Atraumatic Restorative Treatment-Sealed versus Nonsealed First Permanent Molars: A 3-Year Split-Mouth Clinical Trial.

To investigate the efficacy of atraumatic restorative treatment (ART) sealants vs. no sealant in preventing the development of dentine caries lesions in first permanent molars over a period of 3 years. A total of 187 schoolchildren (aged 6-8 years) from a low-income population presenting the 4 first permanent molars without clinically detectable dentine caries lesions were selected to be part of a split-mouth clinical trial. All 4 first permanent molars were investigated in this trial and the children's mouth was split vertically into left and right sides; therefore, 2 molars were randomly allocated to receive ART sealants, while the other 2 molars remained nonsealed. All children received toothbrushing instructions and dietary advice every 6 months for a period of 3 years. Clinical evaluations were performed after 3, 6, 12, 18, 24, and 36 months and both sealant retention and dental caries were scored. Kaplan-Meier survival analysis, log-rank test, and Cox regression with shared frailty analysis were performed. A cavitated dentine caries lesion was considered a failure. The cumulative survival rates of dentine cavity-free first permanent molars were 90% for ART-sealed molars and 90.8% for nonsealed molars, with no statistically significantly difference between sealed and nonsealed molars (p = 0.70). The retention of sealants was not associated with the development of cavitated dentine caries and children presenting a higher baseline caries experience had greater chances of developing dentine lesions. In conclusion, the application of ART sealants was not more efficacious than nonsealing in reducing the development of dentine cavitated lesions in first permanent molars.

Survival rate of pulpectomy in primary teeth using Feapex® paste: a clinical study in infants / Sobrevida de pulpectomia em dentes decíduos utilizando pasta Feapex®: um estudo clínico em bebês

Objective: The aim of this clinical study was to evaluate the survival rate of a new pulpectomy protocol using 2% chlorhexidine digluconate gel and Feapex® paste for endodontic treatment in primary teeth. Material and Methods: A total of 105 pulpectomies were performed in anterior and posterior teeth of 48 infants (1-3 years old) with high caries experience with irreversible pulpitis or pulp necrosis. All treatments were performed by dental surgeons with no specialization in Pediatric Dentistry, under local anesthesia and rubberdam isolation. Manual files were used in conjunction with 2% chlorherixidine gel for root canal instrumentation, and Feapex® paste was used as a obturation material. The clinical and radiographic outcomes were collected by one trained independent evaluator with a follow-up period of 24months. Success was determined by the absence of pain, pathological mobility, pathologic bone rarefaction, pathological root resorption and soft tissue pathology around the affected tooth Survival of the endodontic treatment was evaluated by estimating survival rates through Kaplan-Meier curves. Cox Regression analysis with shared fragility were performed to evaluate the association between the independent variables to endodontic treatment failure (α=5%). Results: After 24 months, the treatment survival was 86% (SE=0.03). Root resorption at baseline was associated with a higher risk of failure (HR=2.81; CI=1.12-7.08; p=0.027). The survival rate of the endodontic treated teeth due to dental trauma was 100%, while teeth with dental caries had lower survival rate (85.05%; p<0.001*). Other variables analyzed included gender, age of the child, tooth position (incisor/molar), restoration type, obturation quality, and caries experience were not associated with treatment failure (p>0.05). Conclusion: The new protocol using 2% chlorhexidine digluconate and Feapex® presented a high survival rate and can be considered as a suitable protocol for pulpectomy in primary teeth.Trial Registration: REBEC (RBR-282s2f) (AU)

