Gingivitis and salivary osmolality in children with cerebral palsy.

AIM: To investigate the influence of salivary osmolality on the occurrence of gingivitis in children with cerebral palsy (CP). DESIGN: A total of 82 children with spastic CP were included in this cross-sectional study. Oral motor performance and gingival conditions were evaluated. Unstimulated saliva was collected using cotton swabs, and salivary osmolality was measured using a freezing point depression osmometer. Spearman's coefficient, receiver operating characteristic (ROC), and multiple logistic regression analyses were performed. RESULTS: Strong correlation (r > 0.7) was determined among salivary osmolality, salivary flow rate, visible plaque, dental calculus, and the occurrence of gingivitis. The area under the ROC to predict the influence of salivary osmolality on the occurrence of gingivitis was 0.88 (95% CI 0.81-0.96; P < 0.001). The cutoff value of 84.5 for salivary osmolality presented good sensitivity and specificity, both higher than 77%. The proportion of children presenting salivary osmolality ≤84.5 mOsm/kgH2 O and gingivitis was 22.5%, whereas for the group presenting osmolality >84.5 mOsm/kgH2 O, the proportion of children with gingivitis was 77.5%. Salivary osmolality above 84.5 increased the likelihood of gingivitis fivefold, whereas each additional 0.1 mL of salivary flow reduced the likelihood of gingivitis by 97%. CONCLUSION: Gingivitis occurs more frequently in children with CP showing increased values of salivary osmolality.

Comparative Analysis of Protaper and Waveone Systems to Reduce Enterococcus Faecalis from Root Canal System in Primary Molars--An in Vitro Study.

OBJECTIVE: To assess, in vitro, the ability of the ProTaper(™) and WaveOne(™) systems to reduce Enterococcus faecalis contamination in primary molars. STUDY DESIGN: Sixty roots of primary molars were contaminated with E. faecalis. Roots were randomly allocated to one of four groups (n=20): ProTaper(™), WaveOne(™), control A, or control B. The files used were S1 and S2/F1 and F2 (ProTaper(™) system) and 25.08 (WaveOne(™) system). In control group A, the root canal was left uninstrumented, whereas in control group B, the root canal was irrigated with NaCl 0.9%. E. faecalis was sampled from the root canal system before and after instrumentation and the Wilcoxon test and Mann-Whitney U were used. RESULTS: There were no differences in E. faecalis counts between pre-instrumentation counts in the ProTaper™ and WaveOne(™) (p>0.05). The ProTaper(™) system led to an 89.36% reduction in E. faecalis burden, versus 78.10% with the WaveOne(™) system (p>0.05). Instrumentation time was shorter with WaveOne(™) (p<0.0001). CONCLUSIONS: The ProTaper(™) and WaveOne™ systems were equally effective in reducing Enterococcus faecalis in primary molars. The WaveOne(™) system was associated with shorter instrumentation time.

Minimal intervention dentistry: What is its clinical application and effectiveness in different continents? - A scoping review.

The aim of minimal intervention dentistry (MID) is to maximize the preservation of dental tissues through the use of modern and effective techniques and procedures. The central objective of MID is to increase the functional life of dental elements and, consequently, the quality of life of the population. The present study aimed to analyze and map the diffusion and clinical application of MID in different continents around the world. To perform this scoping review, the PRISMA checklist was used, adopting the following: population - dentists; concept - effectiveness of MID; and context - continents. The following databases were used: PubMed, European Archives of Paediatric Dentistry, Scientific Electronic Library, Latin Literature American and Caribbean Association in Health Sciences, and SCOPUS. The following keywords were used in the searches: "pediatric dentistry," "atraumatic restorative treatment," "dental caries," "child health," and "glass ionomer cements" using "and" and "or" combined with "minimal intervention dentistry." Studies published before 2010 as well as theses, dissertations, opinion articles, editorials, and guidelines, were excluded from the study. A total of 160 articles were obtained, and 17 articles were screened and selected for full reading. The analysis of the studies reveals the disparity in the use of minimal intervention techniques among continents due to a lack of knowledge of these techniques or lack of confidence in changing professional approaches, thus emphasizing the need for the dissemination and teaching of MID.

