Mechanical stress distribution over the palate by different pacifiers assessed by finite element analysis and clinical data.

The mechanical behavior of each type of pacifier on rigid structures and their various impacts on orofacial growth have yet to be discovered. The study aimed to evaluate the stress distribution over a child's palate by three types of pacifiers using finite element analysis and clinical and laboratory data. Modulus of elasticity was obtained from 30 specimens comprising 10 of each conventional (A), orthodontic (B), and breast-shaped (C) pacifiers. Tongue strength was assessed in eight 3-year-old children (kPa). A hemi-maxilla model was obtained from 2- to 3-year-old skull tomography, and the images of pacifiers A, B, and C were captured using 3D scanning. The Hypermesh® program generated a mesh of 6-node tetrahedral elements for applying forces in the X, Y, and Z directions to enable a nonlinear analysis. Pacifier B exhibited the highest values for distributed stress on the palate, followed by pacifier A. Pacifier B stimulated the maxilla forward and sideways. In contrast, pacifier A promoted a forward and upward load, favoring a more atresic palate. Pacifiers A and B tended to rotate in the sagittal plane, generating tensions in the anterior incisors and favoring the open bite. Pacifier C exhibited lateral expansion by stress induction over the mid-palatal suture with less influence on incisor inclination. Pacifiers showed different detrimental stress distributions on the palate. This information can be helpful for improving recommendations given to parents.

Impact of COVID-19 on pediatric dental care in two epicenters: Italy and Brazil.

The study aimed to compare the adherence of Brazilian and Italian pediatric dentists to the biosafety measures and operative protocols recommended by the health authorities during COVID-19 pandemic and to classify the participants according to their risk of infection. An online questionnaire with 34 questions about sociodemographic and occupational data, dental practice organization, biological risk management, and clinical operative protocols was sent to Brazilian and Italian pediatric dentists using a convenience sampling strategy. Chi-square test and multivariate analysis (two-step cluster) were performed (α = 5%). Of 641 respondents (377 Brazilians and 264 Italians), most were female (94% and 70%, respectively), aged 20-39 years (63%), with over 10 years of professional experience (58% and 49%, respectively). Based on adherence to recommended biosafety measures, participants were classified as "safer" (n = 219) or "less safe" (n = 422). Adherence to recommended protocols by the majority of participants resulted in low contagion rates (Brazilians = 5%; Italians = 12.5%). Participants with extensive professional experience in the dental setting exhibited a greater tendency to implement multiple adaptations (three or more) in their practice. Most participants (Brazilians = 92%; Italians = 80.7%) adopted the recommended minimal intervention dentistry approaches, with the use of fissure sealants and the use of non-rotary instruments for caries removal the most frequently techniques used among Brazilians (36%) and Italians (66%), respectively. Two different profiles of pediatric dentists were identified based on the biosafety protocols adopted during the pandemic. In addition, changes were implemented in the dental care provided to children, with focus on the minimal intervention dentistry.

One-year clinical evaluation of oral rehabilitation after the loss of multiple primary teeth.

This article describes a one-year follow-up of the prosthetic rehabilitation of a child who lost multiple primary teeth due to widespread dental caries. Clinical and radiographic examinations indicated the need for all primary teeth to be extracted. Following the extractions, complete maxillary and mandibular removable prostheses with individualized occlusion and age-appropriate artificial teeth were fitted for functional and esthetic rehabilitation. The treatment improved the patient's speech, masticatory function, and facial esthetics, contributing to the development of normal dietary habits and social integration.

Impact of COVID-19 on pediatric dental care in two epicenters: Italy and Brazil

Abstract The study aimed to compare the adherence of Brazilian and Italian pediatric dentists to the biosafety measures and operative protocols recommended by the health authorities during COVID-19 pandemic and to classify the participants according to their risk of infection. An online questionnaire with 34 questions about sociodemographic and occupational data, dental practice organization, biological risk management, and clinical operative protocols was sent to Brazilian and Italian pediatric dentists using a convenience sampling strategy. Chi-square test and multivariate analysis (two-step cluster) were performed (α = 5%). Of 641 respondents (377 Brazilians and 264 Italians), most were female (94% and 70%, respectively), aged 20-39 years (63%), with over 10 years of professional experience (58% and 49%, respectively). Based on adherence to recommended biosafety measures, participants were classified as "safer" (n = 219) or "less safe" (n = 422). Adherence to recommended protocols by the majority of participants resulted in low contagion rates (Brazilians = 5%; Italians = 12.5%). Participants with extensive professional experience in the dental setting exhibited a greater tendency to implement multiple adaptations (three or more) in their practice. Most participants (Brazilians = 92%; Italians = 80.7%) adopted the recommended minimal intervention dentistry approaches, with the use of fissure sealants and the use of non-rotary instruments for caries removal the most frequently techniques used among Brazilians (36%) and Italians (66%), respectively. Two different profiles of pediatric dentists were identified based on the biosafety protocols adopted during the pandemic. In addition, changes were implemented in the dental care provided to children, with focus on the minimal intervention dentistry.

