Complications following replantation of primary teeth: a case report / Complicações após reimplante de dentes decíduos: um relato de caso clínico

Abstract Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.

Resumo Introdução: a avulsão de dentes decíduos é um evento perturbador e inesperado. Descrição: o presente relato descreve o caso clínico de uma criança de três anos que sofreu avulsão e reimplante dos incisivos centrais superiores decíduos no local do acidente. Os responsáveis procuraram atendimento para a criança na Universidade Federal de Minas Gerais após reimplante. Quatro meses depois, a criança sofreu novo trauma e os dentes reimplantados apresentavam mobilidade avançada, reabsorção radicular e fístula. A conduta clínica foi extração e reabilitação com mantenedor estético fixo. Discussão: a literatura descreve duas opções de tratamento para avulsão de incisivos decíduos: o reimplante e o não reimplante. De acordo com revisão sistemática recente, a dificuldade de se obter um consenso sobre a melhor conduta clínica se deve, em parte, à escassez de publicações que apresentem não apenas acompanhamentos com sucesso clínico, mas também com falhas. O reimplante pode ser influenciado por vários fatores. O tempo decorrido entre o reimplante e a contenção, e o novo episódio de trauma, influenciaram negativamente o prognóstico do presente caso, levando ao insucesso. O reimplante de incisivos decí- duos ainda não é um tratamento baseado em evidências. Portanto, essa opção deve ser escolhida com cautela e em situações ideais. Requer monitoramento clínico e radiográfico para constante avaliação do desfecho.

Mirror image: an unusual case of prolonged tooth retention in twins

Introduction: Studies of twins are important because environmental and genetic factors seem to be related to the phenotypic alterations. Objective: This paper presents a unique case of monozygotic twins with mirror image of a retained primary central incisor. Case report: Twin male brothers, 9-years-old, presented prolonged retention of the primary central upper incisor. The over-retained teeth in one twin were a mirror image of those in the other twin. The first twin presented a prolonged retention of the tooth 51 whereas the other twin presented a prolonged retention of tooth 61. After radiographic exams the over-retained teeth were extracted. Conclusion: Twins may show similarity in pattern of dental anomalies supporting the influence of genetic factors. In identical twins the location of diagnosed anomalies can be mirror imaged. This fact should lead the professional to examine the pair of twins in order to diagnose any dental anomaly that may be present.

Introdução: Estudos feitos em gêmeos são importantes porque fatores ambientais e genéticos parecem estar relacionados às alterações fenotípicas. Objetivo: Este artigo apresenta um caso raro de gêmeos monozigóticos apresentando imagem em espelho de retenção prolongada de incisivos centrais decíduos superiores homólogos. Relato do caso: Os irmãos gêmeos, com 9 anos de idade, não apresentavam história de trauma orofacial ou doença comum da infância. Após exames clínicos e radiográficos foram identificados a retenção do dente 51 no gêmeo 1 e do dente 61 no gêmeo 2. Em ambos os pacientes, os dentes 11 e o 21 estavam em erupção. O tratamento proposto foi a exodontia dos dentes decíduos com anestesia local e acompanhamento. Conclusão: Gêmeos podem apresentar semelhança no padrão de anomalias dentárias devido à influência de fatores genéticos. Adicionalmente, em gêmeos monozigóticos, a localização das anomalias diagnosticadas pode se apresentar invertidas ou imagem em espelho. Esse fato deve estimular o profissional a examinar o par de gêmeos para diagnosticar qualquer anomalia dentária que possa estar presente. O diagnóstico precoce e tratamento adequados devem ser realizados para evitar danos funcionais e estéticos em pacientes com retenções dentárias.

Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial

Abstract Objectives: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). Methodology: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. Results: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all follow-up appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and inter-radicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. Conclusion: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone.

