Comparative evaluation of clinical performance, child and parental satisfaction of Bioflx, zirconia and stainless steel crowns in pediatric patients.

Background: Pediatric dental treatment is challenging in patients with early childhood caries. For clinician its difficult to manage child and provide good work at the same time. Its necessity to have the best equipments as well as materials. Nowadays, aesthetics play an important role in managing decayed teeth. Zirconia crown is better option but requires excessive preparation. As Bioflx is newly developed crown and has combined stainless steel and zirconia properties. Aim: To assess the clinical performance and child and parental satisfaction of Bioflex crowns compared to zirconia and stainless steel crowns. Methods: In this comparative study of Bioflx crowns with zirconia and stainless steel crowns, children aged three to seven years old will be selected, and 72 primary teeth requiring crowns will be randomly distributed into three groups, n = 24: Group I: Preformed stainless steel crown, control; Group II: Preformed Bioflex crown; Group III: Preformed zirconia crown. Crowns will be evaluated for recurrent caries, plaque accumulation, restoration failure, gingival status opposing tooth wear, and clinicians and parental satisfaction at zero, three, six, and 12 months. Results: Bioflx crown will have better clinical as well as parental satisfaction among zirconia and stainless steel crowns. Conclusions: The Bioflx crown can be used as an alternative economical esthetic full-coronal restoration for primary teeth. Trial registration: CTRI registration number: CTRI/2023/05/052256; Date of registration: May 03, 2023. Protocol version: Two; Date: April 22, 2023.

O uso de desenhos como técnica projetiva em odontopediatria / The use of drawings as a projective technique in pediatric dentistry

The dental environment can be considered a stressor for children, and can trigger unwanted behaviors. Pediatric Dentistry is a specialty that requires professionals to know preventive measures and restorative skills to perform dental treatment in children or adolescents. In addition, it is especially important that the professional is concerned with the child's feelings and reactions, allowing the pediatric dentist to identify situations that may generate stress for the patient during the care, and manage the presented behaviors. Recent studies have measured children's reactions and feelings during dental treatments using projective techniques. Given the importance of drawing to identify children's emotions, the objective of this study was to search the literature about the use of drawings as a projective technique in Pediatric Dentistry. Therefore, projective techniques, with an emphasis on drawing, have proved to be an effective instrument to be used in clinical practice to better understand the reactions presented by children during dental care and their relationship with dentists. Thus, avoiding unexpected situations in the office and allowing greater chances of obtaining a positive return from the patient.

O ambiente odontológico pode ser considerado um estressor para o público infantil, capaz de desencadear comportamentos indesejados. A Odontopediatria é uma especialidade que exige do profissional o conhecimento de medidas preventivas e de habilidades restauradoras para a realização do tratamento odontológico na criança ou no adolescente. Além disso, é muito importante que o profissional se atente aos sentimentos e às reações da criança, e identifique situações que possam desencadear estresse para o paciente durante o atendimento odontopediátrico, e maneje os comportamentos apresentados. Estudos recentes têm mensurado as reações das crianças e seus sentimentos durante tratamentos odontológicos por meio de técnicas projetivas. Diante da importância do desenho como meio para identificar as emoções das crianças, o objetivo deste estudo foi fazer uma busca na literatura acerca do uso de desenhos como técnica projetiva em Odontopediatria. As técnicas projetivas, com ênfase no desenho, revelaram-se um instrumento eficaz a ser utilizado na prática clínica a fim de melhor compreender as reações apresentadas pelas crianças durante o atendimento odontológico e seu relacionamento com os dentistas. Elas evitam situações inesperadas no consultório e possibilitam maiores chances de se obter um retorno positivo do paciente.

Dental Cone Beam Computed Tomography in Children: Clinical Effectiveness and Cancer Risk due to Radiation Exposure.

Firstly used in the early 90s to generate 3-dimensional projections of X-ray images, cone beam computed tomography (CBCT) has resulted in a large application in dentomaxillofacial imaging, even in children. CBCT uses ionizing radiation that may cause damage to the DNA, and children are at the greatest carcinogenesis risk due to their higher tissue radiosensitivity and their longer life expectancy compared to adults. The questions of whether the cancer risk is really increased after repeated dental CBCT in childhood and of what the underlying biological basis is have become hot topics in the field of dentistry and radiobiology. We performed an overview of the current literature to assess an acceptable role of CBCT in pediatric dentistry.

