Assessment of the pre-emptive effect of photobiomodulation in the postoperative period of impacted lower third molar extractions: A randomized, controlled, double-blind study protocol.

Photobiomodulation is a safe option for controlling pain, edema, and trismus when applied postoperatively in third molar surgery. However, administration prior to surgery has been under-explored. This study aims to explore the effectiveness of pre-emptive photobiomodulation in reducing postoperative edema in impacted lower third molar extractions. Two groups of healthy individuals undergoing tooth extraction will be randomly assigned: Control group receiving pre-emptive corticosteroid and simulated photobiomodulation, and Photobiomodulation Group receiving intraoral low-intensity laser and extraoral LED cluster application. The primary outcome will be postoperative edema after 48 h. The secondary outcomes will be pain, trismus dysphagia, and analgesic intake (paracetamol). These outcomes will be assessed at baseline as well as two and seven days after surgery. Adverse effects will be recorded. Data will be presented as means ± SD and a p-value < 0.05 will be indicative of statistical significance.

Are imaging exams relevant in aiding the diagnosis of focal osteoporotic bone marrow defect: A systematic review.

Background: Focal osteoporotic bone marrow defect (FOBMD) is a rare and poorly documented pathology corresponding to an unusual hematopoietic tissue in maxillary bones. Several studies have investigated FOBMD but reported different and heterogenous approaches to a correct diagnosis. Therefore, this systematic review evaluated the relevance of imaging exams in aiding FOBMD diagnosis and the implications in surgical planning for dental implants.The research question was: What is the relevance of imaging tests in aiding FOBMD diagnosis? Methods: Online databases were searched to select articles based on eligibility criteria. The studies included in the systematic review were submitted to bias and applicability assessments using the Joanna Briggs Institute tool for study quality assessment. Results: A total of 383 articles were obtained from all the databases, 27 studies were included, and all performed biopsies to confirm the diagnosis. The selected studies evaluated 698 patients, including approximately 80% of women, corroborating the literature that notes a higher prevalence of this lesion in women. The reviewed articles showed a low risk of bias for case series, moderate for case reports, and low for cross-sectional studies. Conclusion: The studies considered in this systematic review have shown that radiographic characteristics may sufficiently identify the lesion and provide a periodic radiographic follow-up. However, it is worth noting the need for CBCT for planning oral rehabilitation through implants to minimize the risks of such complications.

Treatment outcome for dentin hypersensitivity with laser therapy: Systematic review and meta-analysis.

BACKGROUND: Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically. OBJECTIVES: The present study aimed to review clinical trials on the treatment of DH with laser therapy through a systematic review and meta-analysis. MATERIAL AND METHODS: The search of electronic databases resulted in 562 publications up to April 2020. The inclusion criteria were studies carried out on humans and reporting on the treatment of DH with laser therapy. Case reports, literature reviews and systematic reviews were excluded. Selected by abstract, potentially eligible papers were read in full (n = 160). Independent examiners performed data extraction and the assessment of the risk of bias. RESULTS: A total of 34 studies were included in the analysis, and 11 in the quantitative analysis. It was observed that most studies followed up patients for a maximum of 6 months (55%). Through the meta-analysis, we observed statistically significant differences between the average pain before and after 3 months of treatment with highand low-power lasers. However, through indirect comparisons, it was observed that the high-power laser showed a greater tendency to reduce the pain levels after 3 months of treatment as compared to the low-power laser, but without a statistically significant difference. CONCLUSIONS: It was possible to conclude that regardless of the type of laser used in the treatment of DH, this treatment is an effective option for the control of pain symptoms. However, it was not possible to establish a defined treatment protocol, since the evaluation methods are very different from each other. Text for Rewiew and clinical cases.

Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial

Abstract Background Hall technique (HT) has been indicated for teeth with dentinal caries lesion; however, extensive cavities, with more than two surfaces still seem challenging for restorative treatment in pediatric dentistry, resulting in a higher failure rate and an increased need for retreatment. Objectives To compare the survival rate of the Hall technique preformed metal crown (HT) with resin composite restoration (RC) for multi-surface cavitated caries lesions in primary molars. Methodology In this multicenter two-arm randomized clinical trial, children between 4 and 9 years of age with at least one primary molar with cavitated caries lesion involving more than two surfaces, including one buccal or palatal/lingual surface, were selected from 17 Brazilian cities. A total of 364 teeth were allocated into two groups: (1) teeth treated with selective caries removal and RC and (2) treated with the HT. The survival rate was assessed at 6 and 12 months after the interventions. Survival analysis was performed with the Kaplan‒Meier method. Cox regression was used to determine the influence of explanatory variables on the survival rate (α=5%). Results After 12 months, 292 teeth were re-evaluated. A total of 358 teeth were re-evaluated at least once during the study and included in the survival analysis. The HT (87.8%) resulted in a higher survival rate than RC restoration (75.7%) (p=0.004). Conclusion HT has a higher survival rate than RC as a treatment for multi-surface cavitated caries lesions in primary teeth. ClinicalTrials.gov: NCT02782390

Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Alterações na clínica odontológica decorrentes da Pandemia: a mínima intervenção como a primeira opção em Odontopediatria / Changes in the dental clinic resulting from the Pandemic: minimal intervention as the first option in Pediatric Dentistry

A pandemia pelo novo coronavírus impactou a prática clínica odontológica, trazendo a necessidade de consultas mais rápidas, por vezes remotas, e com diminuição na produção de aerossóis, com o intuito de diminuir a disseminação do vírus Sars-CoV-2. Desta maneira, as técnicas abrangidas pela filosofia da Mínima Intervenção (MI) ganharam destaque pois, além dos benefícios para o momento pandêmico atual, são técnicas pautadas em evidências científicas e que podem ser oferecidas com segurança e de maneira integral à saúde bucal dos pacientes. Neste comentário, nós retomamos como o odontopediatra pode agir de maneira minimamente invasiva desde o diagnóstico ao tratamento mais complexo, além de educar o paciente e envolver a família na mudança comportamental, compreendendo seu papel na conquista da saúde bucal. A odontologia de Mínima Intervenção oferece ao paciente, em qualquer idade ou etapa de desenvolvimento, uma abordagem na qual sua família compreende os riscos e benefícios do plano de tratamento e participa das decisões para a construção de uma nova realidade em saúde.

The pandemic caused by the new coronavirus has impacted clinical dental practice, bringing the need for faster consultations, sometimes remote, and with a decrease in the production of aerosols, in order to reduce the spread of the Sars-CoV-2 virus. In this way, the techniques covered by the philosophy of Minimum Intervention (MI) gained prominence because, in addition to the benefits for the current pandemic moment, they are techniques based on scientific evidence and that can be offered safely and in an integral way to the oral health of patients. In this commentary, we revisit how pediatric dentists can act in a minimally invasive way from diagnosis to more complex treatment, in addition to educating the patient and involving the family in behavioral change, understanding their role in achieving oral health. Minimal Intervention Dentistry offers patients, at any age or stage of development, an approach in which their family understands the risks and benefits of the treatment plan and participates in decisions to build a new health reality.

Aesthetic-functional rehabilitation of deciduous anterior teeth without removal of carious tissue: series of clinical cases / Reabilitação estético-funcional em dentes anteriores decíduos sem remoção de tecido cariado: série de casos clínicos

ABSTRACT The treatment of cavity carious lesions in anterior deciduous teeth is a frequent demand in the pediatric dentistry clinic, since the control of the disease in early childhood still presents itself as an inter-factor challenge in child health care. While the scientific evidence on the minimally invasive principles of approach in Dentistry is presented at an increasing level, the alternatives for restorative treatment in anterior deciduous teeth still face the low availability of reports that associate minimal intervention with the aesthetic needs inherent to the treatment. Thus, this article presents a series of cases in which direct restorations in composite resin, without removing carious tissue using polyvinyl matrices, were treatment alternatives for moderate and severe caries lesions in anterior deciduous teeth. It was observed, therefore, that the use of this artifact helped the rehabilitation of compromised dental elements with speed and satisfactory 50 result, suggesting that this is an appropriate approach for application in Pediatric Dentistry, 51 since it offers resistance, durability, besides providing aesthetics and functionality, it presents lower cost and agility as it eliminates the laboratory phase.