Canine transposition as an alternative to trauma of the maxillary incisors: case report

ABSTRACT Objective: The present article aims at reporting the clinical case of a patient who suffered trauma at two years of age, causing almost complete apical displacement of the deciduous maxillary left central incisor and of the permanent incisor. Methods: Ectopia secondary to intrusion was minimized by surgical removal of the ectopic tooth, and the left permanent canine was submitted to orthodontic traction to replace the extracted tooth. Results: The treatment period lasted 36 months, resulting in correct occlusion and a good aesthetic outcome. Conclusions: Dental transposition carried out by means of orthopedic traction is a good alternative in cases of a very unfavorable ectopic tooth position.

RESUMO Objetivo: o presente relato de caso descreve uma paciente que sofreu trauma aos dois anos de idade, causando deslocamento apical quase completo do incisivo central esquerdo decíduo e do incisivo permanente. Métodos: a ectopia resultante da intrusão foi minimizada pela remoção cirúrgica do dente ectópico, e o canino permanente esquerdo foi tracionado ortodonticamente para substituir o dente extraído. Resultados: o período de tratamento durou 36 meses, obtendo-se uma oclusão correta e um bom resultado estético. Conclusões: a transposição dentária realizada através da tração ortopédica é uma boa alternativa em casos de dentes ectópicos em posições muito desfavoráveis.

Clinical, radiographic and histological evaluation of primary teeth pulpotomy using mta and ferric sulfate

Abstract The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue.

Resumo O objetivo deste estudo foi avaliar os resultados clínicos, radiográficos e histológicos do complexo dentino-pulpar de molares decíduos após pulpotomia com agregado trióxido mineral (MTA) e sulfato férrico (SF) 15,5%. Trinta e um molares decíduos foram alocados aleatoriamente nos grupos MTA ou SF. As avaliações clínicas e radiográficas foram realizadas aos 3, 6, 12 e 18 meses de acompanhamento. Os dentes no período regular de esfoliação foram extraídos e processados ​​para análise histológica. Os dados clínicos e radiográficos foram analisados estatisticamente (p≤0,01). O resultados histológicos foram analisados ​​descritivamente. Todos os dentes tratados apresentaram sucesso clínico ao longo dos períodos experimentais. Ambos os grupos exibiram 100% de sucesso radiográfico aos 3, 6 e 12 meses. Aos 18 meses de acompanhamento, um dente do grupo SF apresentou radiolucidez interradicular (p>0,01). Histologicamente, os dentes tratados apresentaram vitalidade pulpar e ausência de infiltrado inflamatório no tecido conjuntivo. Somente o grupo MTA mostrou barreira de tecido duro rodeada por odontoblastos sobre os cotos pulpares. MTA e SF 15,5% são eficazes para pulpotomias de dentes decíduos. Embora o MTA seja considerado o material de primeira escolha, o SF pode ser uma alternativa adequada quando o custo do tratamento é um problema.

Survival and Factors Associated with Failure of Pulpectomies Performed in Primary Teeth by Dental Students

Abstract Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.

Resumo Embora o tratamento endodôntico seja amplamente recomendado para polpa dentária comprometida, não há informações sobre os fatores associados ás falhas nos dentes decíduos. O objetivo do trabalho foi avaliar a sobrevida e os fatores associados à falha de pulpectomias realizadas em dentes decíduos por estudantes de odontologia. A amostra foi constituída por pacientes atendidos em um Serviço Odontológico Universitário e necessitaram de tratamento endodôntico em dentes decíduos. O estudo investigou variáveis relacionadas ao tratamento e fatores do paciente potencialmente associados à falha do tratamento. A sobrevivência das pulpectomias foi analisada pelas curvas de Kaplan-Meier seguido do teste de log-rank (p<0,05). A análise incluiu 81 pulpectomias realizadas em 62 crianças (5,6 ± 1,5 anos). A sobrevida atingiu 62,9% em até 12 meses de seguimento. A maioria das falhas ocorreu nos primeiros 3 meses (p<0,001). Os dentes com lesões cariosas no início do tratamento apresentaram mais falhas do que aqueles com restaurações ou história de trauma (p = 0,002). A sobrevida de dentes endodonticamente tratados restaurados com compósito foi maior do que os preenchidos com cimento de ionômero de vidro (p = 0,006). Pulpectomias realizadas em duas ou mais sessões apresentaram mais falhas (p = 0,028). Os pacientes com gengivite apresentaram mais falhas no tratamento endodôntico (p = 0,022). As falhas do tratamento do canal radicular em dentes decíduos foram mais propensas a ocorrer em um curto período de tempo e quando o tratamento foi realizado em dentes com lesões cariosas. O uso de compósito em vez de cimento de ionômero de vidro aumentou a sobrevivência pulpectomias. Sessões repetidas para o tratamento endodôntico e a falta de hábitos de higiene bucal tiveram um efeito negativo sobre os resultados.

