupo foi dividido em 3 subgrupos (n=10): imersão em saliva artificial remineralizante por 14 dias e simulação de alto desafio cariogênico com ciclagem de pH em saliva ácida com pH 5,5 ou pH 4,5. Após 14 dias de ciclagem de pH, o efeito preventivo de cárie foi avaliado por meio da formação de halo de inibição da mancha branca, adotando-se os escores: 0-ausência e 1-presença. Os testes Kruskal Wallis e Man-Whitney (a=0,05) foram aplicados. A formação de lesões de mancha branca foi observada somente na ciclagem de pH com saliva ácida a pH 4,5; sendo o Transbond Plus Color Change significantemente mais efetivo na prevenção ao desenvolvimento de mancha branca quando comparados ao Fill Magic (p<0,05). O pH da solução desmineralizante influenciou na formação de lesões de mancha branca circunjacentes aos bráquetes em condições de alto desafio cariogênico. A Transbond Plus Color Change apresentou maior efeito preventivo de cárie em relação ao Fill Magic.

Prevalência de más oclusões em crianças de 9 a 12 anos de idade da cidade de Nova Friburgo (Rio de Janeiro) / Prevalence of malocclusion in children aged 9 to 12 years old in the city of Nova Friburgo, Rio de Janeiro State, Brazil

INTRODUÇÃO: o conhecimento da situação epidemiológica da população é importante para o planejamento e execução dos serviços odontológicos. OBJETIVOS: avaliar a prevalência de más oclusões em escolares de 9 a 12 anos de idade da rede municipal de ensino da cidade de Nova Friburgo (Rio de Janeiro). MÉTODOS: a amostra, selecionada aleatoriamente, foi composta por 407 crianças (53,1 por cento do gênero feminino), que foram avaliadas por um profissional treinado, após autorização de seus responsáveis. RESULTADOS: as más oclusões mais prevalentes foram apinhamento (45,5 por cento), sobressaliência exagerada (29,7 por cento), mordida cruzada posterior (19,2 por cento), diastemas anteriores (16,2 por cento), dente parcialmente irrompido (12,0 por cento) e sobremordida exagerada (10,8 por cento). A relação molar mais presente foi a de Classe I (76,7 por cento). A presença de diastemas foi maior no gênero feminino e a sobremordida exagerada foi mais prevalente no gênero masculino, ambas na dentição mista. Sobressaliência negativa e presença de dente parcialmente irrompido tiveram maior prevalência na dentição permanente. CONCLUSÃO: observou-se que a simples avaliação da prevalência das más oclusões não revela a gravidade nem a hierarquia da necessidade de tratamento, fatores importantes no planejamento em Saúde Pública.

INTRODUCTION: Knowledge of a population's epidemiological situation is important in the planning and provision of dental services. OBJECTIVES: Assess the prevalence of malocclusion in children aged 9 to 12 years old from public schools in the city of Nova Friburgo, Rio de Janeiro State, Brazil. METHODS: A randomly selected sample consisting of 407 children (53.1 percent female) who were evaluated by a trained professional, after parental consent. RESULTS: The most prevalent malocclusions were crowding (45.5 percent), excessive overjet (29.7 percent), posterior crossbite (19.2 percent), anterior diastema (16.2 percent), partially erupted teeth (12.0 percent) and excessive overbite (10.8 percent). Class I molar relationship prevailed (76.7 percent). The presence of diastemas was higher in females and excessive overbite was more prevalent in males, both in mixed dentition. Negative overjet and the presence of partially erupted teeth had a higher prevalence in permanent dentition. CONCLUSION: It was observed that the mere evaluation of malocclusion prevalence does not reveal case severity or treatment need, both of which are important factors in public health planning.

Orthodontic treatment need in a group of 9-12-year-old Brazilian schoolchildren.

The present study aimed to evaluate the need for orthodontic treatment in Brazilian schoolchildren presenting both late mixed dentition and early permanent dentition as well as to determine the possible factors associated with this necessity. Our randomly selected sample consisted of 407 schoolchildren aged between 9 and 12 years from Nova Friburgo (State of Rio de Janeiro), Brazil. All the children were evaluated according to the two components of the Index of Orthodontic Treatment Need (IOTN), namely, the Dental Health Component (DHC) and the Aesthetic Component (AC). Data analysis involved multiple logistic regression. Definite need for orthodontic treatment was found in 34.2% and 11.3% of the children according to, respectively, DHC and AC. The most prevalent malocclusions included the following: contact point displacement (crowding), crossbite, and increased overjet. Male gender, permanent dentition and aesthetic reasons were factors associated with a great need for orthodontic treatment. It was concluded that about one-third of the children evaluated had a definite need for orthodontic treatment. This necessity was greater in the permanent dentition, thus emphasizing the importance of an early identification of malocclusions and a timely referral of patients for treatment. The correlation between AC and DHC was considered important since they involve distinctive characteristics.