Objetivo: Avaliar a sobrevida de um novo protocolo para tratamento endodôntico (pulpectomia) em dentes decíduos utilizando gel de digluconato de clorexidina 2% e pasta Feapex®. Material e Métodos: Um total de 105 pulpectomias foram realizadas em dentes anteriores e posteriores diagnosticados com pulpite irreversível ou necrose pulpar em 48 crianças (1-3 anos de idade) com alta experiência de cárie. Todos os tratamentos foram realizados por cirurgiões-dentistas clínicos gerais, sob anestesia local e isolamento absoluto. Limas manuais foram utilizadas em conjunto com cloroherixidina 2% gel para instrumentação dos canais radiculares e pasta Feapex® foi utilizada como material de obturação. Os resultados clínicos e radiográficos foram coletados por um avaliador independente treinado com um período de acompanhamento de 24 meses. O sucesso foi determinado pela ausência de dor, mobilidade patológica, rarefação óssea patológica, reabsorção radicular patológica e ausência de fístula/abscesso ao redor do dente tratado. A sobrevida do tratamento endodôntico foi estimativa utilizando curvas de Kaplan-Meier. Análise de regressão de Cox com fragilidade compartilhada foi realizada para avaliar a associação entre as variáveis independentes com a falha do tratamento endodôntico (α = 5%). Resultados: Após 24 meses, a sobrevida do tratamento foi de 86% (EP = 0,03). A reabsorção radicular no início do estudo foi associada a um maior risco de falha (HR= 2,81; IC= 1,12-7,08; p= 0,027). Dentes tratados endodonticamente devido ao traumatismo dentário na dentição decídua apresentaram taxa de sobrevida de 100%, enquanto dentes com comprometimento pulpar devido à cárie dentária tiveram menor sobrevida (85,05%; p<0,001 *). Todas as outras variáveis analisadas como sexo, idade da criança, dente (incisivo/molar), tipo de restauração, qualidade da obturação e experiência de cárie não foram associadas à falha do tratamento (p> 0,05). Conclusão: O novo protocolo utilizando digluconato de clorexidina 2% e Feapex® apresentou alta sobrevida e pode ser considerado um protocolo adequado para pulpectomia em dentes decíduos.Registro do estudo clínico: REBEC (RBR-282s2f). (AU)

Caries severity declined besides persistent untreated primary teeth over a 22-year period: Trends among children in Goiânia, Brazil.

BACKGROUND: Evidence of time trends in early childhood caries in low- and middle-income countries in the second decade of the year 2000 is scarce. AIM: To assess the trends in early childhood caries prevalence and severity in 2- to 5-year-old children over a 22-year period (1993-2015) in Goiânia, Midwest Brazil. Additionally, we aimed to investigate the changes regarding affected dental arches and teeth. DESIGN: A time-lag analysis of trends in caries was carried out using data from three cross-sectional studies based on the World Health Organization diagnostic criteria, in 1993 (N = 1362), 2001 (N = 1620), and 2015 (N = 548). RESULTS: Caries prevalence declined from 45.1% in 1993 to 29.0% in 2015. Prevalence of severe caries (dmft ≥ 6) in 2015 was nearly one-third of that found in 1993, and the SiC index (mean dmft of the highest tertile) decreased from 4.55 to 3.32. Decline was higher in the 1993-2001 than in the 2001-2015 time-lag. Posterior teeth and second molars had the greatest reductions. High proportions of untreated caries were found in all ages and survey years. CONCLUSION: There were significant changes in caries prevalence and severity, marked by a striking decline from 1993 to 2001, followed by a less prominent decrease up to 2015, and high levels of untreated caries.

Cariology education for undergraduate Brazilian dental students / Ensino da cariologia para estudantes de graduação em odontologia no Brasil

ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

RESUMO Este estudo teve como objetivo apresentar um panorama do ensino de cariologia nos cursos de graduação em Odontologia no Brasil. A coleta de dados foi realizada por meio de uma versão em Português Brasileiro de um questionário de 12 itens (Schulte et al., 2011) que foi enviado a todas as faculdades de Odontologia brasileiras (n = 219). A taxa de resposta foi de 57,0% (n = 125). Dentre as faculdades que responderam o questionário, 84,8% apoiam o desenvolvimento de um currículo brasileiro de cariologia. As disciplinas responsáveis por lecionar os conteúdos de cariologia são principalmente dentística (49,6%), odontopediatria (49,6%), saúde bucal coletiva (44,8%), e cariologia (32%). O ensino teórico de cariologia (74,4%) e os exercícios de pré-clínica (63,2%) são abordados principalmente durante o segundo ano do curso, enquanto as atividades clínicas ocorrem, em geral, no terceiro (71,2%) e quarto (64,8%) anos. Dentre os respondentes, 76,8% das faculdades incluem erosão dentária e 86,4% incluem defeitos dos tecidos dentários duros, como abrasão, no ensino da cariologia. Essa pesquisa foi capaz de determinar o panorama do ensino da cariologia no Brasil e detectar algumas diferenças de currículo entre as regiões do país. A promoção de um workshop para discutir os assuntos que devem ser ministrados aos estudantes de graduação em Odontologia e para desenvolver um currículo brasileiro de cariologia seria válida para reduzir as diferenças no ensino de cariologia no Brasil.

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children.

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

Fluoride varnishes with calcium glycerophosphate: fluoride release and effect on in vitro enamel demineralization.

The aims of this study were (1) to assess the amount of fluoride (F) released from varnishes containing calcium glycerophosphate (CaGP) and (2) to assess the effect of the experimental varnishes on in vitro demineralization. Six test groups using 5 varnishes: base varnish (no active ingredients); Duraphat® (2.26% NaF); Duofluorid® (5.63% NaF/CaF2); experimental varnish 1 (1% CaGP/5.63% NaF/CaF2); experimental varnish 2 (5% CaGP/5.63% NaF/CaF2); and no varnish were set up. In stage 1, 60 acrylic blocks were randomly distributed into 6 groups (n = 10). Then 300 µg of each varnish was applied to each block. The blocks were immersed in deionized water, which was changed after 1, 8, 12, 24, 48 and 72 hours. Fluoride concentration in the water was analyzed using a fluoride electrode. In stage 2, 60 bovine enamel samples were distributed into 6 groups (n = 10), and treated with 300 µg of the respective varnish. After 6 h the varnish was removed and the samples were subjected to a 7-day in vitro pH cycle (6 h demineralization/18 h remineralization per day). The demineralization was measured using surface hardness. The results showed that both experimental varnishes released more fluoride than Duofluorid® and Duraphat® (p < 0.05), but Duraphat® showed the best preventive effect by decreasing enamel hardness loss (p < 0.05). Therefore, we conclude that even though (1) the experimental varnishes containing CaGP released greater amounts of F, (2) they did not increase in the preventive effect against enamel demineralization.

Clinical evaluation of dental treatment needs in chronic renal insufficiency patients.

OBJECTIVE: To evaluate the need for dental treatment in chronic renal insufficiency (CRI) patients undergoing hemodialysis. DESIGN: Transversal study and case control. SETTING: CRI patients were examined at the Pequeno Príncipe Hospital in Curitiba, Brazil. The control group was examined at Nossa Senhora da Conceição Health Clinic in Campo Magro, Brazil. SUBJECTS (MATERIALS) AND METHODS: Thirty-four CRI patients were undergoing hemodialysis. The control group consisted of 34 normoreactive individuals paired by gender and age. INTERVENTIONS: The clinical examination was performed under an artificial light, using an oral mirror, an exploratory probe, a periodontal probe, and a tongue depressor. MAIN OUTCOME MEASURES: This study adopted the methodology proposed by the World Health Organization (WHO). RESULTS: The CRI patient group needs periodontal and orthodontic treatment. The control group needs restorative treatments, prostheses, as well as surgical and endodontic treatment. CONCLUSION: The profile of dental treatment needs proved to be distinct among the studied groups.

