How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Exploring the association between genetic and environmental factors and molar incisor hypomineralization: evidence from a twin study.

BACKGROUND: The etiology of molar-incisor hypomineralization (MIH) remains unknown. Studies indicate that it is multifactorial, and that genetic and environmental factors are involved. Research with twins provides important subsidy to investigate the Influence of genetics and environmental factors that act during pregnancy on the etiology of alterations. AIM: This cross-sectional study evaluated the agreement of molar incisor hypomineralization (MIH) between monozygotic and dizygotic twin pairs and the association with environmental factors. DESIGN: The sample consisted of 167 pairs of twins (8-15 years old), 94 monozygotic and 73 dizygotic. The parents answered a questionnaire on sociodemographic data and pre-, peri-, and postnatal health. A dental examination was performed by two calibrated examiners (Kappa ≥0.88) for MIH diagnosis, following the criteria proposed by the European Academy of Pediatric Dentistry in 2003. RESULTS: The prevalence of MIH was 29.3%. There was greater concordance of MIH between monozygotic twins for affected first molars and permanent incisors (P = 0.0012) and pairs of twins assessed (P = 0.0211). The presence of MIH was associated with family income between one and two wages (P = 0.009, prevalence ratio [PR] = 3.82, confidence interval [CI 95%] 1.40-10.44), above two wages (P = 0.007, PR = 4.60, 95% CI: 1.51-14.05), and gestational hemorrhage (P = 0.032, PR = 5.70, 95% CI: 1.16-28.14). CONCLUSIONS: The greater concordance in the diagnosis of MIH among monozygotic twins indicates a genetic influence, although environmental factors, such as family income and hemorrhage during pregnancy, are also associated with the occurrence of MIH.

Resistência à flexão de cimentos de ionômero de vidro utilizados em tratamento restaurador atraumático com alteração na proporção pó/líquido / Flexural strength of glass ionomer cements used in atraumatic restorative treatment with change in powder / liquid ratio

Objetivo: Avaliar se a alteração na proporção pó/líquido de cimento de ionômero de vidro nacional indicado para ART (Vitro Molar), proporciona melhorias na resistência à flexão comparando-o ao cimento importado, Fuji IX, considerado atualmente o padrão ouro no mercado. Material e método: Foram confeccionados 30 corpos de prova, divididos igualmente entre três grupos (G1 = Vitro Molar, manipulado conforme orientação do fabricante com proporção pó/líquido (1/1); G2 = Vitro Molar com proporção pó/líquido aumentada em 50 % (1,5/1) e G3 = Fuji IX, manipulado conforme orientação do fabricante. Os corpos de prova foram submetidos ao ensaio mecânico de resistência à flexão de três pontos (ISO 9917-2). Uma força foi aplicada no centro até a ruptura dos corpos-de-prova. Os dados foram submetidos à análise de variância e ao teste de Tukey, com nível de significância de 95%. Resultado: Os resultados médios obtidos para força máxima, em MPa, foram: G1: 3,57; G2: 4,54 e G3: 6,32. Houve diferença estatística entre os grupos G1 e G3. O grupo G2 apresentou semelhança estatística quando comparado aos demais grupos. Conclusão: O Vitro Molar com proporção pó/líquido alterada não apresentou diferença estatisticamente significante quando comparado aos demais grupos. O cimento Fuji IX apresentou valor estatisticamente maior de resistência à flexão que o cimento Vitro Molar manipulado na proporção recomendada pelo fabricante.

Objective: To evaluate whether the change in the proportion powder / liquid of national glass ionomer cement formulated for ART (Vitro Molar) provides improvement in flexural strength, approaching the characteristics of the imported cement (Fuji IX). Materials and Methods: 30 specimens were made, divided between three groups (G1 = Vitro Molar with powder / liquid ratio according to manufacturer's directions (1/1), G2 = with Vitro Molar ratio powder / liquid raised to 50%(1,5/1) and G3 = Fuji IX as manufacturer's guidelines), being subjected to mechanical testing flexural strength of three points (ISO 9917-2). A load was applied at the center until the specimens break. The data were submitted to ANOVA and Tukey's test with 95% significance level. Result: The average results obtained for maximum strength were: G1: 3.57; G2: G3 and 4.54: 6.32. There was statistical difference between G1 and G3. The G2 group had statistically similar results when compared to other groups. Conclusion: Vitro Molar with raised powder / liquid ratio did not present a statistically significant difference when compared to the other groups. The Fuji IX cement presented a statistically higher value of flexural strength than the Vitro Molar cement manipulated in the ratio recommended by the manufacturer.