RESUMO O tratamento de lesões cavitadas de cárie em dentes decíduos anteriores é uma demanda frequente na clínica de odontopediatria, visto que o controle da doença na primeira infância ainda se apresenta como um desafio interfatorial nos cuidados em saúde infantil. Enquanto a evidência científica nos princípios minimamente invasivos de abordagem em Odontologia apresenta-se em nível crescente, as alternativas para tratamento restaurador em dentes decíduos anteriores ainda esbarram na baixa disponibilidade de relatos que associem a mínima intervenção às necessidades estéticas inerentes ao tratamento. Assim, este artigo apresenta uma série de casos em que as restaurações diretas em resina composta, sem a remoção de tecido cariado utilizando matrizes de polivinila foram alternativas de tratamento para lesões de cárie moderadas e severas em dentes decíduos anteriores. Observou-se que o uso desse artefato auxiliou a reabilitação dos elementos dentários comprometidos com rapidez e resultado satisfatório, sugerindo que essa é uma abordagem adequada para aplicação em Odontopediatria, já que oferece resistência, durabilidade, além de proporcionar estética e funcionalidade, apresenta menor custo e agilidade na medida que dispensa a fase laboratorial.

Pulp vitality of primary molars with deep caries treated with ART restorations: 2-year RCT

Abstract: The aim of this study was to compare the pulp vitality of primary teeth with deep caries treated with two restorative techniques. The restoration survival rate was also evaluated as a secondary outcome. Children aged from 4 to 8 years with at least one deep carious lesion in molars were selected at the Ibirapuera University dental clinic. One hundred and eight deciduous molars were allocated into two groups: (1) restoration with calcium hydroxide cement lining followed by filling with high-viscosity glass ionomer cement (CHC+HVGIC) or (2) restoration with HVGIC. Pulp vitality and restoration survival were evaluated at 6, 12, and 24 months. Intent-to-treat analysis was used for pulp vitality, and survival analysis was performed with the Kaplan-Meier method (α=5%). Results: At 24 months, 86 restorations were evaluated, and 91 were evaluated at least once during the study. There was no significant difference between the restorative treatments regarding pulp vitality (CHC +HVGIC=70% and HVGIC=68.5%) (OR=1.091; CI95%=0.481-2.475). However, HVGIC (73%) restorations showed a higher survival rate than CHC+HVGIC (50%) (p=0.021). Thus, it can conclude that deep caries in primary molars should be restored with HVGIC, since the technique results in similar pulp vitality to the CHC +HVGIC, but with a higher restoration survival rate.

Lesion sterilization and tissue repair of primary molar to the eruption of its permanent successor: a case report / Esterilização da lesão e reparação de tecidos de molar decíduo: relato de caso clínico até a erupção do permanente sucessor

The aim of this study is to report a clinical case of lesion sterilization and tissue repair in primary molar, with follow-up until the eruption of the permanent successor. A 6-year-old male patient came to the Pediatric Dentistry Clinic at Faculdade Sao Leopoldo Mandic in Campinas-SP, with his mother, complaining of "caries in several teeth". On clinical examination, it was found that tooth 85 had a severe carious lesion with pulp involvement and fistula. Radiographically, radiolucency was observed in the furcation region. It was then decided to perform lesion sterilization and tissue repair of the tooth with CTZ paste. After 6 months of the procedure, the tooth was clinically and radiographically normal and after 3 years it was observed that tooth 85 was in complete root resorption. After extraction, the permanent successor erupted naturally without clinical or radiographic alterations. It can be concluded that the present clinical case demonstrated success in the use of CTZ paste in the lesion sterilization and tissue repair of primary molars, until the complete eruption of the permanent successor. (AU)