Fluoride varnishes with calcium glycerophosphate: fluoride release and effect on in vitro enamel demineralization

The aims of this study were (1) to assess the amount of fluoride (F) released from varnishes containing calcium glycerophosphate (CaGP) and (2) to assess the effect of the experimental varnishes on in vitrodemineralization. Six test groups using 5 varnishes: base varnish (no active ingredients); Duraphat® (2.26% NaF); Duofluorid® (5.63% NaF/CaF2); experimental varnish 1 (1% CaGP/5.63% NaF/CaF2); experimental varnish 2 (5% CaGP/5.63% NaF/CaF2); and no varnish were set up. In stage 1, 60 acrylic blocks were randomly distributed into 6 groups (n = 10). Then 300 µg of each varnish was applied to each block. The blocks were immersed in deionized water, which was changed after 1, 8, 12, 24, 48 and 72 hours. Fluoride concentration in the water was analyzed using a fluoride electrode. In stage 2, 60 bovine enamel samples were distributed into 6 groups (n = 10), and treated with 300 µg of the respective varnish. After 6 h the varnish was removed and the samples were subjected to a 7-day in vitro pH cycle (6 h demineralization/18 h remineralization per day). The demineralization was measured using surface hardness. The results showed that both experimental varnishes released more fluoride than Duofluorid® and Duraphat® (p < 0.05), but Duraphat® showed the best preventive effect by decreasing enamel hardness loss (p < 0.05). Therefore, we conclude that even though (1) the experimental varnishes containing CaGP released greater amounts of F, (2) they did not increase in the preventive effect against enamel demineralization.

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

Proposal of e-learning strategy to teach Atraumatic Restorative Treatment (ART) to undergraduate and graduate students.

BACKGROUND: The aim of this study was to evaluate e-learning strategy in teaching Atraumatic Restorative Treatment (ART) to undergraduate and graduate students. The sample comprised 76 participants-38 dental students and 38 pediatric dentistry students-in a specialization course. To evaluate knowledge improvement, participants were subjected to a test performed before and after the course. RESULTS: A single researcher corrected the tests and intraexaminer reproducibility was calculated (CCI = 0.991; 95% IC = 0.975-0.996). All students improved their performances after the e-learning course (Paired t-tests p < 0.001). The means of undergraduate students were 4.7 (initial) and 6.4 (final) and those of graduate students were 6.8 (initial) and 8.2 (final). The comparison of the final evaluation means showed a statistically significant difference (t-tests p < 0.0001). CONCLUSIONS: The e-learning strategy has the potential of improving students' knowledge in ART. Mature students perform better in this teaching modality when it is applied exclusively via distance learning.

Immunohistochemical expression of biglycan and decorin in the pulp tissue of human primary teeth during resorption.

Primary teeth are interesting models that can be used to study physiological and pathological processes involving cells and extracellular matrices in hard and soft tissues. This study investigated the expression and distribution of biglycan and decorin-the non-collagenous components of the extracellular matrix-in primary teeth tissue, during physiological root resorption. Thirty healthy human primary teeth were grouped together according to root length: Group I - two-thirds root length, Group II - one-third root length, and Group III - teeth with no root. The streptavidin-biotin-peroxidase immunohistochemical method was used with antibodies against the previously named antigens. The proteoglycans studied were found in the pulp and dentin extracellular matrix in all groups without any differences in the proteins, among the groups. Biglycan was observed mainly in predentin and in pulp connective tissue in the resorption area. In addition, decorin was observed mainly in pulp connective tissue, but near the resorption area. Biglycan and decorin were distributed differentially in the dental tissues. The present immunohistocytochemical data, combined with previously reported data, suggest that these proteoglycans could be involved in regulating the physiological resorption process in healthy primary teeth.