Marginal adaptation of pit and fissure sealants after thermal and chemical stress. A SEM study.

PURPOSE: To evaluate the in vitro marginal adaptation (gap formation) in the fissure of different sealer materials (resin sealant, glass-ionomer cement, resin-modified glass-ionomer cement, and adhesive system) submitted to thermal and chemical stress, using scanning electron microscopy evaluation (SEM). METHODS: 80 impacted human third molars were randomly assigned to the following experimental groups (n = 10): FluroShield (F), Helioseal Clear Chroma (H), Vitremer (V), Fuji II-LC (FII), Ketac-Molar (KM), Fuji IX (FIX), Single Bond (SB), and Clearfil Protect Bond (CF). All groups were subjected to thermocycling and 14 days of pH cycling. A blinded and calibrated examiner performed SEM analysis. Gap formation was scored according to: 0 = no sealant marginal gaps; 1 = sealant marginal gaps present or total sealant loss. The score 0 was considered a success, while score 1 represented failure. Data were analyzed by Kruskal-Wallis and Bonferroni tests (P < 0.05). RESULTS: The success rates of SB (100%) and V (90%) were similar, but statistically superior to F (30%), H (20%), FIX (20%), and CF (0%) (P < 0.05). A tendency for similar behaviors of FII and KM to SB and V was observed and for similar behaviors of F, FIX and H to CF. The worst results were obtained for CF.

Bond strength of different orthodontic brackets produced with different materials and fabrication methods / Resistência de união de bráquetes ortodônticos produzidos com diferentes materiais e métodos de fabricação

Objective: The aim of this study was to evaluate the effects of material and processing methods on the bond strength of orthodontic brackets. Material and Methods: Five types of brackets were tested: Conventional metallic (CM), metallic sandblasted (SB), ceramic (C), polycarbonate (PC), and metallic fabricated by melting injection molding (MIM). Shear bond strength (SBS) was conducted to check bond strength of the brackets bonded to bovine teeth (n=10/group), and tensile bond strength (TBS) (20 brackets/group) to check bracket retention to bonding material (n=20/group). Both, SBS and TBS were conducted with 1mm/min crosshead speed in a universal testing machine. Bond strength was calculated in Megapascal (MPa) based on force (N) and bracket area (mm 2). Data normality was verified, and One-way ANOVA was the statistical test with Tukey post-hoc (α=0.05). Results: SB and MIM presented higher SBS compared to C, PC, and CM (p<0.05). SB and MIM also presented significantly higher TBS compared to CM and PC (p<0.05). However, MIM was not different of C for TBS. Conclusion: The type of material and method of fabrication are determinant factors that affect bond strength of orthodontic brackets and melting injection molding (MIM) is a remarkable technology to improve brackets retention during the orthodontic treatment. (AU)

Objetivo: O objetivo deste estudo foi avaliar os efeitos dos materiais e métodos de processamento na resistência de união de bráquetes ortodônticos. Material e Métodos: Cinco tipos de bráquetes foram testados: Convencionais metálicos (CM), metálicos jateados (SB), cerâmico (C), policarbonato (PC), e metálico fabricado por injeção de metal fundido em molde (MIM). A resistência de união ao cisalhamento (SBS) foi conduzida para verificar a resistência de união dos bráquetes aderidos a dentes bonivos (n=10/grupo) e a resistência à tração (TBS) (20 bráquetes/grupo) para verificar a retenção do bráquete ao material adesivo (n=20/grupo). SBS e TBS foram conduzidas com relação carga/velocidade de 1mm/min em uma máquina de ensaios universal. A resistência de união foi calculada em Megapascal (MPa) com base na força (N) pela área do bráquete (mm 2). A normalidade dos dados e a estatística foi realizada utilizando One-way ANOVA e Tukey post-hoc (α=0.05). SB e MIM apresentaram os maiores valores de SBS comparados com C, PC e CM (p<0.05). Resultados: SB e MIM também apresentaram valores significativamente maiores de TBS comparados com CM e PC (p<0.05). Contudo, os valores de TBS para o grupo MIM não foram significativamente diferentes de C. Conclusão: O tipo de material e o método de fabricação são fatores determinantes que afetam a resistência de união de bráquetes ortodônticos e a injeção de metal fundido em molde (MIM) é uma tecnologia relevante para melhorar a retenção dos bráquetes durante o tratamento ortodôntico. (AU)