Relato de caso clínico de paciente com dente natal e neonatal / A case report of a pacient with natal and neonatal tooth

Dentes presentes ao nascimento são denominados de dentes natais. Dentes que erupcionam no primeiro mês de vida são denominados de dentes neonatais. Estes podem ou não ser supra­ numerários. Objetivo: o presente trabalho tem como objetivo relatar o caso clínico de paciente do gênero feminino, com 15 dias de vida, levada pelos pais ao consultório odontológico com a queixa de que a criança nasceu com um dente na região inferior anterior. Relato de caso: ao exame clínico observou-se a presença de dois dentes na região dos incisivos centrais inferiores; um em processo de erupção, sem mobilidade e outro recoberto por tecido gengival. Conclusão: manutenção de dentes natais e/ou neonatais é possível e aconselhável, quando estes são da dentição normal, não apresentam mobilidade nem riscos para a amamentação. Os controles periódicos são importantes para acompanhar o desenvolvimento dentário da criança.

The teeth present at the birth time are called natal teeth. The teeth that erupt within the first month of birth are called neonatal teeth. They can be supernumerary or not. Aim: the present work aims at reporting a case of a female patient, with 15 days of life, taken by her parents to the dental clinic with the complaint that the child was born with a tooth in the lower region. Case report: the clinical examination revealed the presence of two teeth in the region of the mandibular central incisors; one of them, in process of eruption and without mobility, and the other covered by gingival tissue. Conclusion: the maintenance of the natal and/or neonatal teeth is possible and advisable; when these are from an ordinary teething they don't present mobil ity or risks to the breast - feedi ng. Periodic ora I exa m i nations a re i nd icated to follow-u p the child's dental development.

Extracciones dentales atraumáticas en pacientes pediátricos con trastornos de la coagulación: descripción de la técnica y reporte de un caso / Atraumatic tooth extractions in pediatric patients with bleeding disorders: a technical description and report of a case

Se detalla y fundamenta la técnica de extracción atraumática de dientestemporales unirradiculares en pacientes pediátricos con trastornos de lacoagulación utilizando separadores elastoméricos. Se expone el caso deun paciente pediátrico con diagnóstico de defi ciencia de factor X de lacoagulación, quien requirió de la extracción atraumática de los órganosdentarios centrales superiores temporales debido a la gingivorragiapropia de la exfoliación natural.

We describe the technique of atraumatic tooth extraction for single-rooted temporary and permanent teeth in pediatric patients with bleed-ing disorders using elastomeric separators and discuss its benefi ts. We present the case of a pediatric patient diagnosed with coagulation factor X defi ciency who required the atraumatic extraction of his temporary upper central teeth due to gingival bleeding caused by natural exfoliation.