Usos del láser terapéutico en Odontopediatría: Revisión de la literatura. Reporte de casos / Uses of Therapeutic Laser in Pediatric Dentistry: Review of the Literature. Case Reports

RESUMEN El término "LÁSER" es un acrónimo de "Light Amplification by the Stimulated Emission of Radiation" (en español "Amplificación de Luz por Emisión Estimulada de Radiación"). La utilización de la tecnología láser en Odontología ha tenido una constante evolución y desarrollo en los últimos 30 años. Se deben distinguir dos grandes grupos de láseres: De alta potencia o quirúrgicos y de baja potencia o terapéuticos. El más empleado en odontología pediátrica es el terapéutico o LLLT (o "blando"). El láser terapéutico está indicado para diversas anomalías tales como la hipersensibilidad, gingivitis, herpes, parestesias, neuralgias del trigémino, trismus, disfunción ATM, implantes, activación de químicos de blanqueamiento dental, entre otros. Este artículo pretende realizar una actualización de las aplicaciones del láser de baja potencia en el ámbito de la Odontología Pediátrica, así como la presentación de 4 casos clínicos representativos.

ABSTRACT The term "LASER" is an acronym for "Light Amplification by the Stimulated Emission of Radiation" (in Spanish "Amplificación de Luz por Emisión Estimulada de Radiación"). The use of laser technology in dentistry has had a constant evolution and development in the last 30 years. Two large groups of lasers should be distinguished: high-power or surgical and low-power or therapeutic. The most used in pediatric dentistry is the therapeutic or LLLT (or "soft"). The therapeutic laser is indicated for various anomalies such as hypersensitivity, gingivitis, herpes, paresthesias, trigeminal neuralgias, trismus, TMJ dysfunction, implants, activation of teeth whitening chemicals, among others. This article intends to perform an update of the applications of low power laser in the field of Pediatric Dentistry, as well as the presentation of 4 representative clinical cases.

Aplicación del Láser de Baja Potencia (LLLT) en Pacientes Pediátricos: Revisión de Literatura a Propósito de una Serie de Casos / Application of Low Power Laser (LLLT) in Pediatric Patients: Review of the Literature in a Series of Cases

RESUMEN: El uso del láser de baja potencia en odontología está siendo cada vez más frecuente y con excelentes resultados, los equipos más modernos traen pre-establecidos la dosimetría de los parámetros para las diferentes acciones clínicas. El objetivo de esta revisión fue encontrar evidencia científica que permita al clínico tener como una alternativa de tratamiento el uso del láser de baja potencia en patologías orales de tejidos blandos y duros en pacientes pediátricos. Se realizó una revisión de la literatura por medio de buscadores como PubMed, LILACS y SciELO. Después de leer a texto completo todos los trabajos es posible señalar que el láser de baja frecuencia es una buena alternativa terapéutica en la resolución de signos y síntomas en patologías orales que aquejan al paciente pediátrico, puesto que, presenta un rápido control del dolor, la inflamación, el sangrado y acelera los procesos de reparación celular.

ABSTRACT: Low Level Laser Therapy in dentistry is becoming more frequent and has had excellent results, with state of the art equipment having pre-established dosimetry parameters for the various clinical actions. The objective of this review was to find scientific evidence that allows the clinician to have the use of low power laser as treatment alternative, in oral soft tissue and hard pathologies in pediatric patients. A review of the literature was performed through search engines such as PubMed, LILACS and SciELO. After reading the texts, it was possible to point out that low frequency laser is a good therapeutic alternative in the resolution of signs and symptoms in oral pathologies of the pediatric patient. This alternative allows for rapid pain control, reduces inflammation and bleeding, and accelerates cellular repair processes.

Paediatric oral & maxillofacial surgery.