High-power diode laser versus electrocautery surgery on human papillomavirus lesion treatment.

The use of high-power lasers has facilitated and improved human papillomavirus (HPV) treatment protocols and has also become very popular in recent years. This application has been more frequently used in hospitals, especially in gynecology. The present study aimed to evaluate the effects of high-power diode laser to remove oral lesions caused by HPV and the consequent effects on virus load following the wound tissue healing process compared with one of the most conventional surgical techniques involving electrocautery. Surgeries were performed on 5 patients who had 2 distinct lesions caused by HPV. All patients were submitted to both electrocautery and high-power diode laser. Following a 20-day period, when the area was healed, sample material was collected through curettage for virus load quantitative analysis.Observation verified the presence of virus in all the samples; however, surgeries performed with the laser also revealed a significant reduction in virus load per cell compared with those performed with electrocautery. The ease when handling the diode laser, because of the flexibility of its fibers and precision of its energy delivery system, provides high-accuracy surgery, which facilitates the treatment of large and/or multifocal lesions. The use of high-power diode laser is more effective in treatment protocols of lesions caused by HPV.

Dental procedures cause stress in children with cerebral palsy?

BACKGROUND: To evaluate the level of stress during dental care in children and preadolescents with cerebral palsy through biological and psychological parameters. MATERIAL AND METHODS: A total of 38 children aged 7 to 12 years were divided into two groups: one with 18 children with cerebral palsy and the other with 20 healthy children (control group). Saliva was noninvasively collected before and after dental care to analyze salivary biomarkers. The Frankl Behavior Scale and the Facial Image Scale were applied. RESULTS: After the dental procedure, cortisol levels were significantly higher (p = 0.02) in the cerebral palsy group than in the control group. Salivary alpha-amylase was not significantly different between groups. Regarding psychological parameters, anxiety was significantly higher (p = 0.00012) in the cerebral palsy group than in the control group. CONCLUSIONS: There was a change in physiological parameters (salivary cortisol and salivary alpha-amylase) and in psychological parameters (Frankl Behavioral Scale and Facial Image Scale) in patients with cerebral palsy, who exhibited higher stress and anxiety levels than did children without cerebral palsy. Key words:Ortisol, physiological stress, dental care, cerebral palsy, dental treatment anxiety.

The influence of television on the food habits of schoolchildren and its association with dental caries.

OBJECTIVES: The consumption of food with a high-sugar content is encouraged by the food industry through television (TV) aimed at children and may be associated with dental caries. This study aims to evaluate the influence of TV on the food habits of schoolchildren aged years and its association with dental caries. MATERIAL AND METHODS: This was an observational, epidemiological, and cross-sectional study. Five neighborhoods of Belem District were selected, and then two schools from each neighborhood were drawn (one private and one public). All sixth and seventh grade students were selected. Data were extracted from questionnaires completed by schoolchildren and their parents and the decayed, missing, and filled teeth (DMFT/dmft) indices of the schoolchildren. The indices were carried out by three examiners previously calibrated (κ > .80). Logistic regression analysis was performed to investigate the association of variables of study with consumption of cariogenic foods and occurrence of dental caries. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Schoolchildren who watched TV for >90 min were more likely to consume cariogenic foods (OR = 2.38; 95% CI [1.57, 3.60]) and have a DMFT + dmft >1 (OR = 2.10; 95% CI [1.37, 3.26]). Those who consumed cariogenic foods while watching TV were more likely to have DMFT + dmft >1 (OR = 14.75; 95% CI [8.24, 6.40]). Parents who bought foods they saw on TV contributed to a higher consumption of cariogenic foods (OR = 3.29; 95% CI [2.07, 5.24]) and DMFT + dmft >1 (OR = 3.93; 95% CI [2.09, 7.37]) among their children. CONCLUSIONS: TV can influence the eating habits of schoolchildren aged 10 to 12 and the food purchases of their parents, stimulating the consumption of cariogenic foods and contributing to the development of dental caries.

Oral Anomalies In Newborns: An Observational Cross-Sectional Study.

