Pediatric Odontogenic Infections.

Odontogenic infections are a broad group of head and neck conditions that arise from the teeth and surrounding periodontium. These largely preventable infections disproportionately affect members of ethnic and racial minorities and low-income/uninsured groups, and result in significant costs to our health care system. Left untreated, odontogenic infections can spread to deep spaces of the head and neck and can result in life-threatening complications. The mainstay of treatment includes timely treatment of the affected teeth. These infections are a global public health concern that could be diminished with improved access to routine dental care.

Medical Conditions, Oral Health Practices, and Barriers to Treatment among Patients Visiting a Teaching Dental Hospital in Eastern Saudi Arabia.

OBJECTIVE: To assess the prevalence of medical conditions, oral hygiene practices, and dental visits among patients who attended a teaching dental hospital in Dammam, Saudi Arabia. Materials & Methods. This retrospective cross-sectional study used patient records from 2009 to 2015 from the dental hospital of the College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam. Patients' demographics, medical history, oral hygiene practices, reasons for attending the facility, attendance patterns, and smoking habits were studied. RESULTS: The study included 1502 records of patients with 65.1% of males and 34.9% of females. The prevalence of medical conditions was 25.7% in the study. The most common medical conditions included diabetes mellitus (7.2%), hypertension (6.5%), and anemia (4.7%). Only 21.8% reported visiting the dental hospital in the past one year. The prevalence of smoking was 16.7%, and this did not differ significantly between healthy and medically compromised patients (P=0.165). Fillings were the most common (21.6%) reason for visiting a dental hospital, followed by treatment for periodontal problems (12.9%) and oral lesions (12.6%), whereas treatment for braces (orthodontics) was the least common (5%) reason for visiting the hospital. The reasons for visiting the hospital did not differ significantly between healthy and medically compromised patients (P > 0.05). The three most common barriers to dental visits included long waiting time (18.1%), fear of dental treatment (14.4%), and difficulty in getting an appointment (11.3%). CONCLUSION: The study showed that dental patients had a high prevalence of medical conditions. Diabetes mellitus was the most prevalent problem. Most patients visited the dental hospital to receive restorative treatment, and a long waiting time was the most common barrier to dental visits. Public health measures should be taken to improve the general health and oral care of patients.

Avaliação clínica de restaurações Classe V em cavidades tratadas com o laser de Er: YAG associado ao uso de sistemas adesivos autocondicionantes / Clinical evaluation of Class V restorations in cavities treated with Er: YAG laser associated with the use of self-etching adhesive systems

O objetivo deste estudo clínico, controlado, randomizado, cego e prospectivo foi de avaliar a efetividade clínica de restaurações em lesões não cariosas (cavidades Classe V) realizadas em superfícies dentais pré-tratadas ou não com laser de Er:YAG e utilizando dois sistemas adesivos autocondicionantes. Este estudo foi realizado com um total de 91 lesões e divididas em 4 grupos (n = 23) :G1(FL): Sem pré-tratamento e utilizando o adesiso FL-Bond II/Shofu; G2 (CF): sem pré-tratamento e utilizando o adesivo Clearfil SE Bond 2/Kuraray Noritake; G3 (Laser + FL): pré-tratamento associado ao uso do FL-Bond II/Shofu e G4 (Laser + CF): pré-tratamento associado ao uso do Clearfil SE Bond 2/Kuraray Noritake Os dentes avaliados foram os pré-molares de ambas as arcadas. A avaliação foi feita imediatamente após o tratamento e ao longo do tempo, em 3, 6 e 12 meses após a finalização da restauração. Para a avaliação da sensibilidade foi considerado a EVA (Escala Visual Analógica) e para a qualidade da restauração o método do USPHS modificado, considerando a avaliação de perda de retenção, integridade marginal, pigmentação marginal, presença de lesão de cárie em margem de restauração, vitalidade pulpar e sensibilidade pós-operatória. Os dados foram registrados em tabelas de frequência, e os escores transformados em postos para a aplicação do teste ANOVA. A significância estatística foi considerada para valores de p<0,05. Para os resultados da avaliação de sensibilidade houve uma diferença estatística significante da sensibilidade ao longo do tempo (p<0,001), sendo que essa diferença se deu a partir da avaliação T1 (48 horas) em todos os grupos. Em relação aos critérios avaliados no USPHS, foram encontrados variações estatísticas em alguns tópicos: Pigmentação marginal - G1 (FL) (p=0,041) e G2 ( Laser + FL) (p=0,009) e Integridade marginal G1(FL)( p=0,036). Os demais grupos e critérios não apresentaram variações estatísticas significantes.Pré-tratamentos com laser Er:YAG podem ser uma alternativa viável em restaurações adesivas do tipo classe V; no entanto, nenhum efeito sinérgico de ambos os tratamentos combinados foi observado.

