Exploring some aspects associated with dentine hypersensitivity in children.

BACKGROUND: The etiology of dentine hypersensitivity (DH) is still inconclusive and there are few studies concerning it in children. AIM: To evaluate clinical, dietary, and salivary variables in children with DH complaints. DESIGN: Forty-eight children were asked about DH. Data regarding dietary habits were collected from the children's parents and an examination was performed to determine dental erosion. Dental biofilm was estimated by oral hygiene status, according to Greene and Vermillion's Simplified Oral Hygiene Index (OHI-S). Whole saliva was collected under mechanical stimulation and evaluated salivary flow rate, initial pH, buffer capacity, and calcium and phosphate concentrations. The temperature of soft drinks, drinking method, sense of bitter taste, and other variables were also determined. Possible factors associated with DH were analyzed by univariate and multiple Poisson regression analyses. The prevalence ratio (PR) values and 95% confidence intervals (95% CI) were calculated. RESULTS: DH was associated with the presence of dental erosion (PR; 95% CI = 2.23; 1.05 to 4.71) and salivary flow rate (2.49; 1.05 to 5.91). When the presence of erosion was not included, other variables were retained as follows: bitter taste (2.36; 1.38 to 4.03), OHI-S (0.47; 0.23 to 0.97). CONCLUSION: DH in children is associated with factors related to dental erosion.

Salivary profile of children with erosive tooth wear: a transversal study.

The aim of the present transversal study was to evaluate the clinical and biochemical salivary parameters of children with and without erosive tooth wear (ETW). The study population was children aged 4 to 9 years. A trained and calibrated examiner (kappa value for intraexaminer reliability = 0.89) classified the children into ETW (n = 24) and control groups (n = 24), and applied the O'Brien index. The salivary flow rate was initially evaluated by stimulated sialometry (paraffin chewing). Afterwards, the collected saliva was submitted to biochemical analyses of pH, uric acid, total buffering capacity, ferric-reducing antioxidant power, reduced glutathione, calcium, and phosphorus. Among the ETW children, 20 (83%) had dental lesions restricted to enamel, and 4 (17%) presented lesions affecting both enamel and dentin. A statistically significant difference between the groups was obtained only for the pH values (t-test; p = 0.004), with averages of 7.31 and 7.56 for the control and the ETW groups, respectively. Considering the parameters evaluated in general, it is suggested that the salivary profile of children with ETW does not differ considerably from that of children without ETW. However, the pH mean value seems to be slightly higher in ETW children, but is still within the normal physiological range.

Low-level-laser therapy as an alternative treatment for primary herpes simplex infection: a case report.

Gingivostomatitis is the most common primary and symptomatic clinical manifestation of HSV-1 infection. Painful oral lesions appear as ulcerative erosions on the gingiva, palate, buccal mucosa, and tongue, leading to eating and drinking difficulties with an evolution between 10-14 days. This paper describes a case of a 19-month-old boy with severe painful Gingivostomatitis lesions. Low level laser therapy (LLLT) was used with an immediate outcome.

The relationship between the number of erupted primary teeth and the child's height and weight: a cross-sectional study.

The objective of this study is to determine the correlation between the number of erupted primary teeth, the age, sex and the somatic measures of weight and height (length) in a Brazilian population based cross sectional study. A systematic sampling was used. Complete and consistent data were obtained from 870 of a total of 908 children from birth to 36 months of age. Statistical analysis comprised a multiple regression equation, where the number of erupted primary teeth was modeled as the dependent variable and the initial specification included the following independent variables: age, sex, birth-length, birth-weight, weight and length measured at the examination of the child. Results showed that in this study, 86% of the variation of the number of erupted primary teeth was explained by age and height of children (p < 0.001). Age and height showed a stronger correlation with the number of erupted primary teeth than all the tested variables together. It was concluded that primary teeth eruption is highly influenced by age and height (length) of the child. Using the best regression equation found, a chart was constructed where the variation of the number of erupted primary teeth is given according to age and height of the child.

Tooth loss and subluxation in the primary dentition: a twelve-year follow-up case report.

The case of a five-year-old child is reported, who suffered dento-alveolar injury including subluxation of the right upper lateral incisor and avulsion of the upper central incisors and left upper lateral incisor and laceration in the mucosa. The case was followed for 12 years until complete root formation and alignment of the anterior permanent teeth.