O objetivo desse estudo é relatar o caso clínico de esterilização da lesão e reparação de tecidos em molar decíduo com pasta CTZ, com acompanhamento até a erupção do pré-molar sucessor. Paciente do sexo masculino, 6 anos de idade, apresentou-se à Clínica de Odontopediatria da Faculdade São Leopoldo Mandic em Campinas-SP, acompanhado de sua mãe, queixando-se de "cárie em vários dentes". Ao exame clínico, verificou-se que o dente 85 apresentava lesão de cárie severa com envolvimento pulpar e fístula. Radiograficamente, observou-se radiolucidez na região de furca. Optou-se, então, por realizar a esterilização da lesão e reparação de tecidos do dente com pasta CTZ. Após 6 meses da realização do procedimento, o dente apresentava-se clinica e radiograficamente normal e após 3 anos observou-se que o elemento 85 estava em rizólise completa. Feita a extração, o permanente sucessor erupcionou naturalmente sem alterações clínicas ou radiográficas. Pode-se concluir que o presente caso clínico demonstrou sucesso do emprego da pasta CTZ na esterilização da lesão e reparação de tecidos de molar decíduo, até completa erupção do permanente sucessor. (AU)

Extraction of supernumerary teeth in a hospital setting: case report in pediatric dentistry / Exodontia de dentes supranumerários em ambiente hospitalar: relato de caso na Odontopediatria

ABSTRACT The diagnosis and treatment of supernumerary teeth pose a challenge for dental clinicians and pediatric dentists. These teeth are asymptomatic and may cause the delayed eruption of the permanent dentition, altered bone growth and ectopic positioning. This paper reports a case of the surgical removal of supernumerary teeth in the anterior region of the maxilla of a child under general anesthesia in a hospital setting. A six-year-old female patient visited a private dental office in the city of Garanhuns, Brazil, accompanied by her mother, who reported a tooth with a "strange shape" in the anterior region as the main complaint and also reported that her daughter's first dental experience was negative. The clinical examination and imaging tests were performed under general anesthesia to confirm the diagnosis. In view of the patient's dental and behavioral history, surgical treatment was performed in a hospital setting and assisted by a multidisciplinary team. Care in the hospital setting was found to be feasible, providing greater comfort for uncooperative patients.

RESUMO Os dentes supranumerários representam um desafio para clínicos e odontopediatras quanto ao diagnóstico e tratamento. São assintomáticos, podendo gerar atraso na dentição permanente, alteração do crescimento ósseo e posicionamento ectópico. Assim, o presente trabalho teve como objetivo apresentar um relato de caso de remoção cirúrgica de dentes supranumerários na região anterior da maxila de um paciente infantil, em ambiente hospitalar sob anestesia geral. O paciente do sexo feminino, 6 anos, compareceu ao consultório apresentando como queixa a presença de um dente "estranho" na região anterior. Foram realizados o exame clínico e exames de imagem com a confirmação do diagnóstico de dentes supranumerários na região do incisivo central superior direito (11) e do incisivo central superior esquerdo (21). Tendo em vista o histórico odontológico e comportamental da paciente, optou-se em realizar o tratamento cirúrgico em ambiente hospitalar, auxiliado por equipe multidisciplinar. Dessa forma, ao final dos procedimentos foi verificado que o atendimento em ambiente hospitalar é viável para maior conforto do paciente não colaborador.

Dental tissue-derived stem cell sheet biotechnology for periodontal tissue regeneration: A systematic review.

OBJECTIVE: This study aimed to conduct a systematic review of the use of a cell sheet formed by mesenchymal stem cells derived from dental tissues (ddMSCs) for periodontal tissue regeneration in animal models in comparison with any other type of regenerative treatment. DESIGN: PubMed and Scopus databases were searched for relevant studies up to December 2020. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. RESULTS: Of the 1542 potentially relevant articles initially identified, 33 fulfilled the eligibility criteria and were considered for this review. Even with a wide variety of selected study methods, the periodontal tissue was always regenerated; this indicates the potential for the use of these cell sheets in the future of periodontics. However, this regeneration process is not always complete. CONCLUSION: Despite the implantation, ddMSCs sheets have a great potential to be used in the regeneration of periodontal tissue. More in vivo studies should be conducted using standardized techniques for cell sheet implantation to obtain more robust evidence of the relevance of using this modality of cell therapy for periodontal tissue regeneration.