Purpose: To determine the prevalence of oral anomalies in newborns and the influence of maternal and neonatal factors on the development of these anomalies.
Methods: Four hundred newborns were included in the study conducted at the Hospital and Maternity Dom Orione (HMDO) in the city of Araguaína, Tocantins, Brazil. After collecting demographic data and information about the newborns from the medical records, an oral examination was performed by a single examiner.
Results: The prevalence of oral anomalies was 50 percent. Cysts of the oral cavity were the most prevalent anomalies (43 percent), with palatine cysts (26 percent) and alveolar cysts (23 percent) being the most common. Ankyloglossia was present in nine percent of newborns, and congenital eruption cysts and neonatal teeth were present in 0.5 percent and 0.2 percent, respectively. No statistically significant correlation was observed between the prevalence of palatine cysts, alveolar cysts, or ankyloglossia and maternal or neo-natal factors.
Conclusion: Oral anomalies in newborns are not uncommon, making essential the presence of a dentist, especially a pediatric dentist, in the multidisciplinary team of hospitals and maternal wards.

Surface morphology of sound deciduous tooth enamel after application of a photo-absorbing cream and infrared low-level laser irradiation: an in vitro scanning electron microscopy study.

OBJECTIVES: The purpose of this descriptive scanning electron microscopic study was to characterize surface alterations in deciduous tooth enamel after in vitro infrared diode laser irradiation, using a photo-absorbing agent alone and also combined with fluoride, before and after laser irradiation. BACKGROUND DATA: Previous investigations have demonstrated increased enamel caries resistance after laser irradiation. METHODS: Seven extracted or exfoliated primary molar teeth underwent soft tissue débridement and fluoride-free prophylaxis. Buccal surfaces were determined to be caries free by macroscopic examination. Sample groups were divided into: (1) control (no treatment); (2) infrared diode laser irradiation (lambda = 810 nm, 68 nm, 60 mW/mm(2), 30 W) using the photo-absorbing agent alone (IRDL + PA; 500 J/cm(2)); and (3) infrared diode laser irradiation using a photo-absorbing agent combined with 2% fluoride (IRDL + PFA; 500 J/cm(2)). Buccal surfaces were evaluated following standard scanning electron microscopy preparation techniques. Control samples of enamel surfaces were relatively smooth but presented occasional enamel prism ends. There were no areas with cavitations or surface defects. RESULTS: After the IRDL + PA treatment, irradiated surfaces became rough and mildly to moderately irregular with scarce enamel cavitations and without exposure of enamel prism ends. The surfaces had adherent granules and only occasional fine cracks and porosities in surface coatings were noted. After the IRDL + PFA treatment, there was a homogenous confluent surface that masked typical enamel surface markings. The surfaces had well-defined globules resulting from the IRDL + PFA treatment, that were not seen after IRDL + PA treatment. CONCLUSIONS: Treatment of deciduous tooth enamel with infrared diode laser irradiation using a photo-absorbing agent and a photo-absorbing agent combined with 2% fluoride created surface coatings that may act as reservoirs for mineral phases during cariogenic activity on enamel, and also provide a certain degree of protection against cariogenic challenge.

Creches são ambientes saudáveis quando se trata de saúde bucal? / Are day care centers healthy environments, when it comes to oral health? / ¿Son saludables los jardines de infancia en lo que respecta a la salud bucal?

Creches são consideradas ambientes saudáveis, pois, para além de cumprir uma missão de educação, exercem influência em cuidados básicos de saúde, responsabilizando-se pela integridade física e emocional da criança, bem como orientando hábitos de higiene, alimentação e socialização interpessoal. Neste contexto, o objetivo deste estudo foi avaliar ambientes de creches, compreendendo melhor os fatores de risco presentes e os padrões de comportamento ensinados, assim como sua associação com cárie dentária, traumatismo dentário e presença de biofilme. Trata-se de estudo transversal com utilização da Infant/Toddler Environment Rating Scale Revised (ITERS-R), escala de avaliação de ambientes, conduzido em dois municípios do interior do estado do Rio de Janeiro, em creches públicas e particulares. Para avaliação das lesões de cárie, seguiu-se o critério do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS ­ International Caries Detection and Assessment System); para a presença de biofilme, o critério de Alaluusua e Malmivirta; e o critério descrito por O'Brien para lesões traumáticas. A associação entre ambiente e desfechos foi verificada através da comparação de médias para as variáveis numéricas, via teste t de Student e, para variáveis categóricas binárias, empregou-se a regressão logística. Foi verificada uma baixa qualidade dos ambientes das creches em relação à saúde bucal, ficando os escores médios de ambiente no valor mais baixo da escala (entre 1,2 e 1,4), e houve associação estatisticamente significante entre ambientes e cárie (RC: 0,51; IC: 0,29-0,88) e com biofilme (RC: 0,27; IC: 0,17-0,42). Conclui-se que existe uma inadequação do ambiente das creches que não contribui para a construção de conhecimentos relativos à educação para saúde bucal, que se associa com desfechos de saúde bucal. Pode-se, assim, considerar creches como ambientes não saudáveis em relação à saúde bucal.