Compressive strength recovery by composite onlays in primary teeth. Substrate treatment and luting agent effects.

OBJECTIVES: To evaluate 1% NaOCl treatment and two resin luting agent effects on compressive strength recovery in composite onlays on primary teeth and to analyze the fractures type. METHODS: Forty sound primary molars crowns were prepared in the standard machine and randomly divided into four groups (n=10): G1 (1% NaOCl/ 30 min+EnForce); G2 (without 1% NaOCl EnForce); G3 (1% NaOCl/ 30 min+Rely X); G4 (without 1% NaOCl+Rely X). The onlays were made using Z250 composite on plaster models. Ten sound teeth were used as control group (CG). All groups were submitted to compression mechanic test in a universal test machine INSTRON at 1mm/min cross-head speed. After that, the data (kgf) were submitted to ANOVA test (alpha=0.05). Finally, the fracture types were classified in a crescent scale (1-5) related with severity degree and submitted to Fisher's Exact Test (p<0.05). Scanning electronic microscope analysis was done in order to illustrate the fractures sites. RESULTS: The values of compressive strength of experimental groups did not differ each others neither from control group (p>0.05). The results from fracture type showed that types 5 and 4 fractures (most severe) present the highest percentage to experimental groups. Conversely, the CG showed higher percentage of fracture types 2 and 3. CONCLUSIONS: This research found that the composite onlays recovered the compressive strength compared to sound teeth, regardless of the substrate treatment and cement agent used. Nevertheless, no group showed similar type of fractures to CG, which had more frequency of less severe fracture types.

Obesity and dental caries--A systematic review.

PURPOSE: The purpose of this paper was to undertake a systematic review about the relationship between obesity in childhood, adolescence and/or adulthood and the prevalence of dental caries. METHODS: The authors searched Bireme, Medline, ISI, Cochrane Library and the internet for papers from 1984-2004. The main search terms were 'obesity' and 'dental caries'. The inclusion criteria were studies that defined obesity (body mass index) and dental caries (total number of decayed, and filled teeth - DFT/DFS/dft/dfs) in their subjects. The following were excluded from this paper: articles on reviews, dietary guidelines, policy statements, papers related to oral health and nutrition deficiency--underweight, and with no relation between obesity and dental caries prevalence or dental health problems. RESULTS: No systematic review has focused on correlating obesity and caries and only three stud ies had high levels of evidence. CONCLUSION: Only one study with high level of evidence showed direct association between obesity and dental caries. In view of the findings, further well-designed randomised studies are needed to demonstrate the relationship between dental caries and obesity.

Bond strength between fiber posts and composite resin core: influence of temperature on silane coupling agents.

This study evaluated the effect of air drying temperature and different silane coupling agents on the bond strength between glass fiber posts and composite resin core. The post surface was cleaned with alcohol and treated with different silane coupling agents, being three prehydrolyzed silanes [Silano (Angelus), Prosil (FGM), RelyX Ceramic Primer (3M ESPE)] and one two-component silane [Silane Coupling Agent (Dentsply)]. Two post-silanization air drying temperatures, 23ºC and 60ºC, were applied. A cylindrical plastic matrix was placed around the silanized post and filled with composite resin. Each bonded post provided 7 slices for push-out testing. Each slice was loaded to failure under compression at a cross-head speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Scott-Knott tests (α=0.05). Dunnett's test was used to compare the mean of the control group with that of each experimental group. Scanning electron microscopy (SEM) was used to evaluate the interface of the fractured slices. For the 23ºC air drying temperature, the use of RelyX Ceramic Primer resulted in significantly lower bond strength than the other silane coupling agents, while the bond strength with Silane Coupling Agent was the highest of all groups. Only with Silane Coupling Agent, the bond strength for the 23ºC air drying temperature was significantly higher than that for 60ºC air drying. In conclusion, the use of warm air drying after silane application produced no increase in the bond strength between the fiber-reinforced composite post and the composite core. The two-component silane produced higher bond strength than all prehydrolyzed silanes when it was used with air drying at room temperature.