The objective of this clinical, controlled, randomized, blinded and prospective study was to evaluate the clinical effectiveness of restorations in non-carious lesions (Class V cavities) performed on dental surfaces pre-treated or not with Er:YAG laser and using two adhesive systems self-conditioning. This study was carried out with a total of 91 lesions and divided into 4 groups (n = 23) :G1(FL): No pre-treatment and using the FL-Bond II/Shofu adhesive; G2 (CF): without pre-treatment and using Clearfil SE Bond 2/Kuraray Noritake adhesive; G3 (Laser + FL): pre-treatment associated with the use of FL-Bond II/Shofu and G4 (Laser + CF): pre-treatment associated with the use of Clearfil SE Bond 2/Kuraray Noritake The teeth evaluated were the premolars of both arcades. Assessment was performed immediately after treatment and over time, at 3, 6, and 12 months after completion of the restoration. The VAS (Visual Analogue Scale) was used for the sensitivity assessment and the modified USPHS method for the quality of the restoration, considering the assessment of loss of retention, marginal integrity, marginal pigmentation, presence of caries in the restoration margin. , pulp vitality and postoperative sensitivity. Data were recorded in frequency tables, and the scores were transformed into ranks for the application of the ANOVA test. Statistical significance was considered for values of p<0.05. For the results of the sensitivity evaluation, there was a statistically significant difference in sensitivity over time (p<0.001), and this difference occurred from the T1 evaluation (48 hours) in all groups. Regarding the criteria evaluated at the USPHS, statistical variations were found in some topics: Marginal pigmentation - G1 (FL) (p=0.041) and G2 (Laser + FL) (p=0.009) and Marginal integrity - G1(FL)( p =0.036). The other groups and criteria did not present significant statistical variations. Pretreatments with Er:YAG laser can be a viable alternative in class V adhesive restorations; however, no synergistic effect of both treatments combined was observed.

Associação entre idade na primeira consulta odontológica e tipo de tratamento dentário realizado em pacientes infantis: estudo transversal / Association between age of the first dental visit and type of dental treatment performed in infant patients: a cross-sectional study

Objetivo: Avaliar a associação entre idade na primeira consulta odontológica e o tipo de tratamento dentário realizado em pacientes infantis por meio de um estudo transversal que avaliou registros em prontuários odontológicos. Métodos: A coleta de dados foi realizada por meio de prontuários de pacientes de 0-5 anos atendidos em uma Clínica Escola de Odontologia, de março de 2014 a julho de 2018, com registro de informações referentes às características dos participantes e procedimentos odontológicos realizados. Para a análise dos dados, foram calculadas medidas descritivas e posteriormente os dados foram ajustados em um modelo de regressão logística; o desfecho foi o tipo de procedimento realizado, dicotomizado em tratamentos não-invasivos (fluorterapia e/ou restauração) e invasivos (endodontia e/ou exodontia). Resultados: Foram avaliados prontuários de 210 crianças, com média de idade na primeira consulta de 38 meses (DP=14,5). Fluorterpia e/ou restauração foram realizados em 74,8% das crianças, enquanto tratamentos invasivos foram realizados em 25,2% da amostra. A análise ajustada indicou um incremento (OR = 1,03, p = 0,027) na chance de realização de tratamentos invasivos com o aumento da idade das crianças na primeira consulta odontológica. Conclusão: Quanto maior a idade das crianças na primeira consulta, maior a chance de terem recebido um tratamento invasivo. Ressalta-se a importância da consulta odontológica nos primeiros meses de vida, com a finalidade de prevenção e manutenção da saúde bucal.(AU)

Objective: To evaluate the association between the age of the first dental visit and the type of dental treatment performed in infant patients through a cross-sectional study that examined dental records from the years 2014 to 2018. Methods: Data collection was conducted using medical records of patients aged 0 to 5 years treated at a Dental School Clinic, including information about participants' characteristics and the types of dental procedures performed. For data analysis, descriptive measures were calculated, and the data were subsequently fitted into a logistic regression model. The outcome was categorized into non-invasive treatments (fluoridation therapy and/or restoration) and invasive treatments (endodontics and/or extraction). Results: Medical records of 210 children were evaluated, with a mean age of the first dental visit being 38 months (SD = 14.5). Non-invasive treatments, including fluoride therapy and/or dental restoration, were performed in 74.8% of children, while invasive treatments were performed in 25.2% of the sample. Adjusted analysis indicated an increase (OR = 1.03, p = 0.027) in the odds of undergoing invasive treatments as the children's age at the first dental visit increased. Conclusion: Older age at the first appointment was associated with increased odds of receiving invasive treatment. The significance of early dental consultations within the first months of life is underscored, aiming to prevent and maintain oral health.(AU)