Cost analysis of endodontic treatment in primary teeth: results from a randomized clinical trial

Abstract: This study compared the cost of endodontic treatment in primary teeth involving a technique that does not require root canal instrumentation using antibiotic paste (CTZ) with that of the instrumented technique using iodoform paste (GP). This study is part of a randomized, controlled, parallel arm, noninferiority, 1:1 allocation, blinded (patient) multioperator study of 52 primary incisors of children aged 3 to 6 years with caries lesion and pulp involvement. Each technique was performed according to the creators' descriptions. The cost was assessed by analyzing the costs of capital, dental supplies, and professional labor according to the time taken to perform the procedure and the CHEERS guidelines were used to report the cost assessment. Endodontic treatment with CTZ had a 58.33% lower execution cost than GP (US$6.73 and US$16.15, respectively). The t-test showed significant differences between groups regarding treatment time and total cost (p < 0.0001). The CTZ technique seems to be more economically viable than GP for endodontic treatment of primary teeth, requiring a shorter treatment time and lower costs.

Management of deep caries lesions with or without pulp involvement in primary teeth: a systematic review and network meta-analysis

Abstract: There is a lack of evidence about the best approach for cavitated caries lesions with the possibility of pulpal involvement in primary teeth. Thus, the present authors aimed to verify the best treatment for deep caries lesions with or without pulp involvement in primary teeth. The search was conducted in MEDLINE/Pubmed and Web of Science databases until May 2020. Studies that compared techniques to manage deep caries lesions with at least 12 months of follow-up were included. The risk of bias was evaluated using the RoB tool. Network meta-analysis and pairwise meta-analyses were conducted considering the treatment clinical success as an outcome, according to the pulp health condition. From 491 potentially eligible studies, 9 were included. For deep caries lesions with pulp vitality, the Hall Technique presented the highest probability of success (78%). In the event of accidental pulp exposure, pulpectomy presented a 76% chance of providing the best clinical results. For pulp necrosis, no difference was observed between a pulpectomy and non-instrumented endodontic treatment (RR = 0.69; 95%CI: 0.21-2.33) Thus, it was concluded that the Hall Technique may be a better option for deep caries lesions with pulp vitality. In cases of accidental pulp exposure of vital teeth during caries removal, a pulpectomy may be considered the best option. However, there are insufficient studies to build up evidence about the best treatment option when irreversible pulpitis or pulp necrosis is present.

Qualidade de relatos de revisões sistemáticas sobre traumatismo dentário: overview / Quality of systematic review reports on dental traumatism: an overview

Objetivo: Realizar uma overview relacionada ao assunto traumatismo em dentes decíduos e permanentes, bem como analisar a qualidade metodológica e o risco de viés dos trabalhos incluídos (PROSPERO CRD42018107840). Métodos: Este trabalho foi conduzido de acordo com o Preferred Reporting Items for Overviews(PRIO). A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, WebScience, Embase, Cochrane e Scopus; que incluiu publicações até outubro de 2020, sem restrição de ano e idioma. Foram avaliados os critérios de elegibilidade: trabalhos com enfoque em lesões traumáticas dentárias; apresentar termo "revisão sistemática" (RS) e/ou "meta-análise" no título ou resumo, critérios de elegibilidade, técnicas sistematizadas para coleta e análise de dados, e instrumentos para avaliação da qualidade dos estudos incluídos; identificar as bases de dados utilizadas na pesquisa; abranger o assunto: traumatismo de dentes permanentes e/ou decíduos ou tecidos de suporte. Foi realizada a avaliação da qualidade das RSs utilizando o Assessment of Multiple Systematic Reviews (AMSTAR2) e averiguada a aderência do artigo ao Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Os resultados foram analisados pelo Grading of Recommendations, Assessment, Development and Evaluation (GRADE) a fim de classificar a certeza da evidência científica e avaliado o risco de viés pelo ROBIS. Resultados: Foram identificados 2.561 trabalhos, sendo 2.469 excluídos, totalizando 92 artigos incluídos. Nota-se que a partir do ano de 2018 os trabalhos apresentaram melhor qualidade metodológica. E a maioria dos trabalhos apresentaram certeza da evidência científica alta pelo sistema GRADE modificado, e risco de viés baixo pela ferramenta ROBIS. Conclusão: As revisões sistemáticas e meta-análises incluídas apresentaram dificuldade no processo de estruturação metodológica atribuindo, em média, certeza da evidência científica alta para o GRADE, como também risco de viés baixo pelo ROBIS. Descritores: Traumatismos dentários. Revisão. Dentição permanente. Dente decíduo.