Effects of resin luting agents and 1% NaOCl on the marginal fit of indirect composite restorations in primary teeth.

OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1% sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1% NaOCl irrigation+EnForce); G2 (EnForce); G3 (1% NaOCl irrigation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100% relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (α=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1% NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

Bond strength between fiber posts and composite resin core: influence of temperature on silane coupling agents

This study evaluated the effect of air drying temperature and different silane coupling agents on the bond strength between glass fiber posts and composite resin core. The post surface was cleaned with alcohol and treated with different silane coupling agents, being three prehydrolyzed silanes [Silano (Angelus), Prosil (FGM), RelyX Ceramic Primer (3M ESPE)] and one two-component silane [Silane Coupling Agent (Dentsply)]. Two post-silanization air drying temperatures, 23ºC and 60ºC, were applied. A cylindrical plastic matrix was placed around the silanized post and filled with composite resin. Each bonded post provided 7 slices for push-out testing. Each slice was loaded to failure under compression at a cross-head speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Scott-Knott tests (α=0.05). Dunnett's test was used to compare the mean of the control group with that of each experimental group. Scanning electron microscopy (SEM) was used to evaluate the interface of the fractured slices. For the 23ºC air drying temperature, the use of RelyX Ceramic Primer resulted in significantly lower bond strength than the other silane coupling agents, while the bond strength with Silane Coupling Agent was the highest of all groups. Only with Silane Coupling Agent, the bond strength for the 23ºC air drying temperature was significantly higher than that for 60ºC air drying. In conclusion, the use of warm air drying after silane application produced no increase in the bond strength between the fiber-reinforced composite post and the composite core. The two-component silane produced higher bond strength than all prehydrolyzed silanes when it was used with air drying at room temperature.

Este estudo avaliou o efeito da temperatura do ar e diferentes silanos na resistência de união entre pino de fibra e resina composta. Os pinos foram limpos com álcool e tratados com diferentes silanos: três pré-hidrolizados [Silano (Angelus), Prosil (FGM), RelyX Ceramic Primer (3M ESPE)] e um de dois componentes [Silane Coupling Agent (Dentsply)]. Duas temperaturas (23ºC e 60ºC) para secagem do silano foram aplicadas. Matriz plástica cilíndrica foi posicionada em torno do pino já silanizado, e preenchida com resina composta simulando núcleo de preenchimento. Cada cilindro obtido pela união pino/preenchimento foi seccionado, gerando 7 fatias para ensaio mecânico de push-out. Aplicou-se sobre cada fatia carregamento de compressão, com velocidade de 0,5 mm/min, até a falha da amostra. Os dados foram analisados pela ANOVA e teste Scott-Knott (α=0,05). Utilizou-se teste de Dunnett para comparação do grupo controle com cada um dos outros grupos experimentais. Após ensaio mecânico, observaram-se as amostras em microscópio eletrônico de varredura. Para 23ºC, RelyX Ceramic Primer apresentou os menores valores de resistência de união, enquanto o Silane Coupling Agent (Dentsply) obteve os maiores valores. Para o Silane Coupling Agent (Dentsply), os valores de resistência de união foram maiores para temperatura de 23ºC do que 60ºC. Em conclusão, o uso de ar quente após aplicação do silano não gerou aumento nos valores de resistência de união entre pino de fibra e material de preenchimento de resina composta. O silano de dois componentes apresentou maior resistência de união do que todos os silanos pré-hidrolizados quando usados na temperatura ambiente.

Prevalence of dental trauma among children treated in the Pediatric Dentistry Clinic of the State University of Amazonas

Introduction: Dental trauma is an acute energy transmission to the tooth and to the supporting structures that may result in fracture, tooth dislocation, breaking or crushing of supporting tissues. Objective: This retrospective study aimed to evaluate dental trauma prevalence among children treated in the Pediatric Dentistry Clinic of the State University of Amazonas (short UEA) from July 2005 to June 2009. Material and methods: The sample used in the analysis consisted of 171 children treated in the Pediatric Dentistry Clinic of the State University of Amazonas (short UEA), Manaus - Amazonas - Brazil. Results: Dental trauma prevalence among these children was 29.8%. No statistically significant association was found regarding to gender. Conclusion: The prevalence of dental trauma among children treated in the Pediatric Dentistry Clinic of the State University of Amazonas was in average 29.8%, which is agreement with other studies.