Defectos bucodentales en personas con síndrome de Down: una prioridad en salud bucal / Oral-dental defects in people with Down's syndrome: a priority in oral health

RESUMEN El síndrome de Down con frecuencia se acompaña de defectos bucodentales que comprometen la función masticatoria y fonatoria del paciente. Las acciones de prevención y promoción de salud bucal, el diagnóstico precoz y seguimiento de estas enfermedades, contribuyen al logro del verdadero enfoque interdisciplinario que demandan estos pacientes, para lograr una plena inclusión social. Se realizó una búsqueda bibliográfica sobre el tema, con el objetivo de estructurar los referentes teóricos relacionados con los principales defectos bucodentales -congénitos y adquiridos- que afectan a la población con síndrome de Down, para lograr la prevención de estos defectos y el incremento de la calidad de vida de los pacientes. Los defectos bucodentales congénitos más frecuentes encontrados en la trisomía 21, fueron la microdoncia, la macroglosia y la erupción dental tardía. La enfermedad periodontal fue el defecto adquirido de mayor presentación, al que se asocian diversos factores de riesgo, muchos modificables. Las intervenciones tempranas en salud bucal pueden incrementar la calidad de vida de los niños y adultos que padecen este trastorno, ayudándolos a lograr un pleno desarrollo como seres humanos (AU).

ABSTRACT Down's syndrome is frequently accompanied by oral-dental defects compromising the masticatory and phonatory function of the patients. Oral health promotion and prevention actions, precocious diagnosis and follow-up of these diseases contribute to achieving the true interdisciplinary approach these patients demand to reach their full social inclusion. A bibliographic search on the theme was carried out, with the objective of structuring the theoretical referents related to the main oral-dental defects -congenital and acquired-, affecting the population with Down's syndrome to reach these defects prevention and increasing these patients' life quality. The congenital oral-dental defects more commonly found in trisomy 21 were microdontia, macroglossia, and delayed tooth eruption. Periodontal disease was more frequently found acquired defect, to which several risk factors are associated, many of them modifiable. Early interventions in oral health may improve the life quality of these children and adults, helping them to achieve a full development as human beings (AU).

Técnicas alternativas del manejo de la conducta en odontopediatría / Técnicas alternativas para a gestão comportamental em odontologia pediátrica / Alternative behavioral management techniques in pediatric dentistry

Diversas técnicas convencionales han sido utilizadas con gran eficacia; sin embargo, la no aceptación de algunas de ellas por los padres, ciertos condicionamientos éticos y legales así como cambios en la educación actual y el avance en nuevas tecnologías, obligan al odontólogo a un replanteamiento de actitudes. Objetivo: El objetivo del presente trabajo es identificar qué técnicas alternativas son empleadas en la clínica dental por los profesionales para el manejo de la conducta de pacientes infantiles. Material y métodos: Se realizó un cuestionario en la plataforma de Google, remitido vía email a 190 odonto/estomatólogos que tratasen pacientes infantiles, obteniendo una participación de 132 encuestas adecuadas para el análisis de 6 técnicas alternativas de manejo de la conducta. El estudio estadístico se realizó en el programa SPSS aplicando el test de ANOVA para una significación de p= 0,05. Resultados: Un 35,1% de los encuestados utilizaban medios audiovisuales para el tratamiento dental, siendo la televisión el más frecuentemente empleado. La musicoterapia fue la técnica más utilizada (70,5% de los participantes) con mayor frecuencia del sexo femenino, aunque sin diferencias significativas, siendo la música moderna la de mayor aceptación. Un 32,8% utilizaron la ludoterapia como técnica de manejo seguida del empleo de técnicas de relajación con un 25%, ambas con mayor porcentaje femenino. Las dos técnicas menos utilizadas fueron la aromaterapia (6,8%) y la hipnosis (2,3%). Conclusiones: A pesar del incremento en la utilización de técnicas alternativas en el manejo de la conducta, todavía su empleo es escaso por los odonto/estomatólogos.