Child Day Care Centers are considered healthy environments since, beyond the educational role, they still influence basic health care, taking responsibility for the physical and emotional integrity of the child, as well as guiding hygiene habits, feeding habits, and interpersonal socialization. Objectives: In this context, this study aimed to evaluate daycare environments, better understanding the health determinants present and the behavior patterns taught, as well as their association with dental caries, dental trauma, and the presence of biofilm. This is a cross-sectional study using the Infant/Toddler Environment Rating Scale Revised (ITERS-R) for assessing environments, carried out in two municipalities in the interior of the state of Rio de Janeiro, in public and private day care centers. To evaluate caries lesions, the International Caries Detection and Assessment System (ICDAS) criterion was followed; for the presence of biofilm, the Alaluusua and Malmivirta criteria; and for traumatic injuries, the criterion described by O'Brien. The association between environment and outcomes was verified by comparing means for numerical variables, via Student's t-test and, for binary categorical variables, logistic regression was used. A low quality of day care centers regarding oral health was verified, with the average environment scores at the lowest value of the scale (between 1.2 and 1.4), and there was a statistically significant association between environments and caries (RC: 0.51; CI: 0.29-0.88) and with biofilm (RC: 0.27; CI: 0.17-0.42). In conclusion, there is an inadequacy of the day care environment that does not contribute to the construction of knowledge related to oral health education, which is associated with oral health outcomes. Therefore, day cares can be considered unhealthy environments regarding oral health.

Los jardines de infancia se consideran un ambiente saludable porque, además de cumplir una misión educativa, influyen en los cuidados básicos de la salud, se responsabilizan de la integridad física y emocional del niño, y orientan los hábitos de higiene, alimentación y socialización interpersonal. Por tanto, este estudio tuvo por objetivo evaluar ambientes de jardines de infancia para comprender mejor los factores de riesgo presentes y padrones de comportamiento enseñados, así como su asociación con la caries dental, traumatismo dental y presencia de biopelícula. Este es un estudio transversal con utilización de escala Infant/Toddler Environment Rating Scale Revised (ITERS-R), la evaluación de ambientes en guarderías públicas y particulares en dos municipios del estado de Río de Janeiro. Para la evaluación de las lesiones de caries, se siguieron los criterios del International Caries Detection and Assessment System (ICDAS); para una presencia de biopelícula se utilizó el criterio de Alaluusua y Malmivirta, y el descrito por O'Brien para lesiones traumáticas. La asociación entre el ambiente y los resultados se observó por medio de la comparación de medias para las variables numéricas, mediante la prueba t de Student, y para las variables categóricas binarias, se utilizó la Regresión Logística. Se constató una baja calidad de los ambientes con relación a la salud bucal, con puntajes promedio de ambiente en el valor más bajo de la escala (entre 1,2 y 1,4) y hubo asociación estadísticamente significativa entre ambientes y caries (OR: 0,51; IC: 0,29-0,88) y con biopelícula (OR 0,27; IC: 0,17-0,42). Se concluye que las guarderías son inadecuadas, porque no contribuyen a la construcción de conocimientos relacionados con la educación en salud bucal y esto se asocia a resultados de salud oral. Se puede, de esa forma, considerarlos ambientes no saludables relacionados a la salud bucal.