Functional and esthetic rehabilitation of a child with amelogenesis imperfecta: a case report.

Amelogenesis imperfecta (AI) is a tooth disorder characterized by the abnormal development of the enamel in response to mutations in the genes involved in amelogenesis. The objective of this article is to present the clinical case of a child with AI in the primary dentition phase. A 4-year-old boy was presented to a clinic by his mother, who complained that her son's smile esthetics were compromised by "weak and yellow teeth." All the teeth showed yellowish discoloration as well as crumbling or missing enamel. Due to the absence of carious lesions and the presence of normal pulp in the teeth, it was decided to restore the dentition with indirect crowns of ceramic-optimized polymer, also known as ceromer. No preparations were performed on the teeth. For this patient, indirect ceromer restorations presented a good treatment option for the rehabilitation of primary teeth affected by AI.

Surface Hardness of Glass Ionomer Cements used in Atraumatic Restorative Treatment

Objective: To evaluate the surface hardness of a national glass ionomer cement with increased powder / liquid ratio, suitable for the atraumatic restorative treatment technique. Material and Methods: This is a study of the quantitative experimental type, in which 30 specimens were made and divided equally into 03 experimental groups (glass ionomer cement restorative Vitro Molar -DFL in the proportion specified by the manufacturer; glass ionomer cement restorative Vitro molar ratio -DFL modified with incorporation of 50% powder; and Gold Label 9 - GC Corporation in the proportion specified by the manufacturer). After handling, the materials were placed in a Teflon mold for manufacturing the cylindrical samples (5mm x 2 mm), with the aid of a Centrix syringe (Centrix, Shelton, CT, USA). Specimens were stored in liquid petroleum jelly at a temperature 37 ° ± 1 for up to 7 days. The specimens were evaluated by Vickers hardness test at time intervals of 24 hours and 7 days after manufacture. The data were subjected to the Independent Student's-t tests and analysis of variance (ANOVA), and subsequently by Tukey's test at 95% level of significance. Results: The setting time positively influenced the hardness of the two glass ionomer cements (p<0,001). Cement Gold Label 9 showed higher hardness values than cement Vitro Molar (p<0,001), irrespective of the evaluation time interval. The latter in turn, showed improved values when manipulated with the modified powder / liquid ratio (3: 2) (p<0,001). Conclusion: Vitro Molar glass ionomer cement showed higher hardness values when manipulated with the modified powder/liquid ratio.

Recurrent multicentric peripheral ossifying fibroma-like lesion in a child: a case report.

BACKGROUND: Gingival hyperplasias are peculiar conditions that may produce extreme growth that impairs masticatory function and causes psychological and aesthetic disturbances. They can vary from mild interdental papillae localized growth to marked swelling affecting both jaws. CASE PRESENTATION: The aim of this case report is to present a rare case of generalized gingival growth diagnosed in a 4 year-old Caucasian child and followed for 9 years. The lesion covered almost all of the upper and lower teeth and recurred thirty times with the same clinical and histopathological aspects. The clinical features suggested the diagnosis of idiopathic gingival fibromatosis, but the histopathological aspects did not confirm this hypothesis and were consistent with peripheral ossifying fibroma. CONCLUSION: The present case reports a rare gingival growth with challenging diagnosis and treatment.

Natal and neonatal teeth: a review of 23 cases.

Natal teeth erupt in utero, whereas neonatal teeth present during the first month of life. The lower central incisors are the most frequently affected teeth. The etiology is unknown, and the choice of treatment depends on several factors. The purpose of this paper is to review 23 cases of children with natal or neonatal teeth who attended a dental care program in a university maternal and infant oral health clinic. There was no gender predilection. Most were natal teeth (83 percent) and presented a mild degree of mobility (64 percent). Only two patients had breast-feeding difficulties (nine percent). Tooth maintenance was the most common treatment of choice (64 percent), and only two patients presented Riga-Fede disease (nine percent).