Children have differences in their physiology, anatomy and they are continuing to grow and develop. The management of pathology, trauma, deformity and upper airway obstruction in the young growing patient has to take into account these factors in the treatment planning for these conditions. It is important for Oral & Maxillofacial Surgeons to understand the potential impact of disease or injury on the developing facial skeleton and dentition. This chapter will provide an overview of the some of the major components of paediatric maxillofacial surgery and their management.

Pediatric Dental Surgery Under General Anesthesia: Uncooperative Children.

Dental treatment of young pediatric patients can be confounded by lack of cooperation for dental rehabilitation procedures and even examination and/or radiographs. With the recent US Food and Drug Administration warning applied to many anesthetic/sedative agents for children less than 3 years old, a retrospective review of general anesthesia (GA) cases from 1 private pediatric dental practice was studied for age, gender, body mass index, anesthetic duration, airway management used, extent of dental surgical treatment, recovery time, and cardiac/pulmonary complications. For the 2016 calendar year, 351 consecutive GA cases were identified with patients aged 2-13 years. Of these, 336 underwent nasal endotracheal intubation. Forty-six of 351 patients (13%) were younger than 3 years. Median anesthesia duration was approximately 1.7 hours for all age groups. Dental treatment consisting of 8-9 teeth including crowns, fillings, and extractions was most frequently encountered. One hundred sixty-eight patients (48%), however, required care for 10-18 teeth. There were no episodes of significant oxygen desaturation. The overall complication rate was 1.1%, with 2 cases of postextubation croup, 1 case of mild intraoperative bronchospasm, and 1 case of intraoperative bradycardia. Complications did not correlate with children being overweight or obese.

Paediatric laser dentistry. Part 1: General introduction.

AIM: Knowledge of the physical characteristics of different laser lights and optical and thermal properties of oral tissues is very important to understand the interaction of dental lasers with biological tissues. Choosing the correct dental laser is crucial to match specific wavelengths with target chromophores of different tissues; this affinity makes laser irradiation selective and therefore minimally invasive. Various types of lasers are used in dentistry, offering a viable alternative to low and high-speed handpieces and surgical blades, and also minimising fear and discomfort of the patient. Lasers can provide innovative and minimally invasive therapies in different branches of dentistry including preventive and restorative dentistry, traumatic injury treatments and surgical procedures. Laser has also biostimulating and anti-inflammatory effects, as well as analgesic effect.

Remoção de mucocele com laser diodo: relato de caso clínico em paciente infantil / Mucocele removal with laser diode: case report on child patient

A mucocele é uma das lesões benignas que mais afeta a cavidade bucal. O laser de diodo de alta potência é uma opção que substitui ou associa procedimentos complementares aos processos convencionais,tendo mais conforto pós-cirúrgico. O objetivo deste trabalho foi relatar o caso clínico de remoção de mucocele de lábio inferior em paciente infantil utilizando laser de diodo de alta potência. Paciente do sexo feminino, 8 anos de idade, compareceu à clínica de Odontopediatria da Faculdade de Odontologia São Leopoldo Mandic, em Campinas, relatando incômodo no lábio inferior, com a presença de uma “bolinha”. Ao exame clínico observou-se tumefação de consistência mole, flutuante, translúcida, com coloração similar à mucosa bucal. Após diagnóstico, o tratamento baseou-se na remoção cirúrgica com auxílio de laser de diodo de alta potência. Inicialmente foi realizada a anestesia infiltrativa ao redor da lesão, e então a remoção cirúrgica foi conduzida, juntamente com as glândulas acessórias para evitar recidiva, com uso do laser de diodo de alta potência. Ao fim do procedimento foi possível observar que a paciente saiu satisfeita, sendo o prognóstico favorável. No retorno de 30 dias, observou-se que não houve recidiva da lesão. O laser dediodo de alta potência, uma vez que apresenta uma série de benefícios, como excelente hemostasia, sem a necessidade de sutura, redução do edema e dor, cicatrização mais rápida e redução do tempo para realizar o procedimento, parece ser uma opção para remoção de mucocele em Odontopediatria.