Multidisciplinary Therapy of Extensive Oligodontia: A Case Report

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Resumo A oligodontia é uma doença rara, congênita, caracterizada pela ausência de seis ou mais dentes. Este relato de caso descreve uma abordagem terapêutica multidisciplinar de um adolescente de 12 anos de idade com ausência de 11 dentes permanentes. Antes de qualquer procedimento, todos os dentes decíduos foram extraídos devido à pobre relação coroa-raiz. O plano de tratamento foi constituído por duas fases: 1. terapia ortodôntica e fonoaudiológica com o objetivo de ajuste de sobre-mordida e mordida aberta anterior, bem como melhoria da posição da língua, e 2. tratamento reabilitador protético através da instalação de próteses parciais removíveis provisórias. A abordagem multidisciplinar envolvendo os tratamentos ortodônticos, fonoaudiológico e protético reestabeleceram a função mastigatória e a estética, melhorando a autoestima e aceitação social do paciente. .

Comparative evaluation of formocresol and mineral trioxide aggregate as pulpotomy agents in deciduous teeth.

Aim: To evaluate and compare mineral trioxide aggregate (MTA) and formocresol as pulpotomy medicaments by clinical and radiographic assessments and to assess the histological features of both pulpotomy medicaments in deciduous teeth. Materials and Methods: This study was performed on 100 mandibular deciduous molar teeth requiring pulpotomy treatment. Children between age four and six years were randomly selected and divided into formocresol or MTA group. The patients were recalled after 3, 6, 9, 12 months respectively and evaluated clinically and radiographically. Histological assessment was done on lower deciduous canine teeth, which were undergoing serial extraction for interceptive orthodontic purpose. Pulpotomy was done on four teeth with formocresol and another four teeth with MTA. The teeth were extracted after six months following pulpotomy procedure and histologically evaluated. Two freshly extracted carious teeth were taken as controls. Results: Clinical and radiographic criteria were laid and Chi analysis revealed significant difference in mobility ( P≤0.05), periodontal ligament widening ( P≤0.01 level) and inter - radicular radiolucency ( P≤0.02 level) between two groups at the end of 12 months. Histologically, in MTA group, a layer of new dentine formation with less dentinal tubules at the pulpotomized site was found. In formocresol group, increased inflammatory cells, a zone of atrophy, were noted in radicular portion of pulp. Conclusion: MTA is superior to formocresol clinically, radiographically. Histological analysis showed better reparative ability with hard tissue barrier formation with MTA compared to formocresol.

Deciduous dentition treated with puplotomy.

Early loss of decidous teeth can have an unfavorable effect upon the permanent dentition and the entire masticatory system. The majority of children today have little or no caries, and only in a small minority is the caries index high. In order to maximize the effectiveness of preventive measures, the dentist has a duty to determine the patient's caries risk and to introduce an effective individualized preventive program and early treatment

Frecuencia de pérdida de segundos molares temporarios en niños que acudieron al servicio de cirugía pediátrica de la Facultad e Odontología de la Universidad Nacional de Asunción en el año 2010 / Frequency of loss of second deciduous molars in children who attended the pediatric surgery department of the Faculty and Dentistry, National University of Asuncion in 2010

Los dientes temporales desempeñan un papel muy importante en el mantenimiento de la longitud del arco; la pérdida precoz constituye una causa local de anomalía adquirida dela oclusión, consecutivamente a ésta puede ocurrir una disminución del espacio reservado para el sucesor permanente debido a la migración de los dientes adyacentes y el consiguiente acortamiento de la longitud de la arcada. Con el objetivo de determinarla frecuencia de pérdida de los segundos molares temporarios en niños que acudieron al servicio de cirugía infantil de la Facultad de Odontología de la UNA, en el año 2010, se realizó un estudio observacional descriptivo de corte transversal con el componente analítico, la muestra estuvo constituída por 93 pacientes de 3 a 10 años de edad. Para ello se solicitó la autorización de los responsables de la Facultad y la participación voluntaria de los sujetos, previa firma del consentimiento informado de los padres o encargados para la inspección bucal de los niños en quienes se evaluó el estado dentario para dar cumplimiento a los objetivos del trabajo. A más de determinar la frecuencia de pérdida prematura de los segundos molares temporarios, se determinó la relación entre dicha pérdida y el sexo, la arcada y la hemiarcada. Se observó que el 59%de los niños presentó pérdida prematura, correspondiendo el 55,3% a piezas de la arcada superior. Al considerar la hemiarcada, la inferior izquierda fue la más afectada. Sería importante evitar la pérdida prematura de las piezas dentarias a través de medidas preventivas restaurativas y, de no ser posible evitar la exfoliación prematura, utilizar los medios existentes para la mantención del espacio y evitar anomalías en la oclusión.