Effects of resin luting agents and 1 percent NaOCl on the marginal fit of indirect composite restorations in primary teeth

OBJECTIVE: The purpose of this study was to provide information regarding the marginal adaptation of composite resin onlays in primary teeth previously treated with 1 percent sodium hypochlorite (NaOCl) (pulp irrigant) using two different resin luting agents. MATERIAL AND METHODS: Forty extracted sound primary molars had their crowns prepared in a standardized machine and were randomly divided into 4 groups (n=10): G1 (1 percent NaOCl irrigation+EnForce); G2 (EnForce); G3 (1 percent NaOCl irrigation+Rely X); G4 (Rely X). The onlays were made with Z250 composite resin on plaster models. After luting, the tooth/restoration set was stored in 100 percent relative humidity at 37ºC for 24 h and finished with Soflex discs. Caries Detector solution was applied at the tooth/restoration interface for 5 s. The specimens were washed and four digital photos of each tooth were then taken. The extents of the gaps were measured with Image Tool 3.0 software. The percentage data were submitted to a Kruskal-Wallis test (α=0.05). The Relative Risk test analyzed the chance of a gap presence correlated to each group. RESULTS: There were no statistically significant differences (p>0.05) among the groups. The relative risk test revealed that some groups were more apt to have a presence of gaps than others. CONCLUSION: Neither the 1 percent NaOCl treatment nor the resin luting agents caused any alterations in the dental substrate that could have influenced the marginal adaptation of composite onlays in primary teeth.

Análise atuarial em um estudo comparativo de dois cimentos de ionômero de vidro utilizados na técnica de TRA: avaliação direta e indireta após 3 e 6 meses / Actuarial analysis in a comparative study of two glass ionomer cements used in the ART technique: direct and indirect evaluation after 3 and 6 months

O objetivo deste estudo foi avaliar in vivo, direta e indiretamente, o desempenho clínico de dois cimentos de ionômero de vidro de alta resistência - Ketac Molar (3M) e Fuji IX (GC Int. Corp.) - utilizados no Tratamento Restaurador Atraumático. Um total de 82 crianças entre 6 e 9 anos de idade foram incluídas no estudo. O desempenho das restaurações e dos selantes foi avaliado no baseline, 3 e 6 meses após a realização dos procedimentos. As alterações das restaurações e selantes foram comparadas entre os materiais e entre os períodos de avaliação. A análise da chance acumulada de sucesso para as restaurações foi maior para Classe I do que para Classe II utilizando-se o Fuji IX, sendo verifcado similar desempenho para as restaurações em Ketac Molar, porém com menor chance de ocorrência de sucesso. Não houve diferença no desempenho dos materiais utilizados tanto nas restaurações Classe I e Classe II como nos selantes. Concluiu-se que ambos os cimentos após 3 e 6 meses obtiveram alto índice de sucesso, exceto em restauração Classe II, não havendo diferença estatística entre os materiais. Apesar de ter havido perda precoce do selante para ambos os materiais, houve alta taxa de sucesso em relação à prevenção de lesões de cárie.

The objectives of this study were to evaluate in vivo, directly and indirectly, the clinical performance of two glass ionomer cements of high resistance, Ketac Molar (3M) and Fuji IX (GC Int. Corp.) used in the Atraumatic Restorative Treatment. A total of 82 children age between 6 and 9 years old had been included in this study. The performance of the restorations and the sealants was evaluated in baseline, 3 and 6 months after the accomplishment of the procedures. The alterations of the restorations and sealants had been compared between the materials and periods of evaluation. The analysis of the accumulated rate of success for the restorations was higher for Class I than those for Class II using Fuji IX, being verifed similar performance for the restorations using Ketac Molar, however with less chance of possibility of success. There was not difference in the performance of the materials used in the restorations Class I, II and in the sealants. It was concluded that both cements after 3 and 6 months showed high rate of success, except in Class II, did not showing signifcant statistically difference between the materials. Although of early loss of the sealant for both the materials, it was observed high rate of success in relation to the prevention of caries lesion.