Mucocele is a benign lesion that affects the oral cavity. The high power diode laser is an option as anadditional method or as a substitute to conventional procedures, with more post-surgical comfort. The objective of this study was to report a case of lower lip mucocele removal in a child patient using highpower diode laser. A female patient, 8 years old, attended the Clinic of Pediatric Dentistry, São Leopoldo Mandic School of Dentistry in Campinas, reporting discomfort in the lower lip, with the presence of a“ball”. On clinical examination it was observed swelling of soft consistency, floating, translucent, with coloring similar to the buccal mucosa. After diagnosis, the treatment was based on surgical removal with high power diode laser assistance. Initially infiltration anesthesia around the lesion was performed,and then the surgical removal was conducted, along with the accessory glands to prevent recurrence,with high power diode laser use. At the end of the procedure it was observed that the patient leftsatisfied, with a favorable prognosis. At the 30-day post-operative return, it was observed that there was no recurrence. The high power diode laser, since it presents a series of benefits such as excellen the mostasis, without the need for sutures, reduction of swelling and pain, faster healing, reducing the time to perform the procedure, it seems to be an option for removal of mucocele in pediatric dentistry.

Hemangioma: descrição de um caso clínico e sua importância no diagnóstico diferencial / Hemangioma: description of a clinical case and the importance in the differential diagnosis

O hemangioma infantil é um tumor vascular benigno que ocorre devido a uma proliferação anormal dos vasos sanguíneos. O quadro clínico apresenta três fases bem definidas: proliferativa, involutiva e involuída. O diagnóstico é realizado basicamente por meio da anamnese e do exame físico, e quando necessário preconiza-se avaliação histopatológica. O presente trabalho, descreve um caso clínico de um hemangioma presente em um bebê de 3 meses de idade que foi, de principio, diagnosticado como mucocele ou fibroma. A cirurgia excisional foi realizada eo material encaminhado para análise histopatológica, confirmando o diagnóstico de hemangioma. Nessas situações, vale ressaltar a importância do diagnostico diferencial, manobra cirúrgica adequada e a avaliação das características clínicas da lesão para evitar possíveis complicações cirurgicas.

The infantile hemangioma is a benign vascular tumor which occurs due to an abnormal proliferation of blood vessels. The clinical features three well-defined phases: proliferative, involution,and involuted. The diagnosis is made primarily by clinical history and physical examination, but when necessary, help to close the histopathological diagnosis. This paper describes a clinical case of a gift hemangioma in a baby three months old who was, in principle, diagnosed as mucocele or fibroma. The excisional surgery was performed and material sent for histopathological confirmation hemangioma. It is worth emphasizing the importance of differential diagnosis, appropriate surgical maneuver, assessment of clinical characteristics of the lesion to prevent potential surgical complications possible.

Cárie dentária e presença de placa visível em dentes ântero-superiores em crianças de 0 a 5 anos / Dental caries and presence of visible plaque on anterior teeth on 0 to 5 years old children

Objetivo: Identificar a associação entre cárie dentária e placa dental em função do estágio da primeira infância. Materiais e Métodos: Foram examinadas clinicamente 183 crianças de 8 a 69 meses de idade em dois Centros Municipais de Educação Infantil de Curitiba. As crianças foram divididas em dois grupos, de acordo com o estágio da primeira infância, G1 (até 36 meses)e G2 (37 a 69 meses). Experiência de cárie (ceo-d > 0) e presença de placa visível (em pelo menos um incisivo superior) foram avaliadas por um único pesquisador previamente calibrado (Kappainter e intraexaminador> 0,80). As mães responderam a um questionário sobre condições socioeconômicas, hábitos de higiene e alimentação. Os dados foram submetidos à análise bivariada,por meio dos testes de Qui-quadrado de Pearson e Exato de Fisher. Resultados: No grupo G1houve tendência de associação entre experiência de cárie e placa visível (p = 0,053), enquanto no grupo G2 esta associação apresentou-se significativa (p = 0,006). Houve associações entre o padrão de higienização após a alimentação durante a noite e placa visível (p= 0,026) no grupoG1; e entre estado civil das mães e placa visível no grupo G2 (p= 0,043). Conclusão: Dentro da primeira infância, a relação entre cárie dentária e placa visível em dentes anteriores torna-semais evidente com o aumento da idade.