Anchos mesiodistales de dentición temporal en niños de la ciudad de Concepción, Chile y su correlación con el tamaño de coronas metálicas preformadas de stock / Mesiodistal width in temporary molars of Chilean children of Concepción and his correlation with standard preformed steel crowns

Las coronas metálicas preformadas son el tratamiento de elección al restaurar extensas caries en molares temporales. Para lograr un óptimo tratamiento es necesario conocer los anchos mesiodistales de las piezas involucradas en la terapia restauradora. En nuestro medio se utilizan los anchos mesiodistales de otras poblaciones, al conocer que pueden existir diferencias significativas con nuestra población en particular decidimos estudiar el ancho mesiodistal en nuestros pacientes. El propósito de esta investigación fue determinar anchos mesiodistales de molares temporales sanos en niños chilenos, analizando dimorfismo sexual, simetría intraarcada y con la pieza contralateral, así como la concordancia con los tamaños estandarizados de las coronas metálicas preformadas. Se realizó un estudio descriptivo odontométrico, seleccionando 34 niños (17 hombres y 17 mujeres) que asistían a la Clínica de Odontopediatría. Se procedió a medir anchos mesiodistales con un calibre ortodóncico en modelos de yeso obtenidos de cada paciente. Simultáneamente se midieron anchos mesiodistales de coronas metálicas preformadas. No se observan diferencias estadísticamente significativas entre los diámetros de piezas derechas e izquierdas ni entre géneros. Molares inferiores presentaron mayor ancho mesiodistal que los superiores. El promedio de ancho mesiodistal de molares temporales se corresponde de manera significativa con un solo tamaño de corona metálica preformada, salvo en las piezas 5.5 y 8.5 donde la correlación es con 2 tamaños de coronas metálicas.

Metallic preformed steel crowns are the best treatment choice to restaurate extense cavities in temporary molars. To achieve optimal results it is necessary to know the mesiodistal width of the temporary teeth involved. We currently use other population’s data regarding mesiodistal width, and since we believe there could be significant variations in between populations we decided to study mesiodistal width in our patients. The purpose of this investigation was to determine mesiodistal widths of healthy temporary molars in Chilean children.Sexual dimorphism, interarch symmetry and with the contralateral tooth, and comparison with the standard preformed steel crown were analyzed. This is a descriptive odonthometric study. 34 children (17 male, 17 female) assisting to the Pediatric Clinic were selected. Mesiodistal widths were assessed with an orthodontic caliper on a plaster model obtained from each patient. Simultaneously, preformed steel crown mesiodistal widths were measured. Results and conclusions: There were no statistically significant differences between right and left teeth’s mesiodistal width, nor between genders. The mean mesiodistal width of temporary molars corresponds with only one size of preformed steel crown, except on 5.5 and 8.5. In these teeth the width corresponds with two sizes of the preformed steel crown.

Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth - zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer - against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1 percent chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37oC for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (?=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1 percent CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains...