Aim: To carry out an overview related to the subject of trauma to primary and permanent teeth, as well as to analyze the methodological quality and risk of bias in the studied works (PROSPERO CRD42018107840). Methods: this work was carried out according to the Preferred Reporting Items for Overviews (PRIO). The search strategy was applied to the electronic databases PubMed, WebScience, Embase, Cochrane, and Scopus, which included publications until October 2020, with no year or language restrictions. The eligibility criteria were evaluated: studies focusing on traumatic dental injuries; presented the term "systematic review" (RS) and/or "meta-analysis" in the title or abstract, eligibility criteria, systematic techniques for collecting and analyzing data, and instruments to assess the quality of the included studies; identify the databases used in the research; and cover the subject: trauma to permanent and/or deciduous teeth or supporting tissues. An evaluation of the quality of the SRs was performed using Assessment of Multiple Systematic Reviews (AMSTAR2), and adherence of the article to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria was verified. The results were analyzed by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) in order to classify the certainty of scientific evidence, and the risk of bias was assessed by ROBIS. Results: A total of 2,561 papers were identified, of which 2.469 were excluded, totaling a sample of 92 articles. It is noted that from 2018 onwards, the works presented better methodological quality. Moreover, most of the studies showed a certainty of high scientific evidence, determined by using the modified GRADE system and a low risk of bias determined by using the ROBIS tool. Conclusion:The systematic reviews and meta-analyses included in this study presented difficulties in the methodological structuring process, attributing, on average, a certainty of high scientific evidence to GRADE, as well as a low risk of bias determined by ROBIS.

Analysis of the frequency of visualization of morphological variations in anatomical bone features in the mandibular interforaminal region through cone-beam computed tomography.

PURPOSE: The purpose of this study was to analyze the frequency of visualization of anatomical bone features and their possible variations in the mandibular interforaminal region through cone-beam computed tomography (CBCT). METHODS: This is a cross-sectional study that evaluated CBCT scans of the mandible of 141 women and 61 men, obtained by imaging archives from two private clinics of dental radiology. The study analyzed the frequency of visualization of: lingual symphyseal foramen (LSF), additional mental foramen (AdMF), absence of mental foramen (AbMF), mandibular incisive canal (MIC), and anterior loop (AL). Length measurements for MIC and AL were determined at first and following that the respective distances towards vestibular and lingual cortical walls were also individually verified. Statistical analyses included: Student's t test, Chi-square test, and ANOVA for the evaluation of the anatomical features observed through panoramic and parasagittal images' reconstructions. RESULTS: LSF presence was found in 97%, MIC in 75.9%, AL in 24%, AdMF in 4.7%, and AbMF in 2.5%. Chi-square tests demonstrated value results of p < 0.05 only for the presence of left AL in women when compared to men. Mean values for length measures of MIC and AL were of 10.1 and 2.12 mm, respectively. Mean distance from AL towards vestibular and lingual cortical walls was of 2.53 and 4.05 mm, respectively. CONCLUSION: Anatomical variability concerning the mandibular interforaminal region emphasizes the importance of performing CBCT in pre-operative assessment of the mandible for surgical procedures with oral implants.