Qualidade de Vida e Saúde Bucal em Crianças submetidas à Terapia Antineoplásica / Quality of Life and Oral Health in Children undergoing Antineoplastic Therapy / Calidad de Vida y salud Oral de los Niños sometidos a Terapia Antineoplásica

Introdução: O câncer é uma doença grave cujo protocolo de tratamento pode produzir severos efeitos colaterais de ordem psicossocial e física. Os principais efeitos do tratamento antineoplásico podem acometer a cavidade oral, especialmente em crianças, comprometendo a sua qualidade de vida e a do núcleo familiar. Objetivo: Identificar e descrever as lesões bucais relacionadas aos efeitos colaterais produzidos pelo tratamento antineoplásico e avaliar seu impacto sobre a qualidade de vida da criança e da sua família. Método: Estudo qualitativo e transversal, com a participação de 117 crianças pré-escolares atendidas em hospital de referência (Paraíba), por meio do questionário B-ECOHIS, de exames clínicos odontológicos e de prontuários médicos. O tratamento estatístico fundamentou-se na análise descritiva e regressão de Poisson com variância robusta no método (p<0,05). Resultados: As manifestações mais observadas foram mucosite e xerostomia (66,7% e 54,7%, respectivamente). Relativo ao impacto na qualidade de vida da criança, o domínio de maior média foi limitação funcional 3,0 (±1,8) e, na família, função familiar 1,0 (±1,0). Conclusão: O impacto na qualidade de vida das crianças se revelou fraco e, no núcleo familiar, não foi significativo

Introduction: Cancer is a burdensome disease whose treatment protocol can produce severe psychosocial and physical side effects. The main effects of antineoplastic treatment may affect the oral cavity, especially in children, compromising theirs and their family quality-of-life. Objective: To identify and describe side effects-related antineoplastic treatment and to assess its impact on the children's and their families' quality-of-life. Method: Qualitative and cross-sectional study, with the participation of 117 children, preschoolers, consulted at a referral hospital in the State of Paraíba, through the B-Ecohis questionnaire, dental clinical exams and medical records. The statistical treatment was based on descriptive analysis and Poisson Regression with robust variance in the Stepwise method (p<0.05). Results: The most common manifestations were mucositis and xerostomia (66.7% and 54.7% respectively). The impact on the children's quality-of-life affected mostly the domain of functional limitation with mean of 3.0 (±1.8) and 1.0 (±1.0) for the family function in the family. Conclusion: The impact on the quality-of life in children was weak and not significant in the family

Introducción: El cáncer es una enfermedad grave cuyo protocolo de tratamiento puede producir efectos secundarios psicosociales y físicos graves. Entre los principales efectos del tratamiento antineoplásico, algunos afectan la cavidad bucal, especialmente en los niños, comprometiendo su calidad de vida y el núcleo familiar. Objetivo: Identificar los efectos secundarios producidos por el tratamiento antineoplásico y evaluar su impacto en la calidad de vida del niño y su familia. Método: Estudio cualitativo y transversal, con la participación de 117 niños, preescolares, atendidos en un hospital de referencia (Paraíba), mediante el cuestionario B-Ecohis, exámenes clínicos dentales y registros médicos. El tratamiento estadístico se basó en análisis descriptivo y Regresión de Poisson con varianza robusta en el método Stepwise (p<0,05). Resultados: Las manifestaciones más observadas fueron mucositis y xerostomía (66,7% y 54,7% respectivamente). En cuanto al impacto en la calidad de vida del niño, el dominio con mayor promedio fue la limitación funcional 3,0 (±1,8) y la función familiar 1,0 (±1,0) en la familia. Conclusión: El impacto en la calidad de vida de los niños fue débil y en la familia no significativo

Normative need for orthodontic treatment and perception of the need for such treatment among Brazilian adolescents.

OBJECTIVE:: The aim of the present study was to evaluate the normative need for orthodontic treatment and the perception of such need among students aged 11-14 years. METHODS:: A cross-sectional study was conducted with a sample of 346 students, randomly selected from public and private schools. The Dental Aesthetic Index (DAI) was used to evaluate the normative need for orthodontic treatment (NNOT). The perceived need for treatment among students was assessed by a previously validated questionnaire. Data was analyzed by Pearson's Chi-squared test (α = 5%). RESULTS:: The prevalence of malocclusion and NNOT was 65.6%. Of the sample, 73.7% felt they needed treatment, 66.2% wanted orthodontic treatment and 62.7% were satisfied with their dental aesthetics. A statistically significant association was observed between NNOT and the perception of the need for treatment among the students (p < 0.001). CONCLUSION:: The present study demonstrated a high prevalence of malocclusion, which was reflected in the high normative need for orthodontic treatment. The opinion of patients regarding their expectations of orthodontic treatment should be valued. The students perceived a need for orthodontic treatment.