Várias técnicas convencionais têm sido usadas com grande eficácia; contudo, a não aceitação de algumas delas pelos pais, certas condições éticas e legais, assim como as mudanças na educação atual e o avanço das novas tecnologias, forçam o dentista a repensar as atitudes. Objetivo: O objetivo do presente estudo é identificar quais técnicas alternativas são utilizadas na clínica odontológica por profissionais para gerenciar o comportamento de pacientes infantis. Material e métodos: Foi realizado um questionário na plataforma Google, enviado por e-mail a 190 dentistas/stomatologistas que trataram crianças, obtendo 132 pesquisas adequadas para a análise de 6 técnicas alternativas de gestão comportamental. O estudo estatístico foi realizado no programa SPSS aplicando o teste ANOVA para uma significância de p= 0,05. Resultados: 35,1% dos inquiridos utilizaram meios audiovisuais para tratamento dentário, sendo a televisão a mais frequentemente utilizada. A musicoterapia foi a técnica mais utilizada (70,5% dos participantes) pelo sexo feminino, embora sem diferenças significativas, sendo a música moderna a mais amplamente aceita. 32,8% utilizaram a terapia lúdica como técnica de gestão seguida do uso de técnicas de relaxamento com 25%, ambas com uma percentagem maior de mulheres. As duas técnicas menos utilizadas foram a aromaterapia (6,8%) e a hipnose (2,3%). Conclusões: Apesar do aumento do uso de técnicas alternativas na gestão do comportamento, o seu uso ainda é escasso pelos odontologistas/estomatologistas.

Various conventional techniques have been used with great efficiency; nevertheless, the non-acceptance of some of them by the parents, certain ethical and legal conditions as well as changes in the current education and the advance in new technologies, force the dentist to a rethinking of attitudes. Aim: The aim of this paper is to identify what alternative techniques are used by professionals for the behavior's management of pediatric patients in the dental clinic. Material and methods: A questionnaire was carried out on the Google platform, sent via email to 190 odonto / stomatologists who treated pediatric patients, obtaining a participation of 132 appropriate surveys for the analysis of 6 alternative behavior management techniques. The statistical study was carried out in the SPSS program, applying the ANOVA test for a significance of p = 0.05. Results: 35.1% of respondents used audiovisual media for dental treatment, being television the most frequently used. Music therapy was the most applied technique (70.5% of the participants) with the highest frequency of female sex, without significant differences though, being modern music the most widely accepted. 32.8% used play therapy as a management technique followed by the use of relaxation techniques with 25%, both with a higher female percentage. The two least used techniques were aromatherapy (6.8%) and hypnosis (2.3%). Conclusions: Despite the increase in the use of alternative techniques in behavior management, their use is still scarce by dentists / stomatologists.

Efectividad de las técnicas de manejo conductual en odontopediatría. Revisión sistemática / Eficácia das técnicas de gestão comportamental na odontologia pediátrica. Revisão sistemáticaArtigo da revisaoe-220163Vol 11 N° 1 Enero - Junio 2021 / Effectiveness of behavioral management techniques in pediatric dentistry. Systematic review

Objetivo: efectuar una revisión sistemática sobre la efectividad de las técnicas de manejo de la conducta en niños sistémicamente sanos, en la consulta de Odontopediatría. Métodos: Investigación descriptiva, retrospectiva, de estudios observacionales y ensayos clínicos aleatorios controlados que evaluaron la efectividad de las técnicas en niños y adolescentes de 03 a 18 años de edad. Resultados: criterios de inclusión artículos en inglés y español, publicados desde 2014 al 2019. El análisis de la calidad metodológica de los estudios se realizó mediante la guía Strobe y CASPe. Se identificaron términos de búsqueda en inglés en el tesauro MeSH en la base de datos Pub­M/Medline, Scopus /Elsevier, español, se utilizaron descriptores de las Ciencias de la Salud (DeCS/BIREME) en la base de datos SciELO.org Redalyc.org, Latindex, Dialnet y google académico. Hubo homogeneidad en los estudios respecto a la selección de escalas para medir ansiedad y miedo en los niños al recibir tratamiento preventivo, curativo o restaurador. Los estudios evaluaron mayoritariamente técnicas de distracción aplicadas con recursos audiovisuales para determinar efectividad sobre el comportamiento de los niños en el consultorio odontológico. También reportaron disminución de la ansiedad y miedo, después de la aplicación de técnicas de distracción, e informaron que hubo cambios de conducta de pacientes ansiosos y negativos a pacientes positivos y colaboradores. Conclusiones: estudios mostraron una insuficiente calidad en sus diseños, lo que no permitió emitir juicios respecto a la contundencia y solidez de la evidencia sobre la efectividad de las técnicas aplicadas.