Impact of dental fluorosis on the quality of life of children and adolescents / Impacto da fluorose dentária na qualidade de vida de crianças e adolescentes

Introduction: Dental fluorosis is a disturbance of high prevalence caused by the ingestion of fluoride ions present mainly in toothpaste. Preventive measures to avoid it are still controversial. Thus, knowing the impact that fluorosis can cause on the population's quality of life it is important for planning public health policies. Objective: To evaluate the impact of dental fluorosis on the quality of life of children and adolescents. Material and Method: We studied 300 subjects aged 8 to 12 years divided into 4 groups: children (8-10 years) and adolescents (10 to 12 years) with and without fluorosis. The diagnosis of fluorosis was performed according to the index Thylstrup and Fejerskov and quality of life was evaluated using Child Perceptions Questionnaire 8-10 and 11-14. The socio-demographic characteristics of the patients were also evaluated. For inclusion in the sample, selected patients should present eight permanent incisors with crowns fully erupted. Patients who had extensive restorations, fractured teeth, other dental enamel defects and who wore braces were excluded. Result: Fluorosis was present in 64.7% of the patients analyzed and in most cases (80.3%) was mild or very mild. In children, the average overall score of the questionnaire was 15.9 for the group without fluorosis and 18.3 for the group with fluorosis (p = 0.255). The teenagers' score in the group without fluorosis was 26.1, while the group with fluorosis was 22.7 (p = 0.104). Conclusion: Dental fluorosis caused impact on the quality of life of the population analyzed only in the functional domain. .

Introdução: A fluorose dentária é um distúrbio de alta prevalência decorrente da ingestão de íons fluoretos. Medidas preventivas para evitá-la ainda são controversas. Assim, conhecer o impacto que a fluorose pode causar na qualidade de vida de indivíduos é importante para o planejamento de políticas públicas de saúde. Objetivo: Avaliar o impacto da fluorose dentária sobre a qualidade de vida relacionada à saúde bucal (QVRSB) de crianças e adolescentes. Material e Método: Foram avaliados 300 indivíduos na faixa etária de 8 a12 anos. O diagnóstico de fluorose foi realizado segundo o índice Thylstrup e Fejerskov e a qualidade de vida foi avaliada utilizando os questionários de Percepção da Criança 8-10 e 11-14. Foram incluídos pacientes com oito incisivos permanentes com coroas totalmente irrompidase excluídos os que apresentavam restaurações extensas, dentes fraturados, outros defeitos do esmalte dentário e os que usavam aparelho ortodôntico fixo. Os dados foram analisados no programa SPSS(r) (versão 18; Chicago, IL) e realizaram-se os teste Qui-quadrado, Fisher e Mann-Whitney. Foram considerados significantes valores de p<0,05. Resultado: A prevalência de fluorose foi 64,7%, sendo os graus leve e muito leve responsáveis por 80,3% dos casos. Crianças e adolescentes não tiveram impacto na QVRSB no escore geral e domínios sintomas orais, bem-estar emocional e social (p>0,05). Entretanto, apresentaram impacto no domínio limitação funcional (p = 0,039 e 0,013) para crianças e adolescentes respectivamente). Conclusão: Foi observada associação entre fluorose e qualidade de vida apenas no domínio funcional. .

Autogenous bonding of lower incisors: case report and 17-year follow-up.

Among injuries that affect permanent teeth, the most prevalent is an uncomplicated crown fracture. Currently, autogenous bonding of the fragments is still the procedure of choice to restore fractured anterior teeth if the fragments are recovered by the patient and taken to a dental office within a reasonable time in an appropriate storage medium. There is no study or case report in the literature regarding autogenous bonding of lower incisors. This study presents a case with a 17-year follow-up for a 9-year-old patient who underwent uncomplicated crown fractures of the permanent mandibular central incisors and was treated by autogenous bonding of the tooth fragments. After 17 years, clinical and radiographic dental elements present vitality, and the restorations remain without major cosmetic changes. This case shows that autogenous bonding can be considered as a treatment option in the management of fractured lower incisors.

Homogenous bonding--case report and 18-year follow up.

Fracture of the anterior teeth by trauma is the most frequent type of injury affecting the permanent dentition, especially the maxillary central incisors. When the fragment is not available or its use is not recommended, donated extracted teeth (homogenous bonding) can be used. The aim of this paper is to report the successful 18-year follow up of a maxillary central incisor fracture in which homogenous bonding was performed.