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

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

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.

Antimicrobial Activity of Photodynamic Therapy Against Enterococcus faecalis Before and After Reciprocating Instrumentation in Permanent Molars.

OBJECTIVE: The present study sought to evaluate the antimicrobial activity against Enterococcus faecalis of photodynamic therapy applied before and after reciprocating instrumentation of permanent molars. BACKGROUND: Apical extrusion of debris can cause flare-ups due to introduction of bacteria into the periapical tissues. METHODS: Eighteen mesial roots from permanent mandibular molars were selected. The crowns were removed to obtain a standard root length of 15 mm. The included mesial roots had an angulation of 10°-40° and canals with independent foramina. The orifice of each mesiolingual canal was sealed with light-curing resin, and the working length was established visually, 1 mm short of the apical foramen. The roots were rendered impermeable and sterilized, and the mesiobuccal canals were contaminated with a standard strain of E. faecalis for 21 days. Specimens were randomly divided into three groups (n = 6): G1, photodynamic therapy performed before instrumentation and irrigation with 0.9% NaCl (saline) solution; G2, photodynamic therapy performed after instrumentation and irrigation with 0.9% NaCl; and G3 (control), instrumentation and irrigation with 2.5% NaOCl (sodium hypochlorite) solution. Canals were shaped with a WaveOne primary file (25.08) and irrigated with 0.9% NaCl. E. faecalis samples were collected before and after each procedure, and the results were analyzed using descriptive statistics and the Kruskal-Wallis and Wilcoxon tests. RESULTS: Significant reductions in E. faecalis were observed when photodynamic therapy was performed before and after instrumentation of the root canal system (p < 0.05). Reciprocating instrumentation significantly reduced E. faecalis colonies in experimentally contaminated root canal systems (p < 0.05). CONCLUSIONS: Photodynamic therapy was effective in removing E. faecalis from the root canal system, whether performed before or after reciprocating instrumentation.

Salivary flow rate and biochemical composition analysis in stimulated whole saliva of children with cystic fibrosis.

OBJECTIVE: It is recognized that cystic fibrosis (CF) patients present a risk for oral diseases, since it affects exocrine glands, and the treatment consists of a carbohydrate-rich diet. Recognizing the protective function of saliva on maintaining oral health, the aim of the study was to evaluate salivary parameters in stimulated whole saliva from children with CF. METHODS: A case-control study was conducted comparing stimulated whole saliva of healthy (n=28; control group) and CF children (n=21; experimental group). Salivary flow rate, initial pH, buffer capacity (total and in each range of pH), total protein and sialic acid (total, free, and conjugated) concentration, α-amylase and salivary peroxidase activities were evaluated. Data were compared by two-tailed Student t test (95% CI; p ≤ 0.05). RESULTS: CF patients presented a significant reduction in salivary parameters compared with the control group (p ≤ 0.05): salivary flow rate (36%), buffer capacity (pH range from 6.9 to 6.0), sialic acid concentration (total 75%, free 61%, and conjugated 83%); α-amylase and salivary peroxidase activities (55%). Additionally, a significant increase in total protein concentration (180%) of stimulated whole saliva from CF patients was verified compared with the control group (p ≤ 0.05). CONCLUSION: Children with CF presented significant changes in salivary composition, including salivary flow rate, buffering capacity and protective proteins of the oral cavity, compared with children without CF.