Identificação do lado de preferência mastigatória através de exame eletromiográfico comparado ao visual / Masticatory preference side detection using electromyography exam compared to the visual analysis

O objetivo deste estudo foi verificar a freqüência da mastigação preferencialmente unilateral através da eletromiografia comparada à inspeção visual. Participaram deste estudo 29 indivíduos saudáveis, alunos do Curso de Odontologia - Uniararas, na faixa etária entre 18 e 25 anos, de ambos os gêneros, selecionados através dos critérios: dentição permanente completa ou apenas ausência dos 3° molares, sem sinais clínicos de disfunção craniomandibular ou doença periodontal. A análise eletromiográfica foi realizada nos músculos masseteres durante mastigação habitual de cenoura e parafilme. Considerou-se a presença de um lado de preferência mastigatória (LPM) quando os valores de amplitude de contração muscular obtidos em RMS (Root Mean Square) ou Valor Eficaz tivessem uma diferença de pelo menos 20 por cento entre os músculos masseteres direito e esquerdo. A inspeção visual foi realizada por um único observador durante as aquisições eletromiográficas. Considerou-se a presença de um lado de preferência mastigatória quando a mastigação ocorria com uma freqüência de ciclos mastigatórios pelo menos 30 por cento maior por um dos lados, após o registro de 20 ciclos mastigatórios consecutivos. Do total da amostra, 82,8 por cento (24/29) e 72,4 por cento (21/29) apresentaram um lado de preferência mastigatória durante a mastigação de cenoura e parafilme, respectivamente. A concordância entre a eletromiografia e a inspeção visual foi verificada em 83 por cento das observações. Pode-se concluir que a maioria dos sujeitos examinados nessa pesquisa possuia um lado de preferência mastigatória durante mastigação habitual de cenoura e parafilme e que a eletromiografia pode ser usada como parâmetro para detecção do lado de preferência mastigatória

Efeito do Hidrato de Cloral e do Diazepam em crianças não cooperativas ao tratamento odontológico / Chloral Hydrate and Diazepam effect in non-cooperative children under dental care

Avaliara-se os efeitos do diazepam (Valium® - 5mg) e hidrato de cloral 16% (40 mg/Kg) via oral em 20 crianças de três a sete anos, com "comportamento definitivamente negativo" (escala de Frankl) no tratamento odontológico. Foram atendidas, em duas sessões, sendo que em apenas uma administrou-se hidrato de cloral (n=10) ou diazepam (n=10). Os sinais vitais (pressão arterial, temperatura corporal, frequência cardíaca e respiratória) foram monitorados antes, durante e após a intervenção, nas duas sessões. O tratamento (restauração de cáries oclusais) foi dividido em quatro etapas: anestesia (5 min), isolamento absoluto (5 min), remoção de tecido cariado com instrumento rotatório (10 min); restauração (5 min), realizado por um único profissional e filmado. Três avaliadores assistiram separadamente às sessões, empregando a escala de comportamento de McKee, com escores concernentes ao choro, cooperação, ansiedade e sono. Aplicou-se o teste de Wilcoxon e a análise de variância, com significância de 95%. Os sinais vitais não foram alterados durante as sessões e durante as etapas do tratamento com e sem medicação. Os escores das sessões com o diazepam foram significativamente maiores do que com hidrato de cloral, indicando maior eficácia do diazepam. O comportamento foi mais negativo quando se administrou ambos os medicamentos na primeira sessão.

Efeito da limpeza coronária e do preparo mecânico de sulcos e fissuras oclusais sobre a penetraçäo de selantes / Evaluation of prophylaxis techniques on the sealants penetration in occlusal pit and fissure

Os autores avaliaram o efeito da limpeza coronária através do método convencional, Profident, e escovaçäo, e do preparo mecânico de sulcos e fissuras oclusais, pela técnica invasiva, sobre a penetraçäo dos selantes Delton e Prisma Shield, em 48 pré-molares extraídos. Estes foram divididos em grupos segundo materiais e técnicas e avaliados macro e microscopicamente através de microscopia eletrônica de varredura. Concluíram que o selamento oclusal pela técnica invasiva exibiu maiores percentuais de penetraçäo que a técnica näo invasiva, para ambos os selantes, sendo a diferença estatisticamente significante ao nível de 5 por cento; comparando-se os materiais, o selante Delton exibiu os maiores percentuais de penetraçäo para ambas as técnicas, em média; quanto aos métodos de limpeza, observaram que os melhores resultados foram obtidos quando se empregou o selante Prisma Shield pela técnica näo invasiva e método de limpeza convencional, sendo a diferença entre as outras situaçöes estatisticamente significante ao nível de 5 por cento

