Eficácia da pasta CTZ no tratamento endodôntico de dentes decíduos em crianças com deficiência: estudo clínico prospectivo / Efficacy of CTZ paste in endodontic treatment of primary teeth in children with disabilities: prospective clinical study

É imprescindível a atenção odontológica em pacientes com deficiência, e as boas condições de saúde da cavidade bucal, estão relacionadas com a qualidade de vida e o não agravamento de suas doenças sistêmicas. Estes pacientes têm o risco aumentado em desenvolver patologias bucais, como cárie dental e doenças periodontais, que se não tratadas podem evoluir para um processo infeccioso. Deste modo o objetivo do presente estudo é o tratamento de dentes decíduos com comprometimento pulpar destes pacientes, utilizando uma técnica endodôntica simplificada e pouco invasiva; esta alternativa é o uso da pasta antibiótica CTZ (cloranfenicol, tetraciclina e óxido de zinco e eugenol). Para tanto, foram selecionados 6 pacientes do NEAPE (Núcleo de Estudo e Atendimento a Pacientes Especiais), com idade média de 5 anos. Como metodologia realizou-se a pulpotomia de 13 dentes com pulpite irreversível ou necrose pulpar. Neste estudo foi avaliado o desempenho clínico e radiográfico pós tratamento destes elementos dentais em 14, 90 e 180 dias. Os resultados observados foram positivos para a manutenção do dente decíduo até sua esfoliação fisiológica. Diante disso, a pesquisa demonstrou que com uso da pasta CTZ é possível trazer benefícios para os pacientes não colaborativos, evitando extrações dentárias frente a um comprometimento pulpar(AU)

Dental care for patients with disabilities is essential, and their good oral health conditions are related to quality of life and the non-worsening of systemic diseases. These patients have increased risk of developing oral pathologies, such as dental caries and periodontal diseases, which, if left untreated, can develop into infectious processes. Thus, the present study aims at the treatment of primary teeth with pulp involvement in these patients through a simplified and little invasive endodontic technique, which is the use of the antibiotic CTZ paste (chloramphenicol, tetracycline and zinc oxide and eugenol). To this end, 6 NEAPE (Center for Study and Care for Special Need Patients) patients were selected, with average age of 5 years. As methodology, pulpotomy of 13 teeth with irreversible pulpitis or pulp necrosis was performed. In this study, the clinical and radiographic performance after treatment of these dental elements was evaluated at 14, 90 and 180 days. The observed results were positive for the maintenance of primary teeth until its physiological exfoliation. Therefore, the research showed that with the use of the CTZ paste, it is possible to bring benefits to non-collaborative patients, avoiding tooth extractions of pulp involvement(AU)

Abordagem de pacientes com ansiedade ao tratamento odontológico no ambiente clínico / Management of patients with dental anxiety at clinical environment

Objetivos: Discutir a ansiedade frente ao tratamento odontológico e apresentar as principais escalas disponíveis para a sua mensuração nas crianças e nos adultos. Materiais e métodos: para esta revisão de literatura os artigos foram selecionados na base de dados online PubMed, dentre os publicados entre 1979 até julho de 2015, e que estavam de acordo com os critérios STROBE e CONSORT. Resultados: Foram selecionados 30 artigos e a revisão destes mostrou que a escolha das escalas depende da idade do paciente, de sua capacidade cognitiva, bem como do tempo disponível para a aplicação dos instrumentos. A ansiedade odontológica e a condição em saúde bucal dos pais e dos filhos estão diretamente relacionadas. Conclusão: o Cirurgião-Dentista deve estar atento para diagnosticar e quantificar a ansiedade adequadamente, visando o estabelecimento de estratégias de abordagem comportamental e clínica individualizadas, tornando a consulta odontológica mais eficaz e menos estressante, tanto para o profissional quanto para os seus pacientes.