Immunohistochemical expression of biglycan and decorin in the pulp tissue of human primary teeth during resorption

Primary teeth are interesting models that can be used to study physiological and pathological processes involving cells and extracellular matrices in hard and soft tissues. This study investigated the expression and distribution of biglycan and decorin-the non-collagenous components of the extracellular matrix-in primary teeth tissue, during physiological root resorption. Thirty healthy human primary teeth were grouped together according to root length: Group I - two-thirds root length, Group II - one-third root length, and Group III - teeth with no root. The streptavidin-biotin-peroxidase immunohistochemical method was used with antibodies against the previously named antigens. The proteoglycans studied were found in the pulp and dentin extracellular matrix in all groups without any differences in the proteins, among the groups. Biglycan was observed mainly in predentin and in pulp connective tissue in the resorption area. In addition, decorin was observed mainly in pulp connective tissue, but near the resorption area. Biglycan and decorin were distributed differentially in the dental tissues. The present immunohistocytochemical data, combined with previously reported data, suggest that these proteoglycans could be involved in regulating the physiological resorption process in healthy primary teeth.

Descompressão de cisto dentígero na maxila / Decompression of a maxillary dentigerous cyst

This study describes the case of a dentigerous cyst in a six-year-old patient treated by decompression of the lesion. The patient?s main clinical complaint was facial asymmetry with displacement of the nasal cavity. Clinical examination showed an extensive lesion in the left side of maxilla invading the nasal cavity. An interdisciplinary course of treatment for this patient was indicated to preserve the impacted permanent tooth inside the lesion. A panoramic radiograph and computed tomography scan were requested for planning the surgery. A decompression surgery was performed and an incisional biopsy revealed the presence of a dentigerous cyst in the maxilla. A second operation was performed two years later to disimpact the permanent incisor and promote its eruption by means of orthodontic traction. The patient was thoroughly followed for a few years. Bone repair at the dentigerous cyst site was perfect.

Este artigo relata o caso de um cisto dentígero em um paciente de seis anos de idade em que a técnica utilizada para tratamento foi a de descompressão. A queixa clínica principal do paciente era assimetria facial e deslocamento da cavidade nasal. Ao exame clínico pôde-se constatar uma lesão extensa na maxila, do lado esquerdo que invadia a cavidade nasal. Foi planejado um tratamento interdisciplinar com a finalidade de preservar o dente permanente impactado que se localizava no interior da lesão. Foram requisitadas para o diagnóstico e planejamento cirúrgico uma radiografia panorâmica e uma tomografia computadorizada. A cirurgia de descompressão foi inicialmente realizada e a biópsia incisional revelou a presença de um cisto dentígero na maxila. A segunda intervenção cirúrgica foi realizada após dois anos, com a finalidade de tracionar o incisivo permanente para permitir que o mesmo pudesse irromper na cavidade bucal por meio de tração ortodôntica. O paciente foi rigorosamente acompanhado por alguns anos e pôde-se observar uma perfeita reparação óssea na área em que havia o cisto dentígero.

Tipo de aleitamento e presença de açúcar nas bebidas das mamadeiras dos bebês / Type of breastfeeding and presence of sugar in the content of baby bottles

This study aims at analyzing the feeding of babies, either by breastfeeding or using a baby bottle, time until weaning, as well as the presence of sugar in the content of baby bottles. Data from 305 babies, aged 0 to 36 months, were collected using questionnaires answered by their mothers. Information on age, gender, feeding habits and the presence of sugar containing substances in the baby bottles was collected. Most mothers used baby bottles (70.2%), and this rate increased with the babies? age. During the babies' first six months of life, 46.2% of mothers fed their babies exclusively on breast, whereas 38.5% of the babies were fed from baby bottles since birth, together with breastfeeding, and 15.3% of the babies at this age range were exclusively fed from baby bottles. Weaning occurred in 20.0%. 82.6% of the babies fed from baby bottles received sugar in their diet. Feeding from a baby bottle was found to be present since the first month of a baby's life, and its use was predominant until the age of 3 years. Sugar is present in the diet of the majority of the babies fed from bottles.