Efficacy of Sealing with Glass Ionomer Cement and Transversal Brushing Technique in Erupting First Molars: 18-Month Clinical Follow-Up

Objective: To verify the effectiveness of sealing with glass ionomer cement and transversal brushing in the prevention and treatment of initial caries lesions in erupting permanent molars of children aged 5-7 years. Material and Methods: Healthy teeth with ICDAS scores 1 or 2 were selected. One hundred and thirty-one children (79 teeth in the control group - 75 teeth in the test group) were randomly assigned into the two experimental groups: (1) transversal brushing technique for plaque control with conventional flat bristles and fluoridated dentifrice or (2) sealing the occlusal surfaces with glass ionomer cement (Vitro Molar®). Follow-up was performed for 18 months and the survival analysis was applied to test the occurrence of lesion progression. Results: The mean age of children was 5.4 years and it was verified that, by examining the initial tooth condition, the probability of progression was 66% lower when the tooth had initial caries lesions than when it was healthy; the probability of molar progression was about 74% lower in the test group compared to the control group. The mean time for lesion development in the test group (16.8 months; SD = 0.5) was greater than that in the control group (16.5 months; SD = 0.5; p=0.008). Conclusion: Sealing reduces the progression of caries disease in initial lesions when compared to the transversal brushing technique.

Assessment of Extruded Debris in Primary Molars Comparing Manual and Reciprocating Instrumentation

Objective: To compare the amount of extruded debris in primary molars after manual instrumentation or WaveOne system. Material and Methods: Twenty-five primary molar roots with mild and moderate root angulation (between 10 to 20º), having at least two thirds of root length, no pathological reabsorption (internal or external) or furcation perforation, were selected for this study. Roots were standardized at 6 mm in length, inserted and stabilized in individual acrylic resin blocks with random distribution into two groups: G1 (n=12): Instrumentation with crown-down manual technique; and G2 (n=13): instrumentation with WaveOne system. Blocks with roots were weighed before and after instrumentation, allowing the calculation of extruded debris using both mechanical preparations. Data analysis was performed by Bioestat 4.0 statistical software using Mann Whitney test. Results: The mean weight of extruded debris in manual instrumentation and WaveOne system have no significant difference (p=0.8704). Conclusion: Manual crown-down instrumentation or WaveOne system does not influence the amount of extruded debris after mechanical preparation, suggesting that both techniques were effective in canals clean causing similar extrused debris, however more studies with largest sample should be done to better validate this evidence.

Laser for bone healing after oral surgery: systematic review.

The purpose of this study is to perform a systematic review on the use of lasers in oral surgery for bone healing. Selection of articles was carried out by two evaluators in Pubmed and Web of Science databases for published articles and OpenGray for gray literature. Search strategy was developed based on the PICO Question "Does the use of lasers after oral surgery improve bone healing?". Eligibility criteria were: being on laser; evaluate bone healing; involve oral surgery; do not be about implant, periodontics, orthodontics, osteonecrosis or radiotherapy, nor revisions, clinical cases, etc. Data were collected from each article in a structured spreadsheet and a descriptive analysis was performed. Risk assessment of bias of the articles was carried out through the tool elaborated by the Cochrane collaboration. A total of 827 potentially relevant references were identified. No articles were found in OpenGray. Eleven articles met the eligibility criteria and were included in the systematic review. Most of studies were in vivo and in jaw, being conducted with low-power lasers which were applied immediately after the surgical procedure of extraction. Neoformation and bone density were the outcomes of choice and there was a tendency of increase in bone density, neoformation, regeneration, mineralization, or bone condensation when laser was applied. Regarding the bias risk assessment, studies were not clear in reporting most of the parameters. Low-power laser therapy seems to reduce time of bone healing in oral surgery, although there are no defined protocols and the level of evidence is still considered weak.