Este estudo avaliou in vitro a atividade antibacteriana de 4 materiais obturadores de canais radiculares de dentes decíduos - cimento de óxido de zinco e eugenol (OZE), pasta Calen espessada com óxido de zinco (Calen/OZ), cimento Sealapex e cimento EndoREZ - sobre 5 cepas bacterianas comumente encontradas em infecções endodônticas: Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli e Staphylococcus aureus, usando o teste de difusão em ágar (técnica do poço). A pasta Calen, digluconato de clorexidina a 1 por cento (CHX) e água destilada foram usados como controle. Sete poços por placa foram preparados em pontos eqüidistantes e imediatamente preenchidos com os materiais experimentais e controle. Após incubação das placas a 37oC por 24 h, o diâmetro dos halos de inibição do crescimento bacteriano formados ao redor dos poços foi medido (em mm) com um paquímetro digital sob luz refletida. Os dados obtidos foram submetidos à análise de variância e ao pós-teste de Tukey (?=0,05). Com relação à atividade antibacteriana, evidenciaram-se diferenças estatisticamente significantes (p<0,0001) entre os halos de inibição formados pelos diferentes materiais, para todos os microrganismos avaliados. A K. rhizophila foi inibida mais eficazmente pelo OZE (p<0,05), enquanto que o E. faecalis foi inibido mais eficazmente pela Calen/OZ (p<0,05). O S. mutans foi inibido pela Calen/OZ, cimento Sealapex e OZE na mesma intensidade (p>0,05). A E. coli foi inibida mais eficazmente pelo OZE, seguido pela Calen/OZ e pelo cimento Sealapex (p<0,05). O S. aureus foi inibido pela Calen/OZ e OZE na mesma intensidade (p>0,05), e menos intensamente pelo cimento Sealapex (p<0,05). O cimento EndoREZ apresentou atividade antibacteriana apenas frente a K. rhizophila e ao S. aureus. A pasta Calen e a Calen/OZ ocasionaram halos de inibição maiores que a CHX quando o microrganismo indicador foi o E. faecalis. Pode-se concluir que a atividade antibacteriana...

Loss of space and changes in the dental arch after premature loss of the lower primary molar: a longitudinal study.

The purpose of the study was to evaluate the space changes, dental arch width, arch length and arch perimeter, after the unilateral extraction of lower first primary molar in the mixed dentition period. A longitudinal study was conducted among forty children in the age group of 6-9 years, who reported for extraction of lower first primary molar in the department of Pedodontics, Govt. Dental College, Trivandrum. Study models were made from alginate impression taken before extraction and after extraction at the periodical intervals of two months, four months, six months and eight months. The mesiodistal width of lower first primary molar of the non-extracted side was taken as the control. The results of the study showed statistically significant space loss in the extraction side ( P value < 0.01) and no significant space loss in the control side (P value > 0.05). The rate of loss was greatest in the first four months. The arch width, arch length and arch perimeter had no significant change from initial to eight months follow up. The present study challenges the use of a space maintenance under the circumstances of premature loss of mandibular primary molar for preventing space loss.

Management of nasally erupting deciduous canine in operated cleft lip and alveolus patient.

Nasally erupting tooth is a rare finding seen associated with cleft lip and alveolus. It may be diagnosed as a result of symptoms such as difficulty in breathing, pain on sneezing or blowing the nose or may remain asymptomatic. A case of a 4 year old male child operated for bilateral cleft lip and alveolus with unilateral right sided nasally erupting deciduous canine is presented here.

Van der Woude syndrome: a case report.

Among the many disturbances of development and growth that involve the oral and perioral structures, cleft lip and palate is perhaps the commonest. Dental literature is replete with syndromes associated with cleft lip and palate, one of which is Van der Woude syndrome. The characteristics of Van der Woude syndrome is the association of cleft lip and/or palate with distinctive lower lip pits. A case of Van der Woude syndrome in an 11-year-old boy and his sister is presented.

Intrusäo e avulsäo em dentes decíduos - relato de caso / Primary dentition avulsion and intrusion - report case

Este artigo tem por objetivo relatar um caso de avulsäo e intrusäo na dentiçäo decídua, discutir as dificuldades no manejo do paciente traumatizado, as possíveis consequências do trauma na dentiçäo permanente e condutas preventivas