[Evaluation of the dental eruption pattern and of enamel defects in the premature child]. / Os defeitos do esmalte e a erupção dentária em crianças prematuras.

BACKGROUND: The purpose of this study was to analyze the relation between enamel defects and delay of dental eruption with prematurity. METHODS: the sample consisted of 100 premature children ranging from six months to six years of age, observed in the Children Institute of the Medical School of the USP. An anamnesis of the oral cavity was carried out by just one observer who analyzed the chronology of teeth eruption as well as the occurrence of enamel defects. A medical evaluation was also conducted in order to detect potential problems during the prenatal, neonatal and postnatal periods. The statistical assessment included descriptive analysis, average frequency and a confidence interval of 95%. RESULTS: Defects appeared in 35% of the premature children; 51.43% of those affected had been born with a low weight (< 2500g), compared to 14.29% born with normal weight (> 2500g). No relationship was found between the occurrence of defects with a low Apgar score during the first minute, second minute and five minutes (p=0.628; p=0.308;p=0.,193). The most common defects were white opacities, in the deciduous (19.0%) as well as in the permanent dentition (100%). The incisor and cervical halves of the vestibular faces were the most affected reaching values of 88.04% for the deciduous dentition and of 100% for the permanent one. In about 42% of children eruption of teeth took place between 6 to 10 months of age. CONCLUSIONS: Premature children may have enamel defects caused by different factors that appear during pregnancy with a possible association between low weight and enamel defects. Furthermore, premature children had teeth eruption in a normal period, nevertheless, until 36 months of age with less teeth total than children born at normal term.

Histogenesis and clinical analysis of 2 cases of congenital gingival granular cell tumour.

Dentistry for babies aims to contribute to the formation of a generation with fewer dental problems, higher quality of oral health and more aware of the importance of prevention. The congenital gingival granular cell tumour (CGCT) is a rare benign soft tissue tumour in the newborn that can lead to respiratory difficulties and feeding. The aim of this work was to report two cases of CGCT in babies and discuss the clinical and histological differential diagnosis and their treatment, as well as the importance of knowledge of this pathology for dentists. Clinical features and treatment approaches are presented and discussed. The surgical approach improved the child quality of life and restored the parent's confidence and emotional stability. Knowledge of this pathology helps in better diagnosis and treatment, which lead to a better quality of life of children and return confidence and emotional stability to parents.

Resin composite restoration in primary anterior teeth using short-post technique and strip crowns: a case report.

A case report describing a technique for the restoration of endodontically treated primary maxillary incisors with resin composite short posts and celluloid strip crowns in a 3-year-old boy is presented. The technique offers the advantages of using one restorative material, improving esthetics, and reducing chairtime and costs.

Intracanal reinforcement fiber in pediatric dentistry: a case report.

A technique for the restoration of carious primary maxillary incisors using indirect resin composite crowns and intracanal reinforcement fiber is described. Endodontic treatment was previously performed on each tooth. The advantages of using an intracanal reinforcement fiber include resin composite crown reinforcement, translucency, and relative manipulation facility. In addition, the use of indirect resin composite crowns provides good shape and esthetics, as well as reduced chair time for the child. The technique is illustrated in a case report in which indirect resin composite crowns and an intracanal reinforcement fiber are placed in a 3-year-old girl.

Lingual epidermoid cyst: case report in an infant.

The purpose of this article was to present a rare case of epidermoid cyst on the ventral region of the tongue in a 15-month-old child. During clinical examination, a sessile, yellowish lesion measuring approximately 0.5 cm was noticed. The lesion had existed since the child's birth and was causing discomfort due to friction of the tongue against the alveolar ridge during mastication. The chosen treatment was total removal of the lesion. The histopathological findings confirm the diagnosis of an epidermoid cyst, characterized by the presence of: (1) a cyst cavity lined by stratified squamous epithelium with keratinization on the surface; and (2) connective tissue with a mild inflammation. The proposed treatment was considered successful as the case was solved and there was no recurrence.

Erosive potential of different types of grape juices.