Objective: To identify the association between dental caries and plaque in the different stages of the early childhood. Materials and Methods: 183 children 8-69 months of age from two Municipal Centers of Children Education, in Curitiba, were clinically examined for cariesand visible plaque. Children were divided in two groups according to the different stages ofthe early childhood, G1 (up to 36 months), G2 (37 to 69 months). Caries experience (ceo-d>0)and visible plaque on at least one upper incisor were evaluated by one previously calibrated examiner (kappa>0,80). Mothers were invited to answer a questionnaire about socioeconomic aspects, dental hygiene and feeding habits. Data were submitted to bivariate analysis using Pearson´s chi-square and Fisher´s exact tests. Results:G1 showed a tendency of association between caries experience and visible plaque (p=0,053), while in G2 a significant association wasfound (p=0,006).Association was found in G1 between dental hygiene after feeding during thenight and visible plaque (p=0,026), and between mother´s marital status and visible plaque onG2 (p=0,043). Conclusion: The association between dental caries and visible plaque on anteriorteeth becomes more evident on the late stages of early childhood.

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.

Anxiety in Children submitted to Dental Appointment

Objective: To determine anxiety in children undergoing dental treatment and to evaluate associated factors. Material and Methods: The sample consisted of 48 children during dental appointment in dental clinics of the Franciscano University Center, 48 caregivers, and 46 dentistry students. The modified Venham Picture Test was used to determine anxiety of children during dental appointment, before and after treatment. For determining anxiety related to dental care among caregivers, the modified Corah's dental anxiety scale was used. The Lipp`s stress symptoms inventory for adults was applied to determine the stress level of dentistry students. In addition, the individual characteristics of participants were recorded to determine their association with the presence of anxiety. Results: Anxiety was observed in 60.4% of children, and it was related to invasive dental procedures (p = 0.021), history of dental pain (p = 0.002), presence of bruxism (p = 0.028), anxious caregivers (p = 0.023), and stress of the dental student that conducted the appointment (p = 0.005). Conclusion: Overall, the majority of pediatric patients showed anxiety, which was directly related to misbehavior during dental care. Moreover, anxiety was related to individual characteristics of children and was influenced by the anxiety level of caregivers, as well as the emotional state of dentistry students during the dental appointment.

Síndrome Gorlin-Goltz asociado a fisura labiopalatina bilateral / Gorlin-Goltz syndrome associated with bilateral cleft lip and palate

El síndrome de Gorlin-Goltz corresponde a un trastorno de herencia autosómica dominante. Uno de los criterios menores de este síndrome es la fisura labiopalatina. Si bien esta corresponde a la anomalía congénita maxilofacial más prevalente, un porcentaje variable está asociado a síndromes. Presentar un caso de un paciente con síndrome de Gorlin-Goltz y fisura labiopalatina bilateral asociada constituye el propósito de esta presentación. Se trata de un paciente de 12 años de edad, con diagnóstico de síndrome de Gorlin-Goltz remitido por genetista. Clínicamente presenta anomalías cutáneas, óseas, dentarias, neurológicas, tumores, hoyuelos palmoplantares, prognatismo mandibular y fisura labiopalatina bilateral operada. Es importante reconocer las características asociadas no solo al área craneofacial, sino también a otras partes del cuerpo. Se requiere de la atención de un equipo multidisciplinario en el que el odontólogo también debe participar. La mayoría de las publicaciones se enfocan solo en el manejo quirúrgico de los quistes y no en el de otras secuelas asociadas, como lo es la fisura labiopalatina(AU)

Gorlin-Goltz syndrome is an autosomal dominant inheritance disorder. Cleft lip and palate is one of the minor criteria for this syndrome. Cleft lip and palate is the most prevalent congenital maxillofacial anomaly, and a varying percentage is associated with syndromes. Present the case of a patient with Gorlin-Goltz syndrome and associated bilateral cleft lip and palate. A 12-year-old male patient was referred by the geneticist with a diagnosis of Gorlin-Goltz syndrome. Clinical examination revealed skin, bone, dental and neurological anomalies, as well as tumors, palmoplantar pits, mandibular prognathism and operated bilateral cleft lip and palate. It is important to examine not only features associated with the craniofacial region, but also with other parts of the body. An interdisciplinary team is required of which the odontologist should be a member. Most publications only refer to the surgical management of cysts and not to associated sequels, such as cleft lip and palate(AU)

A comparative evaluation of nebulized dexmedetomidine, nebulized ketamine, and their combination as premedication for outpatient pediatric dental surgery.