Objetivo: Realizar uma revisão sistemática da eficácia das técnicas de gerenciamento de comportamento em crianças sistemicamente saudáveis, na consultório de Odontopediatria. Métodos: Estudos descritivos, retrospectivos, observacionais e ensaios clínicos controlados e randomizados que avaliaram a eficácia das técnicas em crianças e adolescentes de 03 a 18 anos. Resultados: Os critérios de inclusão foram artigos em inglês e espanhol, publicados de 2014 a 2019. A análise da qualidade metodológica dos estudos foi realizada na guia Strobe and Consort. Os termos de pesquisa em inglês foram identificados na tesauro MeSH na base de dados PubMed / Medline, Scopus / Elsevier e, em espanhol, os descritores de Ciências da Saúde (DeCS / BIREME) foram utilizados na base de dados SciELO.org Redalyc.org, Latindex, Dialnet e Google Scholar. Houve homogeneidade nos estudos em relação à seleção de escalas para medir ansiedade e medo em crianças ao receber tratamento preventivo, curativo ou restaurador. Os estudos avaliaram principalmente técnicas de distração aplicadas com recursos audiovisuais para determinar sua eficácia na comportamento de crianças na consultório odontológico. Eles também relataram diminuição da ansiedade e medo, após a aplicação de técnicas de distração, e relataram que houve mudanças comportamentais de pacientes ansiosos e negativos para pacientes positivos e colaborativos. Conclusões: Os estudos mostraram qualidade insuficiente em seus desenhos, o que não permitiu julgamentos sobre a força e a força das evidências sobre a eficácia das técnicas aplicadas.

Aim: to conduct a systematic review of the effectiveness of behavior management techniques in systemically healthy children, in the Pediatric Dentistry office. Methods: Descriptive, retrospective, observational studies and randomized controlled clinical trials that evaluated the effectiveness of the techniques in children and teenangers aged 03 to 18 years. Results: The inclusion criteria were articles in English and Spanish, published from 2014 to 2019. The analysis of the methodological quality of the studies was carried out using the Strobe and Consort guide. English search terms were identified in the MeSH thesaurus in the Pub¬M / Medline, Scopus / Elsevier database, and in Spanish, descriptors of Health Sciences (DeCS / BIREME) were used in the SciELO.org database, Redalyc.org, Latindex, Dialnet and Google Scholar. There was homogeneity in the studies regarding the selection of scales to measure anxiety and fear in children when receiving preventive, curative or restorative treatment. The studies mostly evaluated distraction techniques applied with audiovisual resources to determine their effectiveness on the behavior of children in the dentistry office. They also reported decreased anxiety and fear, after the application of distraction techniques, and reported that there were behavioral changes from anxious and negative patients to positive and collaborative patients. Conclusions: The studies showed insufficient quality in their designs, which did not allow judgments regarding the strength and strength of the evidence on the effectiveness of the techniques applied.

Eficacia de la musicoterapia para reducir la ansiedad dental en niños con discapacidad / Eficacia da musicoterapia para redução da ansiedade dental em crianças com discapacidades / Effectiveness of Music Therapy in reducing dental anxiety in children with disabilities

Objetivo: Evaluar la eficacia de la musicoterapia para la reducción de la ansiedad dental en niños entre 5 a 12 años con discapacidad durante la atención odontológica. Materiales y métodos: Estudio cuasi experimental. Se evaluaron 40 pacientes, divididos aleatoriamente en 2 grupos: grupo de expuestos y no expuestos a musicoterapia. El nivel de ansiedad fue registrado por la escala de imagen facial antes y después de la atención clínica, el comportamiento durante la atención a través de la escala de Frankl y el nivel de ansiedad de los padres a través de la escala modificada de Corah. Se registraron las funciones vitales de ambos grupos antes y después de dicha atención. El análisis de los datos se realizó análisis descriptivo (media ± desviación estándar) y análisis inferencial: Test de T-Student y Chi cuadrado (p<0,05). Resultados: Se encontró que la presión arterial inicial/ final en el grupo expuesto fue (Sístole: 108.75 ± 8.56/ 95.50 ± 6.86, Diástole: 67.75 ± 7.15 / 57.75 ± 6.38), y en el grupo no expuesto (Sístole: 101.75 ± 8.77/ 110.15 ± 13.31, Diástole: 59.20 ± 6.08) respectivamente, y la frecuencia cardiaca inicial/final en el grupo expuesto (72.30 ± 7.18 / 63.95 ± 6.12); y en el grupo no expuesto (66.50 ± 9.88 / 73.90 ± 11.46). Se encontraron diferencias estadísticamente significativas en los valores de la presión arterial (sístole, p<0,001 y diástole, p=0,007) y frecuencia cardiaca final (p=0,001), así como una reducción de los niveles de ansiedad final en el grupo expuesto a musicoterapia (p=0,001).