The purpose of the present study was to evaluate the erosive potential of different types (concentrated and powdered) and commercial brands of industrialised grape juices. The pH of all five fruit drinks was measured at two time points: immediately after preparation and 24 hours later. Sixty specimens of bovine enamel were randomly allocated and immersed in different types of grape juice (n = 10) for 10 minutes four times a day for fifteen days. The enamel alteration was analysed using surface Knoop microhardness (KHN) and surface roughness (Ra) tests at baseline and on the 5(th), 10(th) and 15(th) days of the experiment. Two way ANOVA, Tukey's post hoc and Pearson's correlation tests were used for statistical analysis (α = 5%). The grape juices presented pH values ranging from 2.9 to 3.5. All of the tested juices promoted significant enamel mineral loss (p < 0.05) on the first evaluation (5(th) day of immersion) and produced a significant increase in the mean roughness from the 10(th) day on when compared to the control group (p < 0.05). By the 15(th) day, all of the beverages had produced surface roughnesses that were significantly higher than that of the control group. The results suggest that all grape juices, regardless of their commercial presentation, present erosive potential.

Dental Anxiety and Behavior in Young Children Undergoing Different Distraction Techniques

Objective: To evaluate anxiety and behavior in groups of children undergoing various distraction techniques during dental treatment in a public clinic. Material and Methods: The research was a randomized study with a systematic convenience sample consisting of 62 children with 4-6 years (5.18±0.77) in both genders; they were divided in four groups (G1 - control group and three experimental Groups: G2 - mirror and conversation, G3 - toys and G4 - children's stories) and evaluated in the first 2 visits to the dentist. Age and previous experience were also evaluated. The Facial Image Scale (FIS) and the Behavior Rating Scale (BRS) were applied, the data was analyzed using the Chi-square test with a significance level of p < 0.05 and the Spearman correlation coefficient. Results: In comparison to the studied variables (anxiety and behavior), the distraction technique during dental care could not reduce anxiety and improve the behavior in all groups in the first visit, but the group receiving the distraction technique with a hand mirror reached the best results in behavior in the second visit (p=0.022; Raj:-2.68). There is no influence on anxiety among children with or without previous experience (p = 0.603), but the age of 4 years showed higher levels of anxiety (p=0.039). Conclusion: Only the distraction technique with the mirror was able to reduce anxiety and improve behavior in the second visit.

Assessment of Glass Ionomer Cements (GIC) Restorations after Acidic Erosive Challenges: An in vitro Study

Objective: To analyze the marginal adaptation of two different Glass Ionomer Cements (GIC) after erosive challenges. Material and Methods: Sixty sound extracted primary canines were selected and class V cavities were made. Teeth were allocated into 6 groups according to restorative material: 1) high-viscosity GIC (Ketac™Molar Easymix) and 2) resin-modified GIC with nanoparticles (Ketac™N100), low pH beverage erosive challenge (Orange juice and Coca-Cola) or distilled water as control. Thereafter the sample was restored and subjecting to thermocycling. The sample was immersed for a 10-days period for the erosive simulation and then embedded in methylene blue solution during 4 hours. Finally teeth were sectioned for further analysis. Marginal adaptation test was performed by two trained examiners using the Salama et al. criteria. Descriptive and Kruskal-Wallis test (α=5%) were used to analyze the data. Results: The groups treated with Ketac™Molar EasyMix were similar in terms of marginal sealing ability when submitted to Orange juice and Coca-Cola but significantly worse than water. For samples restored with the Ketac™N100 the worst results were found in the Coca-Cola group. Conclusion: Erosive challenges with acidic drinks affected the marginal adaptation of the tested GIC.

Quantification of Dental Biofilm in Children with Dental Erosion

To quantify dental biofilmthrough the simplified oral hygiene index (OHI-S) proposed by Greene and Vermillion in children with dental erosion comparing them to children without this oral health problem.Material and Methods:The study included 48 children aged 4-9 years treated at the Clinic of Pediatric Dentistry of the Cruzeiro do Sul University, examined by a single trained and calibrated examiner according to O'Brien index for the diagnosis of dental erosion, in which 24 children had erosion lesions in teeth and 24 children did not have this oral health problem. Later, children received guidance and standardization for the OHI-S evaluation. Data were analyzed by the Poisson univariate logistic regression. Prevalence ratio (PR) values and 95% confidence intervals (CI 95%) were calculated. Results:The mean (standard deviation) of the OHI-S of children who had dental erosion was 1.19 (0.38), lower than children in the group without dental erosion 1.73 (0.44). The amount of biofilm on teeth was associated with the presence of dental erosion (OR 95% CI = 0.393; 0188-0822) and p-value = 0.013. Regarding the reduction in the WSL dimension, no significant difference between groups was observed (p = 0.931). Conclusion:Children with dental erosion showed a significantly lower amount of biofilm compared to children without this oral health problem, and dental biofilm can be a possible protective factor against acid attacks and development of dental erosion...