BACKGROUND: This study was designed to evaluate and compare the efficacy and safety of nebulized dexmedetomidine, nebulized ketamine, and the combination of these drugs for premedication in pediatric outpatient dental surgeries. METHODS: A prospective, randomized, double-blinded study was conducted in the Alexandria Main University Hospital after approval of the Medical Ethics Committee. Informed written consent was obtained from the patient's parents. Sixty children classified as ASA physical status I and II and aged 3 to 6 years were enrolled in the study. Patients were randomly categorized into 3 equal groups. Group K was premedicated with nebulized ketamine (2 mg/kg), group D was premedicated with nebulized dexmedetomidine (2 µg/kg), and group DK was premedicated with combined nebulized dexmedetomidine and ketamine (1 µg/kg + 1 mg/kg). The primary end point was the level of sedation when the child was first seen in the operating room 30 minutes after sedation. The secondary end points were tolerance of mask induction, hemodynamic changes, analgesia, sedation at emergence, and wake-up behavior. RESULTS: Studied groups were comparable as regards demographic data (age, weight, sex, and ASA physical status, all P > 0.226) and patients' acceptance of drugs (P = 0.968). Level of sedation at 30 minutes was significantly greater in group DK than in either group K (P = 0.003) or group D (P = 0.009). Group DK had the briefest recovery times, followed in order by group K and group D with progressively longer recovery times. Recovery times were significantly briefer in group DK than in either group K (P = 0.039) or group D (P < 0.001). Group DK had significantly briefer discharge times than group D (P < 0.001). Postoperative analgesia was significantly better in group DK compared with group K (P = 0.008). CONCLUSIONS: A nebulized combination of low-dose ketamine and dexmedetomidine produced more satisfactory sedation and provided a smoother induction of general anesthesia than nebulized ketamine or dexmedetomidine alone, with more rapid recovery and no significant side effects.

Dentes supranumerários impactados: relato de caso clínico / Supernumerary impacted teeth: case report

Dentes supranumerários impactados representam um desafio para os Odontopediatras. Estes dentes podem causar atraso na erupção do dente permanente, alteração do crescimento ósseo e posicionamento ectópico do dente permanente. O presente artigo relata a resolução de um caso de dois dentes supra numerários, em ambiente de consultório odontológico, sob sedação e com excelente sucesso clínico radiográfico.

Supernumerary impacted teeth represent a challenge to pediatric dentists. Their presence can cause failure of eruption of permanent teeth, growth and development alterations and displacement of teeth. The case reported in this paper presents the resolution of a case of two supernumerary impacted teeth in a dental office environment, under sedation and with excellent radiographic clinical success.

Ansiedade do responsável em relação ao atendimento odontopediátrico / Anxiety of guardian in relation to pediatric dentistry

Visto que, a influência dos responsáveis sobre a ansiedade da criança é notória, o objetivo da presente pesquisa foi verificar o nível de ansiedade odontológica do responsável pela criança em tratamento odontológico e quais fatores a influenciam. O estudo foi aprovado pelo comitê de ética local. A amostra foi de conveniência, com participação de 72 pais e/ou responsáveis por crianças na faixa etária de 6 a 13 anos de idade, presentes para atendimento odontológico nas instituições participantes: UAPS Jardim América/Serrinha de Várzea da Palma-MG, UAPS de Moema-MG e UninCor de Belo Horizonte-MG, selecionadas também por conveniência. Para a coleta de dados, foram utilizadas entrevista semiestruturada e a Dental Anxiety Scale (DAS), antes do atendimento da criança. Os dados foram registrados no programa SPSS versão 17.0. A maior parte dos responsáveis, que apresentaram maior valor na DAS, relataram ansiedade quando suas crianças vão ao Cirurgião-Dentista (p=0,002). O DAS dos responsáveis também se mostrou associado a características do consultório (p=0,009) e do profissional (p=0,009), à percepção sobre a ansiedade da criança (p=0,032) e à sua própria escolaridade (p=0,011). Pode-se concluir que, geralmente os responsáveis mais ansiosos também acham que suas crianças ficam ansiosas ao ir ao Cirurgião-Dentista. Portanto, o odontopediatra deve atuar de forma conjunta, abordando pais e/ou responsáveis para um tratamento tranquilo e resolutivo.