El estudio se propone analizar el tipo de leche utilizada, materno y/o artificial, sus periodos de uso y la presencia de azúcar en los biberones. Participaron 305 infantes de 0 a 36 meses, cuyos datos fueron obtenidos por medio de un cuestionario aplicado a las madres. Éste contenía informaciones sobre edad y sexo de los niños, tipo de alimentación que recibían y presencia o no de azúcar en los biberones. El tipo de alimentación más utilizada era artificial (70,2%), porcentaje que aumentó junto con la edad de los niños. La lactancia materna exclusiva durante los primeros seis meses de vida correspondía a 46,2% del grupo. Para 38,5% el biberón fue introducido conjuntamente con la lactancia materna desde el nacimiento y para 15,3% la lactancia artificial fue exclusiva (biberón). El desmame ocurrió en 20,0%. La dieta de 82,6% de los bebés presentaba azúcar en las bebidas del biberón. La leche artificial está presente desde el primer mes de vida y su uso predomina hasta los 3 años de edad.El azúcar está presente en la dieta de la mayoría de los bebés alimentados con biberón

O estudo propõe analisar o tipo de aleitamento utilizado, seja materno e/ou artificial, o seu tempo de uso, assim como a presença de açúcar na mamadeira dos bebês. Participaram 305 bebês de 0 a 36 meses, cujos dados foram obtidos através de um questionário junto às mães. Este continha informações sobre idade e gênero dos bebês, tipo de aleitamento e substâncias açucaradas introduzidas nas mamadeiras destes. O tipo de aleitamento mais utilizado foi o artificial (70,2%), sendo que aumentou com o decorrer da idade. Nos seis primeiros meses de vida, o aleitamento materno exclusivo foi realizado por 46,2% das mães, sendo que a mamadeira foi introduzida conjuntamente ao aleitamento materno desde o nascimento em 38,5% dos bebês e 15,3% destes receberam aleitamento artificial exclusivo (mamadeira). O desmame ocorreu em 20,0%. A dieta de 82,6% dos bebês continha açúcar nas bebidas da mamadeira. O aleitamento artificial está presente desde o primeiro mês de vida e seu uso é predominante até os três anos de idade. O açúcar está presente na dieta da maioria dos bebês amamentados com mamadeira.

Abordagem terapêutica em molares decíduos anquilosados: relato de caso clínico / Terapeutícal approach of ankylosed decíduous molars: case report

A anquilose dento alveolar, comum em molares decíduos, é definida como uma intercorrência no processo da erupção dentária, caracterizada pela fusão anatõmica entre o cemento e/ou dentina com o osso alveolar. Pode apresentar diferentes graus de infraoclusão, ocorre em qualquer etapa do período eruptivo e a sua etiologia é desconhecida. O diagnóstico precoce é de extrema importância para evitar a instalação de má-oclusão. O objetivo deste trabalho é apresentar uma revisão de literatura sobre a anquilose, bem como o relato de um caso clínico com os respectivos tratamentos.

The dentoalveolar ankylosis, common in deciduous molars, is an anomaly of dental eruption, due to abnormal fusion between cemento and/or dentine with the alveolar bone. It is characterized by presents different degrees of infraocclusion that can occurs in distinct stages of eruptive period which etiology is ignored. In order to prevent malloclusions, the correct diagnosis of dentoalveolar ankylosis seems to be very important. This paper aims to presents a dentoalveolar ankylosis literature review and a clinical case report, with the respective treatment.

Patrones de lactancia en bebés, su primer contacto con el azúcar y el dentista / Patterns of breastfeeding in infants, their first contact with the sugar and the dentist