Eficácia da adesão em dentes decíduos: análise da literatura / Efficacy of adhesion in primary teeth: review of the literature

Com o objetivo de discutir os aspectos envolvidos na eficácia da adesão em dentes decíduos, realizou-se esta revisão de literatura. Concluiu-se que o processo de adesão é um fenômeno complexo, que sofre a influência direta das propriedades físico-químicas do adesivo e do aderente. Sendo a dentina de dentes decíduos e a dentina de dentes permanentes substratos morfológica e quimicamente diferentes, o processo adesivo deveria ser diferenciado para ambos os tipos dentais: o condicionamento ácido em dentina de dentes decíduos ainda se encontra sem protocolo estabelecido, porém, sabe-se que esse substrato se apresenta mais reativo aos ácidos do que a dentina de dentes permanentes; quanto maior o tempo de exposição desse substrato ao condicionamento ácido, menores os valores de resistência da união; esses dentes apresentam ainda camada híbrida mais espessa do que a dos permanentes e, quanto menor a espessura da camada híbrida, melhores serão os resultados do processo adesivo. Com relação à umidade dentinária, esta altera os valores de resistência da união. Porém, estudos sobre a umidade dentinária foram realizados somente em dentes permanentes, e mais pesquisas devem ser realizadas para evidenciar sua influência na adesão a dentes decíduos. Assim, com o objetivo de alcançar valores de resistência de união tão satisfatórios quanto os encontrados para os dentes permanentes, um protocolo específico para o processo adesivo em dentes decíduos deve ser estabelecido

Tratamento endodôntico de dentes decíduos. II. Emprego do tricresol-formalina como curativo intracanal / Endodontic treatment in deciduous teeth.II. The use of tricresol-formalin as intracanal medication

As autoras pesquisaram o efeito do tricresol-formalina, utilizado como curativo intracanal em dentes decíduos com polpas mortificadas, portadores de fístulas, ou abscessos, que apresentavam, radiograficamente, destruição óssea a nível de bifurcação. Com base nos resultados obtidos, constataram ao exame clínico, rápida regeneração dos tecidos envolvidos (7 dias). Com o exame radiográfico foi observado, nos períodos iniciais do experimento, neo-formação óssea muito significativa. Todavia, este fenômeno não foi completo, pois no final da pesquisa foram encontradas pequenas regiões de rarefação óssea, determinando um sucesso radiográfico significativo (69,91 por cento, entretanto, o sucesso clínico foi de 100 por cento

Prevalência de má oclusão em pré-escolares de Piracicaba - SP / Malocclusion prevalence in Brazilian preschoolers from Piracicaba - SP

Este trabalho teve por objetivo avaliar clinicamente as relações morfológicas oclusais de crianças com idade entre três anos e seis meses a seis anos e 11 meses, freqüentadoras de creches municipais da cidade de Piracicaba-SP. Foram analisadas as relações ântero-posteriores e transversais dos arcos dentais decíduos que foram classificados de acordo com a morfologia presente em: Relação dos incisivos - sentido vertical: (mordida aberta anterior, Sobremordida (overbite), Normal - incisivo superior cobrindo até um terço do incisivo inferior); Relação dos incisivos - sentido horizontal: (mordida cruzada, Sobressaliência (Overjet), Normal - incisivo superior cobrindo até um terço do incisivo inferior, por vestibular); Relação ântero-posterior de caninos decíduos: (classe I - canino superior ocluindo no espaço entre o canino e o primeiro molar inferior; Classe II - canino superior ocluindo anteriormente ao espaço entre o canino e o primeiro molar inferior; Classe III - canino superior ocluindo posteriormente ao espaço entre o canino e o primeiro molar inferior); Relação terminal dos segundos molares decíduos: Degrau mesial, Degrau distal, Plano Vertical. As crianças foram examinadas por um CD (GPN), pela então acadêmica (CAS) e pela fonoaudióloga (VVD) para a análise da oclusão. A análise foi realizada através de estatística descritiva observando-se as variáveis em análise: alterações oclusais. Pelos resultados concluiu-se que houve alta prevalência de má oclusão na amostra (71,6 por cento), encontrando-se a mais alta incidência para a mordida aberta anterior associada à mordida cruzada lateral posterior