Histopathologic and SEM analysis of primary teeth with pulpectomy failure.

OBJECTIVE: The objective of this study was to identify the probable factors associated with pulpectomy failure of primary teeth through qualitative analysis by histopathology (HIST) and scanning electron microscopy (SEM). STUDY DESIGN: A longitudinal clinical investigation of the efficacy of pulpectomy in primary teeth with irreversible pulp changes was carried out with 133 teeth (66 children) evaluated up to 48 months. The overall success was 86.1% during follow-up. Of the 18 teeth extracted as a result of treatment failure, 8 presented sufficiently undamaged roots to be randomly selected for HIST (n = 4) and SEM (n = 4) analysis. RESULTS: Necrotic tissue and chronic inflammatory cells were observed in all specimens submitted to HIST as external radicular resorption associated with Howship's lacunae. SEM analysis showed apical and furcation areas heavily infected with microorganisms and Howship's lacunae. CONCLUSION: These findings suggest that the main factors responsible for pulpectomy failure were technique limitations associated with the morphological irregularities created by external/inflammatory resorption.

Correlação dos hábitos de dieta e higiene oral de crianças com os níveis de Streptococcus mutans / Correlation between dietary and oral hygiene habits and the Streptococcus mutans levels in schoolchildren

Objetivo: Avaliar a correlação dos hábitos de dieta e higiene oral com os níveis de Streptococcus mutans (SM) e de biofilme entre escolares. Método: Oitenta e duas crianças de 6-8 anos de idade foram selecionadas para o estudo. Um questionário foi utilizado com os responsáveis pelas crianças. Utilizou-se o método da espátula de madeira para coleta de saliva, sendo pressionada sobre a placa Rodac®, contendo 12 ml do meio MSKB. As placas foram incubadas por 72 horas em jarra de anaerobiose, com atmosfera de N2 (80%), H2 (10%) e CO2 (10%) a 37°C. As UFC foram contadas, utilizando microscópio estereoscópio e expressas em escores, de acordo com o seguinte critério: *0 = Ausência de SM; *1 = Baixo (1-10UFC); *2 = Médio (11-100 UFC); *3 = Elevado (101-250 UFC); *4 =Muito Elevado (> 250 UFC). Para análise estatística usou-se o programa SPSS. Resultados: 82% das crianças tinham nível médio de SM. Níveis alto e muito alto de SM foram observados em 55% das crianças que consumiam doces entre as refeições (x2= 0,509). Apesar de não ter sido significante a relação entre nível de SM e hábitos de higiene oral (P = 0,228), observou-se que as crianças que escovavam seus dentes três vezes ou mais possuíam níveis baixos ou médios de SM. Conclusão: Os hábitos de dieta e higiene oral não mostraram correlação estatisticamente significante com níveis de SM, e essa correlação não foi encontrada com o índice de biofilme.

Orthodontic treatment need in a group of 9-12-year-old Brazilian schoolchildren

The present study aimed to evaluate the need for orthodontic treatment in Brazilian schoolchildren presenting both late mixed dentition and early permanent dentition as well as to determine the possible factors associated with this necessity. Our randomly selected sample consisted of 407 schoolchildren aged between 9 and 12 years from Nova Friburgo (State of Rio de Janeiro), Brazil. All the children were evaluated according to the two components of the Index of Orthodontic Treatment Need (IOTN), namely, the Dental Health Component (DHC) and the Aesthetic Component (AC). Data analysis involved multiple logistic regression. Definite need for orthodontic treatment was found in 34.2 percent and 11.3 percent of the children according to, respectively, DHC and AC. The most prevalent malocclusions included the following: contact point displacement (crowding), crossbite, and increased overjet. Male gender, permanent dentition and aesthetic reasons were factors associated with a great need for orthodontic treatment. It was concluded that about one-third of the children evaluated had a definite need for orthodontic treatment. This necessity was greater in the permanent dentition, thus emphasizing the importance of an early identification of malocclusions and a timely referral of patients for treatment. The correlation between AC and DHC was considered important since they involve distinctive characteristics.