Since the influence of the guardians on the anxiety of the child is notorious, the aim of this research was to determine the level of dental anxiety of the guardian in dental treatment and which factors influence it. The study was approved by the local ethics committee. The convenience sample comprised 72 parents and/or guardians of children aged 6-13 years old, present at participating institutions for dental treatment: UAPS Jardim América/Serrinha of Várzea da Palma-MG, UAPS of Moema-MG and UNINCOR of Belo Horizonte-MG, also conveniently selected. In order to collect data, a semi-structured interview and the Dental Anxiety Scale (DAS) were used before the child’s treatment. Data were recorded using SPSS version 17.0. Most guardians, who showed the highest value in the DAS, reported anxiety when their children go to the dentist (p=0.002). The guardians DAS was also associated with both office (p=0.009) and professional (p=0.009) features, the perception of the child’s anxiety (p=0.032) and their own education (p=0.011). It can be concluded that generally the most eager guardians also find that their children are anxious to go to the dentist. Therefore, the pediatric dentist must act jointly, approaching parents and/or guardians for a tranquil and decisive treatment.

Diente natal / Natal teeth

INTRODUCCIÓN: se denominan dientes natales a aquellos dientes que se encuentran presentes en la cavidad bucal en el momento del nacimiento. Estos constituyen una alteración de erupción precoz y se presenta con más frecuencia en la región de los incisivos centrales inferiores. Dichos dientes pueden ocasionar trastornos en la alimentación, ulceraciones traumáticas sublinguales llamada entonces enfermedad de Riga-Fede y preocupaciones en cuanto a la posible aspiración de los mismos. OBJETIVO: describir las características de una niña con diente natal y los aspectos más relevantes del diagnóstico y tratamiento. PRESENTACIÓN DEL CASO: a la consulta de odontopediatría se presentó una madre con una niña de un mes de nacida, remitida del Servicio de Pediatría debido a la sospecha de presencia de un diente en el momento de su nacimiento. Dada la dificultad para la lactancia, la gran movilidad del diente y el alto riesgo de desprendimiento, el tratamiento aplicado fue la EXODONCIA. CONCLUSIONES: el caso presentó un diente natal pequeño y con ningún desarrollo radicular. El tratamiento aplicado fue exodoncia por el grado de movilidad del diente y forma cónica y puntiforme que tenía riesgo de desprendimiento. Por tener un mes de nacida no existía peligro de deficiencia de la coagulación resultante de la síntesis insuficiente de vitamina K que ocurre en los primeros días de vida. Aunque la presencia de diente natal es infrecuente es de gran importancia el conocimiento del diagnóstico y tratamiento del diente natal para el estomatólogo(AU)

INTRODUCTION: natal teeth are defined as those teeth that are present in the mouth at the time of birth. Natal teeth form an alteration of early eruption; generally the lower temporary central incisors are the most common tooth affected. These teeth are rare anomalies in newborns that can cause feed disturbances, tongue ulceration (Riga-Fede disease) and risk of aspiration of them. OBJECTIVE: the aim of this paper is to present a case report of a newborn girl with neonatal tooth and the most relevant aspects concerning the diagnosis and treatment. CLINIC CASE: a30 -day-old female baby was brought to our department, because she had one tooth at birth. Due to the great mobility it was decided to extract the mobile natal teeth. COMMENT: natal teeth, in most cases are small and with poor root development. The treatment of these teeth will depend on the degree of tooth mobility and presence of sharp incisal edge.The extraction must do after of the first weeks, because the vitamin K levels are low in the first days after birth and this is very important for the clot formation(AU)

Use of three-dimensional computed tomography images in dental care of children and adolescents in Korea.