Objetivo:Avaliar a eficacia da musicoterapia para redução da ansiedade dental em crianças com discapacidades entre 5 a 12 anos durante o atendimento odontológico. Materiais e métodos: Estudo quase experimental. Avaliou-se 40 pacientes divididos aleatoriamente em dois grupos: grupos de expostos e não expostos a musicoterapia. O nível de ansiedade foi registrado pela escala de imagem facial antes e durante o atendimento odontológico, o comportamento durante o atendimento foi através da escala de Frankl e o nível de ansiedade dos padres através da escala modificada de Corah. As funções vitais foram registradas antes e depois do atendimento. O análises de dados foi realizado através análises descritivas (média ± ds) e análises inferenciais: Teste de T-Student e Chi Quadrado (p<0,05). Resultados: A pressão arterial inicial/final no grupo exposto foi (Sístole: 108.75 ± 8.56/95.50 ± 6.86, Diástole: 67.75 ± 7.15/ 57.75 ± 6.38), e no grupo não exposto (Sístole: 101.75 ± 8.77/110.15 ± 13.31, Diástole: 59.20 ± 6.08) respetivamente, e a frequência cardíaca inicial/final no grupo exposto (72.30 ± 7.18/ 63.95 ± 6.12); e no grupo não exposto (66.50 ± 9.88 / 73.90 ± 11.46). Se encontraram diferenças estatisticamente significativas nos valores da pressão arterial (sístole, p=0,000 e diástole, p=0,007) e frequência cardíaca final (p= 0,001), assim como na redução dos níveis de ansiedade final no grupo exposto à musicoterapia (p=0,001). Conclusão: O uso da musicoterapia diminuiu significativamente os níveis da ansiedade durante o atendimento odontológico nos pacientes com discapacidades

Objective: To evaluate the effectiveness of music therapy in reducing dental anxiety in children with disabilities between 5 and 12 years old during dental care. Materials and methods: Quasi-experimental study. 40 patients were evaluated, randomly divided into 2 groups: a group exposed to music therapy and a group not exposed to it. The levels of anxiety were registered using the Facial Image Scale before and after the dental care, the behaviour during dental care using the Frank Scale and the level of anxiety of the parents using the Modified Corah Scale. The vital functions of both groups were registered before and after the dental care. The data analysis was performed using descriptive analysis (media ± standard deviation) and inferential analysis: T- Student test and Chi square (p<0,05). Results: It was found that the initial/final blood pressure in the exposed group was (Systole: 108.75 ± 8.56/ 95.50 ± 6.86, Diastole: 67.75 ± 7.15/ 57.75 ± 6.38), and in the unexposed group (Systole: 101.75 ± 8.77/ 110.15 ± 13.31, Diastole: 59.20 ± 6.08), and the initial/final heart rate in the exposed group was (72.30 ± 7.18/ 63.95 ± 6.12); and in the unexposed group (66.50 ± 9.88/ 73.90 ± 11.46). Statistically significant differences were found in the values of blood pressure (systole, p=0,000 y diastole, p=0,007) and heart rate (p= 0,001), as well as a reduction in the levels of anxiety in the exposed group to music therapy (p=0,001). Conclusion: The use of Music therapy significantly reduces levels of anxiety during dental care in patients with disabilities.

Prospects on Nano-Based Platforms for Antimicrobial Photodynamic Therapy Against Oral Biofilms.

Objective: This review clusters the growing field of nano-based platforms for antimicrobial photodynamic therapy (aPDT) targeting pathogenic oral biofilms and increase interactions between dental researchers and investigators in many related fields. Background data: Clinically relevant disinfection of dental tissues is difficult to achieve with aPDT alone. It has been found that limited penetrability into soft and hard dental tissues, diffusion of the photosensitizers, and the small light absorption coefficient are contributing factors. As a result, the effectiveness of aPDT is reduced in vivo applications. To overcome limitations, nanotechnology has been implied to enhance the penetration and delivery of photosensitizers to target microorganisms and increase the bactericidal effect. Materials and methods: The current literature was screened for the various platforms composed of photosensitizers functionalized with nanoparticles and their enhanced performance against oral pathogenic biofilms. Results: The evidence-based findings from the up-to-date literature were promising to control the onset and the progression of dental biofilm-triggered diseases such as dental caries, endodontic infections, and periodontal diseases. The antimicrobial effects of aPDT with nano-based platforms on oral bacterial disinfection will help to advance the design of combination strategies that increase the rate of complete and durable clinical response in oral infections. Conclusions: There is enthusiasm about the potential of nano-based platforms to treat currently out of the reach pathogenic oral biofilms. Much of the potential exists because these nano-based platforms use unique mechanisms of action that allow us to overcome the challenging of intra-oral and hard-tissue disinfection.

Multidisciplinary approaches to odontogenic lesions.