Treatment of Riga-Fede disease using laser therapy: clinical case report / Tratamento de lesão de Riga-Fede com laserterapia: relato de caso clínico

ABSTRACT Neonatal teeth arise in the oral cavity in up to 30 days of life. Early eruption of teeth associated with dental trauma on the ventral surface of the tongue during breastfeeding may lead to a set of signs and symptoms called the Riga-Fede lesion, which manifests as a chronic ulceration on the ventral surface of the tongue. Establishing the treatment plan is a challenging task. The pediatric dentist and pediatrician, should act in promoting health and recovery of the baby with the disease, taking care not to neglect the weight loss in newborns. The aim of this study was to demonstrate the clinical implications of a Riga-Fede lesion and treatment approach using laser therapy. A 43-day-old child was referred to pediatric dentistry, presenting weight loss and a congenital lingual injury caused by a neonatal tooth. The treatment, after radiographic examination was extraction of tooth 71, topical application of Triacinolone acetonide and laser therapy. Laser therapy has been shown to be a possible treatment option for Riga-Fede lesions, reducing the healing time to four days, allowing the return to feeding and improvement in the pain symptoms from the first day of application.

RESUMO Os dentes neonatais surgem na cavidade oral em até 30 dias de vida. A erupção precoce dos dentes associado ao trauma dental na língua durante a amamentação pode levar a um conjunto de sinais e sintomas chamado de lesão de Riga-Fede, que se manifesta como uma ulceração crônica no ventre da língua. O estabelecimento do plano de tratamento é uma resolução desafiadora. O odontopediatra, bem como o pediatra, deve atuar na promoção de saúde e recuperação do bebê com a doença instalada, com o cuidado de não negligenciar a perda de peso em neonatos. O objetivo desse trabalho foi demonstrar as implicações clínicas de uma lesão de Riga-Fede e abordagem de tratamento utilizando a laserterapia. Uma criança de 43 dias foi encaminhada para tratamento com odontopediatra, apresentando perda de peso e uma lesão no ventre lingual ocasionada por um dente neonatal. O tratamento efetuado, após exame radiográfico, foi a exodontia do elemento dental 71, aplicação tópica de Triacinolona acetonida e laserterapia. A laserterapia mostrou-se uma possível opção de tratamento para lesões de Riga-Fede, reduzindo o tempo de cicatrização para quatro dias, possibilitando o retorno à alimentação e melhora da sintomatologia dolorosa desde o primeiro dia da aplicação.

Odontodisplasia regional: relato de caso clínico / Regional odontodysplasia: a case report

A Odontodisplasia Regional é uma anomalia dental rara, que envolve os tecidos dentários de origem ectodérmica (esmalte) e mesodérmica (dentina, polpa e cemento). O objetivo deste trabalho foi relatar um caso clínico de odontodisplasia regional em uma criança. Paciente de nove anos, sexo masculino, tendo como queixa principal a ausência de alguns dentes decíduos e a não irrupção dos dentes permanentes em determinada região da maxila. O dente 16, que havia irrompido, apresentava-se clinicamente, com um esmalte hipoplásico e hipomineralizado e uma imagem radiográfica bastante tênue, por isso sendo conhecido como "dente fantasma". Foram apresentados nesse relato, aspectos clínicos e radiográficos e destacadas as questões envolvidas na elaboração de um plano de tratamento. Há poucos estudos disponíveis sobre a odontodisplasia regional. A anamnese detalhada e o conhecimento das características clínicas e radiográficas são imprescindíveis para um correto diagnóstico.

Regional Odontodysplasia is a rare dental anomaly involving dental tissues of ectodermal (enamel) and mesodermal (dentin, pulp and cement) origin. The aim of this study was to report a case of regional odontodysplasia in a child. A nine-year-old male patient who the main complaint was the absence of some deciduous teeth and the non - eruption of permanent teeth in a specific area of the maxilla. The tooth 16, which had erupted, had hypoplastic and hypomineralized enamel, presenting a radiographic image lacking clearness, for that reason being known "ghost teeth". In this case report, clinical and radiographic aspects were presented and were highlighted the issues involved in the elaboration of a treatment plan. There are few available studies about regional odontodysplasia. The detailed anamnesis and the knowledge of the clinical and radiographic characteristics are essential for a correct diagnosis.