Association between clinical manifestations of sickle cell anemia in children and the occurrence of dental caries: a cross-sectional study / Associação entre manifestações clínicas da anemia falciforme em crianças e a ocorrência de cárie dentária: um estudo de corte transversal

Objective: The aim of this study was to determine the association between clinical manifestations of sickle cell anemia (including hospitalization and pain crisis) and dental caries in children in Bahia. Material and Methods: The study design was crosssectional, and the population included children aged from 6 to 96 months from August 2007 to July 2008 (N = 686). Interviews were performed to identify the sociodemographic profiles of the participants, and oral examinations were conducted by three examiners who were previously trained and calibrated to identify the presence of dental caries according to World Health Organization (WHO) criteria. Logistic regression analysis was performed for confirmatory analysis and estimation of confidence intervals (CIs). Results: The results showed that pain crises and hospitalizations were positively associated with caries (crude odds ratio (OR) = 2.11 and adjusted OR = 1.24; crude OR = 2.50 and adjusted OR = 1.46, respectively), but these associations were not statistically significant. Conclusion: The severity of the sickle cell condition alone was not sufficient to aggravate the prevalence of caries; thus, there are no major differences in caries prevalence between children with and without sickle cell disease. (AU)

O objetivo deste estudo foi determinar a associação entre as manifestações clínicas da anemia falciforme (incluindo hospitalização e crise de dor) e cárie dentária em crianças na Bahia. Material e Métodos: O desenho do estudo foi transversal e a população incluiu crianças de 6 a 96 meses de agosto de 2007 a julho de 2008 (N = 686). Foram realizadas entrevistas para identificar os perfis sociodemográficos dos participantes, e os exames bucais foram realizados por três examinadores previamente treinados e calibrados para identificar a presença de cárie dentária de acordo com os critérios da Organização Mundial da Saúde (OMS). A análise de regressão logística foi realizada para análise confirmatória e estimativa de intervalos de confiança (IC). Resultados: Os resultados mostraram que as crises de dor e hospitalizações foram positivamente associadas à cárie (razão de chances bruta (OR) = 2,11 e OR ajustado = 1,24; OR bruto = 2,50 e OR ajustado = 1,46, respectivamente), mas essas associações não foram estatisticamente significantes. Conclusão: A gravidade da doença falciforme isoladamente não foi suficiente para agravar a prevalência de cárie; assim, não há grandes diferenças na prevalência de cárie entre crianças com e sem doença falciforme.(AU)

Factors associated with feeding practices among Brazilian children aged 12 to 23 months old / Fatores associados à prática alimentar de crianças brasileiras de 12 a 23 meses de vida

Abstract Objectives: a quantitative analytical cross-sectional study aimed to identify demographic characteristics to access health services and housing conditions in relation to inadequate feeding practices among Brazilian children from 12 to 23 months of age. Methods: the analysis of the feeding practices (consumption of recommended food groups) of 2541 Brazilian children (aged 12-23 months old) was performed using data from the Pesquisa Nacional de Saúde 2013 (National Health Survey). Descriptive and multivariate statistics used the Decision Tree Analysis based on CHAID (Chi-squared Automatic Interaction Detector) algorithm, as well as hierarchically adjusted Poisson regression analyses were performed. The variables were entered in a hierarchical model at distal (demographic), intermediate (access to health) and proximal (housing conditions) levels. Results: the results showed a high prevalence of sugar consumption (85.5%; CI95%=83.7-87.2) and highlighted inadequate feeding practices among non-white children (p=0.001), resident in the North (p<0.001) and Northeast (p=0.010) of Brazil and in towns in the countryside (p<0.001) presented feeding practices that were not recommended for consumption in the food groups. Conclusions: non-white children, who lived in the North and Northeast regions of Brazil and in the countryside, which are known to be more socioeconomically vulnerable, were more likely to experience inadequate feeding practices.

Resumo Objetivos: estudo transversal analítico, de natureza quantitativa buscou identificar características demográficas, de acesso aos serviços de saúde e de condições de moradia relacionadas à prática alimentar de crianças brasileiras de 12 a 23 meses de vida. Métodos: a partir dos dados da Pesquisa Nacional de Saúde 2013, as práticas alimentares de 2541 crianças brasileiras de 12 a 23 meses, foram analisadas quanto à recomendação de consumo dos grupos alimentares. A análise das características associadas às práticas alimentares foi realizada pela árvore de decisão usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector) e análise de regressão de Poisson ajustada hierarquicamente. As variáveis foram inseridas em modelo hierárquico em níveis distal (demográficas), intermediário (acesso à saúde) e proximal (condições de moradia). Resultados: verificou-se uma alta prevalência no consumo de açúcar (85,5%; IC95%=83,7-87,2) e que crianças que não eram da cor branca (p=0,001), e residiam nas regiões Norte (p<0,001) e Nordeste (p=0,010) do país e em cidades do interior (p<0,001) apresentaram práticas alimentares que não atingem a recomendação de consumo dos distintos grupos alimentares. Conclusão: crianças que não eram da cor branca, residentes no Norte/Nordeste e no interior, áreas de maior vulnerabilidade do país, foram mais propensas à práticas alimentares inadequadas. Medidas para melhorar tais práticas devem abordar as desigualdades socioeconómicas e intervenções de promoção à saúde.