El objetivo de esta investigación fue evaluar el patrón de lactancia, primer contacto con el azúcar y primera visita al dentista de los bebés con relación al estado socioeconómico familiar. Participaron 129 niños de 0 a 36 meses, cuyos datos fueron obtenidos por medio de un cuestionario realizado a las madres y exámenes clínicos bucales de los bebés en ambulatorios públicos y privados. La forma de lactancia más utilizada fue artificial (59%), siendo empleada desde el inicio de la vida y volviéndose más prevalente con el aumento de la edad. El primer contacto con el azúcar ocurrió principalmente después de los 3 meses de edad, sin embargo, 20% de las madres ofrecieron azúcar a sus hijos antes de los tres primeros meses de vida. El mayor número de bebés acudieron durante el primer año de vida al dentista (43%) siendo la prevención su principal motivo (65%). La prevalencia de actividad de caries para la muestra fue de 17%. Estos resultados correspondieron a madres que poseían grado escolar secundario y superior completo y recibían de 1 a 3 salarios mínimos. Conclusión: el patrón de amamantamiento en bebés es esencialmente artificial en los primeros meses de vida, lo que contribuye para que ocurra el primer contacto con el azúcar muy precozmente. La primera visita al dentista ocurre generalmente durante el primer año de vida del bebé

To analyze the pattern of feeding, first contact with sugar and first babies visit to the dentist with respect to family socioeconomic status. One hundred and twenty nine children, from 0 to 36 months, participated in the study. The data was obtained through a questionnaire conducted for their mothers and clinical oral exams of the babies in public and private outpatient departments. Results: bottle feeding was most widely used (59%), being employed since the beginning of the life and becoming more prevalent with the increasing age. The first contact with sugar occurred mostly after 3 months of life; however, 20% of mothers offered sugar for their children before the first three months of life. Most of the babies visited the dentist within their first year of life (43%) and the main reason was prevention (65%). All these results corresponded to mothers who had completed high school and higher education, as well as perceive 1 to 3 minimum wages. The pattern of breastfeeding in babies is essentially artificial in the first months of life, which contributes to appear the first contact with the sugar very early. The first visit to the dentist occurs during the first year of life of the baby

Prevalência de maloclusão em escolares do município de Campinas, São Paulo / Prevalence of malocclusion in schoolchildren in the municipality of Campinas, São Paulo, Brazil

Objetivo: Avaliar a prevalência e tipos de maloclusão em escolares do município de Campinas, São Paulo. Método: Foram examinados 660 escolares, em três escolas do município de Campinas. A faixa etária variou de 6,5 até 18,1 anos (média ± d.p. = 12,2 ± 2,3 anos). Os exames clínicos intrabucais foram realizados por quatro dentistas devidamente treinados e calibrados, consistiram em inspeção visual, utilizando apenas espátulas de madeira descartáveis e sondas milimetradas, em salas cedidas pelas escolas, com boas condições de visão e iluminação natural. Os critérios adotados para classificar as oclusões normais e maloclusões foram os estipulados por Andrews(1), Angle(2) e Maia(3). Resultados: Os dados obtidos indicaram que não houve diferença estatisticamente significante entre os gêneros. A maloclusão foi encontrada em 87,4% dos escolares examinados, concordando com a maioria dos trabalhos nacionais e internacionais. A maloclusão de Classe I foi a mais prevalente (39,7%) entre os escolares examinados, seguida da Classe II, com 36% dos casos, sendo que a Classe II divisão 1 teve uma maior prevalência (22,7%) em relação à Classe II divisão 2 (13,3%). A maloclusão de Classe III esteve presente em 11,7% da amostra. Conclusão: A prevalência de maloclusão é alta e independente do gênero na população de escolares estudada. A maloclusão mais prevalente foi a de Classe I, seguida da classe II divisão 1.

Objective: To evaluate the prevalence and types of malocclusion in schoolchildren in the municipality of Campinas, São Paulo, Brazil. Method: Six hundred and sixty schoolchildren at three schools in the municipality of Campinas were examined. The age bracket ranged from 6.5 up to18.1 years (mean ± s.d. = 12.2 ± 2.3 years) The intraoral clinical exams were performed by four duly trained and calibrated dentists, consisted of visual inspection using only disposable wooden spatulas and millimetric probes, performed in rooms provided by the schools, with good conditions of visibility and natural lighting. The criteria adopted for classifying normal and malocclusion were those stipulated by Andrews(1), Angle(2) and Maia(3). Results: The data obtained indicated that there was no statistically significant difference between the genders. Malocclusion was found in 87.4% of the schoolchildren examined, in agreement with the majority of Brazilian and International studies. Class I malocclusion was the most prevalent (39.7%) among the schoolchildren examined, followed by Class II, with 36% of the cases, and there was higher prevalence of Class II division 1 (22.7%) in comparison with Class II division 2 (13.3%). Class III malocclusion was present in 11.7% of the sample. Conclusion: There is high prevalence of malocclusion, irrespective of gender, in the studied population of schoolchildren. The most prevalent malocclusion was Class I, followed by Class I division 1.