Biofilme dental em crianças com erosão dentária / Dental biofilm in children with dental erosion

Objetivo: o presente estudo quantificou o biofilme dental por meio do índice de higiene oral simplificado (IHO-S) de Greene e Vermillion, em crianças com erosão dentária, comparando-as com crianças sem esse problema de saúde bucal. Sujeitos e método: participaram do estudo quarenta crianças, de quatro a nove anos de idade, examinadas por um único examinador treinado de acordo com o índice de O´Brien para o diagnóstico de erosão dentária, sendo que vinte crianças apresentavam erosão nos dentes e vinte crianças não a apresentavam. Posteriormente, elas receberam orientaçõese padronização para a avaliação do IHO-S. Os dados foram analisados pela regressão logística univariada de Poisson. Valores de razão de prevalência (RP) e intervalos de confiança de 95% (IC 95%) foram calculados. Resultados: a média (desvio padrão) do IHO-S de crianças com erosão foi de 1,20 (0,40), menor que as crianças do grupo controle 1,75 (0,45). A quantidade de biofilme foi associada à presença de erosão dentária (RP IC 95% = 0.390; 0.180-0.833) e valor de p = 0.027. Conclusões: crianças com erosão nos dentes apresentaram uma quantidade significativamente menor de biofilme em relação às crianças sem esse problema. O biofilme pode ser um possível fator protetor contra os ataques ácidos e o desenvolvimento da erosão dentária.

Desenvolvimento e avaliação da eficiência da estabilização protetora na odontopediatria: um estudo piloto / Development and assessment of the effectiveness of protective stabilization in pediatric dentistry: a pilot study

Objetivo: desenvolver um modelo de estabilização protetora para crianças, com a finalidade de promover qualidade no atendimento e avaliar a sua eficiência na prática clínica. Materiais e método: uma amostra de conveniência composta por vinte cirurgiões dentistas, que atuam no atendimento de crianças com perfil de não colaboradoras. Foi aplicado um questionário com perguntas relacionadas ao conhecimento prévio e à percepção sobre os métodos de estabilização protetora. Com base nas informações coletadas considerando a opinião desses profissionais, foi desenvolvido um novo modelo de estabilização protetora, baseado em modelo já existente (Pedi-Wrap), porém modificado com um tecido mais macio com desenhos para maior conforto e aceitação das crianças e responsáveis. Para composição das peças, os materiais empregados foram compostos por tecidos de algodão e tela garça, velcro, elástico, botões, linhas e viés. O modelo desenvolvido na pesquisa foi utilizado em crianças não colaboradoras de 1 a 6 anos de idade, testados por cada um dos vinte cirurgiões dentistas, em seguida foi aplicado um novo questionário aos profissionais, para se saber a opinião desse novo modelo. Resultados: na opinião dos profissionais, a região de maior movimentação durante um atendimento odontológico é a cabeça das crianças (35%), o tipo de estabilização mais utilizado é a mãe segurando a criança (35%), sendo que 45% dos profissionais avaliados não estão satisfeitos com a estabilização protetora utilizadas no dia a dia. Em relação ao modelo desenvolvido, todos os dentistas acharam eficiente e visualmente agradável. Conclusões: a roupa de estabilização protetora desenvolvida apresentou características como a facilidade na manipulação, agradabilidade e contribuiu no atendimento às crianças.

Rugosidade superficial das resinas compostas: estética e longevidade clínica / Surface roughness of composite resins: esthetic and clinical longevity

Introdução: com os avanços tecnológicos, os pesquisa-dores e as indústrias odontológicas tentam desenvolver materiais com características que melhorem a estética e ao mesmo tempo a longevidade clínica. Sabe-se que a superfície de um material restaurador influencia di-retamente na estética e na sua longevidade clínica, in-dicando o sucesso ou insucesso desse. Objetivo: este estudo, realizado por meio da revisão da literatura, teve como objetivo apresentar os achados da literatu-ra sobre a comparação da rugosidade superficial dos compósitos nanoparticulados em relação aos compó-sitos microparticulados e microhibridos, para verificar os possíveis sucessos e insucessos dessa tecnologia de ?nanoparticulas? implantada recentemente na odon-tologia. Revisão de literatura: muitos estudos mostram que uma superfície irregular, com rugosidades, impli-ca no manchamento e no acúmulo de biofilme dental, acarretando prejuízo à restauração e à saúde bucal do paciente. Também se conseguiu observar importantes diferenças superficiais dos compósitos nanoparticula-dos com os compósitos microhíbrido e microparticu-lado. Considerações finais: a superfície dos compósitos nanoparticulados é mais regular que a dos compósitos microparticulados e microhíbridos, essa regularidade é fundamental para a estética e para a longevidade clíni-ca do material.

Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth.

OBJECTIVE: To assess the effect of a fluoride varnish and gel on the erosive wear of primary and permanent teeth. DESIGN: Sixty human primary (n=30) and permanent (n=30) enamel specimens were randomly assigned to one of the following groups: APF gel (1.23% F), NaF varnish (2.26% F), and control (no treatment). Fluoride gel was applied for 4 min and fluoride varnish for 24 h. Six daily demineralisation-remineralization cycles of 5 min of immersion in a cola drink (pH 2.3) and 30 min in artificial saliva were conducted during 7 days. All specimens were stored in artificial saliva between and after cycles. Surface Knoop microhardness (%SMHC) readings were performed at baseline, 48 h and 7 days. Data were tested using ANOVA and Tukey's tests (p<0.05). RESULTS: For primary enamel, the mean %SMHC (+/-SD) after 48 h and 7 days was, respectively: gel (31.0+/-14.4 and 36.9+/-7.5), varnish (26.7+/-9.5 and 38.3+/-8.7), and control (35.8+/-8.6 and 45.0+/-8.6). For permanent enamel, such values were: gel (37.5+/-7.7 and 27.8+/-7.5), varnish (31.7+/-9.6 and 27.4+/-11.1) and control (48.6+/-6.4 and 43.1+/-6.4). In primary enamel, erosion inhibition by fluoride was not significant at 48 h (p=0.203) and 7 days (p=0.082). In permanent specimens, both products showed a significant effect (p<0.001). CONCLUSIONS: Both fluoride varnish and gel were able to inhibit erosive enamel loss but mainly in the permanent experimental groups. Primary and permanent enamel substrates reacted differently to both demineralization by a cola drink and remineralization by fluoridated compounds.

Dental erosion in cerebral palsy patients.

PURPOSE: The objective of this study was to evaluate the presence and severity of dental erosion in cerebral palsy (CP) patients. METHODS: A group of 48 noninstitutionalized individuals with CP, 2 to 18 years old (8.8+/-3.9 years), has been diagnosed with the disorder. Dental erosion was evaluated according to O'Brien. Results were compared to a control group composed by 26 patients with no neurological damage aged 4 to 18 years (11.3+/-3.5 years). RESULTS: Presence of deep dental erosion was significantly higher in CP individuals when compared to the control group. Concerning motor disorder, no statistical difference has been observed between the types of CP. Most of the affected teeth observed in the study group were the upper and lower molars and upper incisors. CONCLUSIONS: Cerebral palsy patients have a higher risk of dental erosion development.

Occlusal characteristics in cerebral palsy patients.

PURPOSE: The purpose of this study was to evaluate the occlusal characteristics of 104 randomly selected, noninstitutionalized patients with a medical diagnosis of cerebral palsy (CP). METHODS: Patients were grouped according to the CP motor disorder and clinical patterns. Occlusal characteristics were collected by one examiner. Nonparametric statistical tests, including Fisher's exact test (P) and chi-square test were used. RESULTS: The results showed that Class II molars were statistically higher (P<.05) for spastic patients. Anterior open bite and an increased overjet were significant (P<.01) in spastic patients with clinical patterns of quadriplegia, double-hemiplegia, and diplegia. Double hemiplegia patients presented a higher incidence of open bite (64%) with an edge-to-edge overjet (45%). A deep overbite was presented in athetoid (50%) and ataxic (67%) patients. A high incidence of tooth wear was observed in the athetoid group (54%). CONCLUSION: Spastic patients presented a high incidence of open bite and Class II malocclusion. A low level of malocclusion was observed in the ataxic group compared to the other groups studied. Further studies would be useful to determine if neurological injuries can be the cause of changes of the craniofacial growth and development patterns resulting in malocclusion in cerebral palsy patients.