PURPOSE OF REVIEW: To give an overview of technical considerations and relevant literature in the management odontogenic pathology with involvement of the maxillary sinus. RECENT FINDINGS: Infections, cysts, benign neoplasms (odontogenic and nonodontogenic), and inflammatory conditions impact the maxillary sinus in various ways, could result in significant expansion within the maxillary sinus and significant infections. SUMMARY: This manuscript provides an overview of common pathologic entities of the oral cavity proper that impacts the maxillary sinus health, with discussion of the role of the otorhinolaryngologist and the dental specialist.

Treatment of dental complications in sickle cell disease.

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. This is an update of a previously published review. OBJECTIVES: To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 01 August 2019. Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field. Date of last search: 07 November 2019. SELECTION CRITERIA: We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS: Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS: No randomised controlled studies were identified. AUTHORS' CONCLUSIONS: This Cochrane Review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.

Treatment of dental and orthodontic complications in thalassaemia.

BACKGROUND: Thalassaemia is a quantitative abnormality of haemoglobin caused by mutations in genes controlling production of alpha or beta globins. Abnormally unpaired globin chains cause haemolytic anaemia by causing membrane damage and cell death within organ systems and destruction of erythroid precursors in the bone marrow. The life-long management of the general health effects of thalassaemia in affected individuals is a highly challenging issue in and of itself; and failure to deal with dental and orthodontic complications in people with thalassaemia exacerbates the public health, financial and personal burden posed by the condition. There exists a lack of evidence-based guidelines for care-seekers and providers to best deal with such dental and orthodontic complications in thalassaemia, which this review seeks to address. OBJECTIVES: The main objective of this review was to assess different methods to treat dental and orthodontic complications in people with thalassaemia. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We searched the reference lists of relevant articles and reviews.Date of last search: 01 August 2019.We also searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 22 July 2019. SELECTION CRITERIA: We searched for published or unpublished randomised controlled trials for treatment of dental and orthodontic complications in individuals diagnosed with thalassaemia, irrespective of phenotype, severity, age, gender and ethnic origin. DATA COLLECTION AND ANALYSIS: Two review authors independently screened 35,202 titles from search results. We identified four unique randomised controlled trials, of which one seemed potentially relevant. Based on closer inspection, the trial was found not to be eligible for inclusion. MAIN RESULTS: We did not find any relevant trials for inclusion in the review. AUTHORS' CONCLUSIONS: We were unable to draw any conclusions due to the lack of available data and trials. This review highlights the need for conducting and appropriate reporting, of high-quality randomised controlled trials investigating the effectiveness of various treatment modalities for dental and orthodontic complications in people with thalassaemia.

Tratamento com MTA Repair HP de extensa perfuração radicular após iatrogenia: relato de caso / Treatment with MTA Repair HP of extensive root perforation after iatrogeny: case report

Objetivo: relatar um caso clínico de perfuração radicular causada por iatrogenia, em terço cervical e médio de um incisivo central superior, dente 21, com presença de lesão óssea periapical. Relato de caso: clinicamente, pôde-se constatar ausência de edema e fístula. Na avaliação da condição pulpar e dos tecidos perirradiculares, o dente apresentou dor na palpação, ausência de mobilidade e de dor em percussão vertical e horizontal. Após os exames de imagem obtidos por meio de tomografia computadorizada de feixe cônico (TCFC; Prexion 3D), constatou-se lesão perirradicular extensa, canal radicular obliterado e perfuração radicular em face vestibular após tentativa de acesso cirúrgico. Como escolha de tratamento, optou-se por recuperar o trajeto original do canal de maneira a obter acesso intracanal, realização do preparo químico-mecânico e obturação pela técnica do cone único, para posteriormente promover o selamento adequado da perfuração com MTA Repair HP (Angelus, Londrina, PR, Brasil). Após seis meses, o dente apresentava-se assintomático e, radiograficamente, observou-se o reparo da lesão periapical. Considerações finais: o correto planejamento, o conhecimento dos materiais utilizados e a abordagem terapêutica foram de suma importância para o manejo adequado do caso. (AU)

Objective: to report a clinical case of root perforation, caused by iatrogeny in the cervical and middle third of an upper central incisor, tooth 21, with presence of periapical bone lesion. Case report: clinically, there was no edema and fistula. Facing the evaluation of the pulp condition and the periradicular tissues, the tooth presented pain on palpation, absence of mobility and pain on vertical and horizontal percussion. After the imaging exams, obtained by cone-beam computed tomography (CBCT; Prexion 3D), extensive periradicular lesion, obliterated root canal and root perforation were observed in the buccal face after attempted surgical access. As a choice of treatment, we chose to recover the original path of the canal in order to obtain intracanal access, chemicomechanical preparation and obturation by the single-cone technique to later promote proper sealing of the perforation with MTA Repair HP (Angelus, Londrina, PR, Brazil). After six months, the tooth was asymptomatic and, radiographically, the repair of the periapical lesion was observed. Final considerations: the correct planning, knowledge of the materials used and therapeutic approach were of paramount importance for the proper management of the case. (AU)

Department of Veterans Affairs Consensus: Preradiation dental treatment guidelines for patients with head and neck cancer.