Different bacterial models for in vitro induction of non-cavitated enamel caries-like lesions: Microhardness and polarized light miscroscopy analyses.

The aim of this study was to compare different bacterial models for in vitro induction of non-cavitated enamel caries-like lesions by microhardness and polarized light microscopy analyses. One hundred blocks of bovine enamel were randomly divided into four groups (n = 25) according to the bacterial model for caries induction: (A) Streptococcus mutans, (B) S. mutans and Lactobacillus acidophilus, (C) S. mutans and L. casei, and (D) S. mutans, L. acidophilus, and L. casei. Within each group, the blocks were randomly divided into five subgroups according to the duration of the period of caries induction (4-20 days). The enamel blocks were immersed in cariogenic solution containing the microorganisms, which was changed every 48 h. Groups C and D presented lower surface hardness values (SMH) and higher area of hardness loss (ΔS) after the cariogenic challenge than groups A and B (P < 0.05). As regards lesion depth, under polarized light microscopy, group A presented significantly lower values, and groups C and D the highest values. Group B showed a higher value than group A (P < 0.05). Groups A and B exhibited subsurface caries lesions after all treatment durations, while groups C and D presented erosion-type lesions with surface softening. The model using S. mutans, whether or not it was associated with L. acidophilus, was less aggressive and may be used for the induction of non-cavitated enamel caries-like lesions. The optimal period for inducing caries-like lesions was 8 days.

Simultaneous activation technique: an alternative for bonding composite resin to glass ionomer.

PURPOSE: The purpose of this study was to evaluate a new simultaneous activation technique (SAT)-for the union between glass ionomer cements and composite resins. METHODS: Forty primary molars were embedded in self-curing acrylic resin. Class I cavity preparations were performed on the dentin surface and the teeth were randomly divided into 4 groups (N = 10). Two groups were restored with the SAT and 2 by etching the ionomer surface/sandwich technique (ST). The materials tested were Vidrion F (SS/ White), Vitremer (3M), and Z100 (3M). After 24 hours in aqueous solution at 37 degrees C, a tensile test was performed. The microleakage study was also performed by selecting 40 primary molars which were distributed in the same way as in the bond strength test. Furthermore, 1 tooth from each group of the microleakage test was evaluated by means of scanning electron microscopy. RESULTS: The SAT and ST did not show statistically significant differences in both tests. CONCLUSIONS: The SAT is a less complex, quicker, and feasible alternative for the bonding of glass ionomer cements to composite resins in primary molars.

Photodynamic therapy in pediatric dentistry.

Conservation of deciduous teeth with pulp alterations caused by caries and trauma is a major therapeutic challenge in pediatric dentistry as a result of the internal anatomy and life cycle characteristic. It is essential that the root canal procedures sanitizers have a performance in eliminating bacterial. In this context, antimicrobial photodynamic therapy (PAT) is promising and emerging as adjuvant therapy in an attempt to eliminate the microorganisms persistent to chemi-mechanical preparation. Since there is presence of oxygen in cells, photosensitizer activated by light can react with molecules in its vicinity by electrons' or hydrogen's transfer, leading to microorganism death. This paper reports the case of 4-year-old patient, female, with early childhood caries. The proposed endodontic treatment incuded chemomechanical treatment allied to PAT in the decontamination of root canals using methylene blue dye 50 µg/mL during 3-5 minutes and 40 J/cm(2) as energy density, taking into account the need for tissue penetration and effectiveness of PAT inside the dentinal tubules.