Objectives: to present the main dental anxiety scales available for children and adults, explainits association between parents and siblings. Methodology: the articles were selected in PubMed, from 1979 until July 2015, chosen studies were according to STROBE and CONSORT. Results: Thirty articles were selected, after their review it was found that the choice of scales depends on patients’ age, cognitive ability, and available time to implement the instruments. Parents’ dental anxiety and oral health conditions interfere directly with those in children. Conclusion: Is mandatory for professionals to diagnose and quantify oral health literacy levels and anxiety, in order to establish clinical and behavioral approach strategies, making a most effective and less stressful dental appointment, for both, the professional and patients.

Situación de salud oral de niños uruguayos portadores de coagulopatías hereditarias: Centro Hospitalario Pereira Rossell, Montevideo, Uruguay / Oral health in uruguayan children with inherited bleeding disorders: Pereira Rossell Hospital, Montevideo, Uruguay

Propósito: describir la situación de salud oral de los niños portadores de coagulopatías atendidos en el Servicio de Hemoterapia del Centro Hospitalario Pereira Rossell de Montevideo,Uruguay, entre febrero del 2008 y diciembre del 2009, y compararla con un grupo sin coagulopatías. Método: se realizó un estudio retrospectivo de casos y controles. El grupo deestudio estuvo conformado por 39 pacientes (edad: 8,62 ±4,20 años) y el grupo de control, por 78 (edad: 6,5 ± 2,88 años). El análisis de los hallazgos fue descriptivo. Resultados: enel grupo de niños con coagulopatías se encontró un índice ceo-d 2,85 ± 2,41 y un CPO-d 1,96 ±2,59, ambos ligeramente superiores al grupo control. Según la clasificación de lacoagulopatía se registró: hemofilia A en 17 pacientes, hemofilia B en 7, deficiencia de factor XII en un paciente y enfermedad de von Willebrand en 14. La adherencia al tratamientofue calificada como buena en 15 pacientes, mientras que fue mala en los 24 pacientes restantes. Conclusión: este es un primer reporte de salud oral en niños con coagulopatías en Uruguay. Es necesario hacer un seguimiento y aumentar la cobertura de este programa para mantener la salud oral de estos pacientes...

Aim: Describe the oral health status of children with inherited bleeding disorders who attended the Pereira Rossell Hospital in Montevideo Uruguay for dental care, between February 2008 and December 2009, and compare it with children without bleeding disorders. Methods:A retrospective case-control study was carried out. The study group consisted of 39 patients (age: 8.62 ± 4.20 years), while the control group had 78 patients (age 6.5 ± 2.88). Descriptive analysis was done to the data. Results: The study group had a dmf-s index 2.85± 2.41 and a DMF-s 1.96 ± 2.59, being slightly higher than in the control group. The bleeding disorder classification was: Hemophilia A, 17 patients; Hemophilia B, 7 patients; factor XII deficit, 1 patient; and Von Willebrand disease, 14 patients. Commitment to the treatmentwas determined as good in 15 patients and bad in 24 patients. Conclusion: This is the first oral health report on children with bleeding disorders from this program in Uruguay. It isnecessary to follow up the patients and increase the program coverage in order to maintain the oral health of this kind of patients...

Seen but not heard: a systematic review of the place of the child in 21st-century dental research.

BACKGROUND: The position of children in society has changed with increasing emphasis on children's rights and child-centred services. This study aimed to describe the extent to which contemporary oral health research has been conducted with or on children. DESIGN: A systematic review of the child dental literature from 2000-2005 was conducted. A purposive sample was used to develop categories describing the level of involvement of children in research. Four main categories were developed: children as the objects of research, proxies used on behalf of children, children as the subjects of research with some involvement and children as active participants with their perspectives explored. Electronic databases were searched and exclusion criteria applied. Each of the resulting papers was examined and categorised. The frequency distribution in each category and the distribution of these categories according to subject were calculated. RESULTS: The search revealed 3266 papers after application of the exclusion criteria. Of these, 87.1% were categorised as research where children were used as objects, 5.7% were found to involve proxies (parents or clinicians), 7.0% involved children to some extent and 0.3% involved children actively. CONCLUSION: Most oral health research is conducted on children, in future research should strive to be conducted with children, involving them as fully as possible.