Few protocols have been published for the dental management of patients with head and neck cancer to prevent complications from head and neck radiation therapy. Radiation therapy not only affects the tumor cells targeted, but also the dentition, bone, salivary gland, and oral soft tissue structures. A comprehensive dental evaluation prior to head and neck radiation therapy can help prevent many complications. The following clinical guidelines were established by a workgroup of oral health providers within the Department of Veterans Affairs. This workgroup focused on developing a set of recommendations regarding dental care prior to the initiation of head and neck radiation therapy based on the best clinical evidence and expert consensus. A systematic algorithm was developed for the evaluation including pre-exam data gathering, examination, education, and treatment, followed by maintenance and postradiation dental follow-up. This document is evidence-based, patient-centered, consistent with accepted practices of care and safety, and in accordance with applicable statutes and regulations.

Dental Problems in Primary Care.

Oral health directly affects overall health and quality of life. More Americans lack dental insurance than medical insurance. Patients with poor oral health are more likely to have respiratory and cardiovascular diseases, adverse pregnancy outcomes, and diabetes mellitus. Early childhood caries is the most common chronic condition in American children. Certain illicit and prescription drugs increase the risk of enamel erosion and caries formation in adults. Incision and drainage is the treatment of choice for dental abscess. Risk factors for periodontal disease include smoking, diabetes, human immunodeficiency virus infection, use of certain medications, and genetic susceptibility. Patients with gingivitis typically present with swollen, erythematous gum tissue that bleeds easily with brushing or flossing. One in three children will have an injury to the primary teeth, and one in five 12-year-old children will have an injury to the permanent teeth. All dental fractures should be evaluated with imaging and managed in conjunction with a dental professional. Immediate reimplantation is the preferred treatment for avulsed permanent teeth. Primary care clinicians are well positioned to reduce rates of oral disease. Family physicians can incorporate oral health into routine practice through counseling about diet, oral hygiene, smoking cessation, and fluoride supplementation; application of fluoride varnish; and screening for dental disease.

Modern Trends in Dental Medicine: An Update for Internists.

Traumatic injuries, genetic diseases, and external harmful agents such as bacteria and acids often compromise tooth integrity. There is an unmet medical need to develop alternative, innovative dental treatments that complement traditional restorative and surgery techniques. Stem cells have transformed the medical field in recent years. The combination of stem cells with bioactive scaffolds and nanostructured materials turns out to be increasingly beneficial in regenerative dental medicine. Stem cell-based regenerative approaches for the formation of dental tissues will significantly improve treatments and will have a major impact in dental practice. To date there is no established and reliable stem cell-based treatment translated into the dental clinics, however, the advances and improved technological knowledge are promising for successful dental therapies in the near future. Here, we review some of the contemporary challenges in dental medicine and describe the benefits and future possibilities of certain novel approaches in the emerging field of regenerative dentistry.

Treatment options for odontogenic maxillary sinusitis: a review.

OBJECTIVE: The aim of this article is to review the main treatment options for odontogenic sinusitis that are used today. MATERIAL AND METHODS: Search on PubMed, Cochrane Library, PMC, Science Direct data bases. For a literature review search keywords were used: odontogenic sinusitis, odontogenic maxillary sinusitis treatment OR diagnosis, maxillary sinusitis of dental source OR dental origin OR etiology. RESULTS: 2886 articles were found in the databases using keywords. After duplicate citations screened, inclusion/exclusion criteria applied, excluded articles after titles, summaries and full-text reading 25 articles were included in the literature review. CONCLUSION: Although clinical symptomatology is not conspicuous among other types of sinusitis, the odontogenic maxillary sinusitis treatment regimen is different. It consists of eliminating dental infection and management of sinusitis. The usage of Caldwell-Luc approach is limited these days and recommended only when a better access to sinus is needed, for example, removing large foreign bodies. Endoscopic sinus surgery is widely used these days to remove the inflamed sinus mucosa, foreign bodies, displaced teeth, while preserving physiological function of the sinus. Sometimes dental infection removal alone is sufficient to resolve the odontogenic maxillary sinusitis, but sometimes concomitant endoscopic sinus surgery or Caldwell-Luc approach is necessary for full resolution.