Abordagem odontopediátrica integrada em crianças com paralisia cerebral / Odontopediatrics approach integrated in children with cerebral palsy

Este estudo tem a finalidade de descrever métodos de atendimento que minimizem as dificuldades encontradas durante a realização do tratamento odontológico em pacientes com paralisia cerebral. A classificação, a etiologia e os problemas sistêmicos associados são relatados para que o profissional possa conhecer o tipo de paralisia cerebral com a qual está trabalhando e alcançar sucesso no tratamento odontológico, tanto curativo como preventivo.

Bond strength analysis of intracanal posts used in anterior primary teeth: an in vitro study.

The purpose of this in vitro study is to assess the bond strength of three different posts used to restore primary anterior teeth. These posts were made by composite resin, 0.7 mm alpha-shaped orthodontic wire and dentin posts. Thirty roots of extracted primary anterior teeth, with initial physiological resorption, were mounted in a container filled with self cured resin and were endodontically treated Thirty posts were prepared using three different materials: 10 composite resin posts (Z100), 10 alpha-shaped orthodontic wire and 10 dentin posts. A bulk of composite resin (Z100) was made over the posts using a circular Teflon bisected strip. The specimens were stored in 37 degrees C water solution for 24 hours before tensile bond strength tests in 0.5 mm/min speed were performed (Instron model 4442 test machine--Instron Corporation). The results were submitted to the Kruskal-Wallis test and there were no significant statistical differences among the three types of posts assessed (p = 0.8666). The dentin posts technique might be considered an alternative for rehabilitation in pediatric dentistry, because of the possibility of natural resorption.

Tendência da experiência de cárie dentária em crianças de 5 a 59 meses de idade do Município de Diadema (SP) entre os anos 1995 e 2004 / Trens in dental caries in children 5-59-months-old in Diadema, Brazil from to 2004

O objetivo do presente estudo foi conhecer a tendência da experiência de cárie dentária em crianças de 5 a 59 meses de idade do município de Diadema - São Paulo. Para isso foi realizado no ano de 2004 um levantamento epidemiológico básico de saúde bucal e coleta de dados socioeconômicos. Os resultados de prevalência e severidade de cárie dentária desse levantamento foram comparados a outros quatro estudos epidemiológicos realizados sob o mesmo critério metodológico nos anos de 1995,1997, 1999 e 2002. Todos os dados de cada um dos cinco estudos transversais foram coletados durante o dia de Campanha Nacional de Multivacinação Infantil nos respectivos anos de estudo. Examinadores calibrados realizaram o exame intrabucal e foi feita uma entrevista para coletar dados socioeconômicos. Para avaliar a tendência de cárie foram realizadas análises lineares, transversais e semi-longitudinais utilizando os índices epidemiológicos de Knutson e ceo-s. A análise epidemiológica comparativa a partir dos estudos realizados entre 1995 e 2004 indica que houve evidente redução na prevalência e severidade de cárie quando se comparam as mesmas faixas etárias (análise linear), mas não quando se analisou crianças do mesmo coorte de nascimento (análise semi-longitudinal). As análises feitas da participação de indicadores socioeconômicos indicam que há associação significativa entre a experiência de cárie dentária em crianças e salário, grau de escolaridade e jornada de trabalho dos pais. As novas gerações da população de crianças menores de 5 anos de idade do município de Diadema estão possuindo uma melhor saúde bucal