Advances in computed tomography (CT) technology - from traditional CT to cone beam (CB) CT - have benefitted both the dentists and their young patients. We therefore wanted to determine the prevalence of CBCT use in pediatric dentistry in Korea. Our first approach was to conduct an institutional survey to evaluate the use of CBCT for diagnosing and evaluating dental problems in pediatric patients. Our second approach was to review any articles published during 2002-2011 in the Journal of the Korean Academy of Pediatric Dentistry that described clinical use of CBCT. The journal articles surveyed indicated that there were three areas in which CBCT was most useful. The most prevalent use was for diagnosis and monitoring of the growth of cystomas and other tumors in the mouth. The second most common use of CBCT was localization of impacted teeth and evaluation of their relations with adjacent teeth. The third use was to observe supernumerary teeth and evaluate their relations with the roots of adjacent teeth. Compared with traditional CT, CBCT has shorter acquisition times and causes less radiation exposure to the patient. There are fewer side effects with CBCT because its accuracy allows minimally invasive treatment for such problems as impacted and supernumerary teeth.

Celulitis facial en niños con criterio de hospitalización / Children with facial cellulitis and hospitalization criterion

La celulitis facial puede convertirse en un grave riesgo vital cuando no se tiene en cuenta el tratamiento adecuado. Constituye un problema de salud en la población de edades pediátricas, pues es la segunda causa más frecuente de ingreso hospitalario en la cirugía maxilofacial, luego de los traumatismos maxilofaciales. Objetivo: describir el comportamiento y el manejo terapéutico por la Atención Primaria de Salud en los municipios de Playa, Marianao y Lisa de La Habana. Métodos: se realizó un estudio observacional retrospectivo en 53 pacientes que fueron ingresados en el Servicio de Cirugía Máxilo Facial del Hospital Pediátrico Docente Juan Manuel Márquez, desde enero de 2001 a enero de 2007. Resultados: hubo ausencia de significación estadística entre sexos y entre los grupos de edades. La media de la edad fue de 8 años, con una desviación estándar de 4. La celulitis más frecuente fue la odontógena (60,4 por ciento). El 60,3 por ciento de los pacientes fueron mal manejados por la atención primaria. Los grupos dentarios más afectados sugieren que las acciones preventivas deben encaminarse mayormente a la población con dentición temporal y mixta. Conclusiones: hubo mayor representación del sexo masculino y del grupo de 1 a 5 años. El tipo de celulitis facial predominante fue la odontógena. En más de la mitad de los casos el tratamiento antimicrobiano aplicado en la atención primaria de salud fue inadecuado. Al momento del ingreso predominó la evaluación clínica severa(AU)

Facial cellulitis can become a serious vital risk when doctors don't keep in mind the appropriate treatment. It constitutes a health problem in pediatric population, because it is the second more frequent cause of hospital admittance in the Maxillofacial Surgery Service, followed by maxillofacial traumatisms. Objective: to understand facial cellulitis behavior and to describe the therapeutic handling in Primary Health Care (PHC) in Playa, Marianao, and Lisa municipalities in Havana. Method: a retrospective observational study was performed on 53 patients who were admitted to the Maxillofacial Surgery Pediatric Teaching Hospital "Juan Manuel Marquez", from January 2001 to January 2007. Results: there was no statistical significance between genders and age groups, the mean age was 8 years with a standard deviation of 4. The most frequent was odontogenic cellulitis (60.4 per cent). 60.3 per cent of patients were poorly handled by the primary care service. The most affected dental groups suggest that preventive measures should be directed mostly to people with temporary and mixed teething Conclusions: there was higher representation in male patients and the 1 to 5 age group. Odontogenic facial cellulitis was the predominant type. Antimicrobial treatment was inadequate in more than half of cases at the primary health care. At admission severe clinical evaluation prevailed(AU)