Association between molar hypomineralization, genes involved in enamel development, and medication in early childhood: A preliminary study.

BACKGROUND: Molar hypomineralization (MH) is defined as a multifactorial condition, and thus, its presence may be defined by interactions between environmental and genetic factors. AIM: To evaluate the association between MH, genes involved in enamel development, and the use of medication during pregnancy in early childhood. DESIGN: One hundred and eighteen children, 54 with and 64 without MH, were studied. The data collected included demographics, socioeconomic data, and the medical history of mothers and children. Genomic DNA was collected from saliva. Genetic polymorphisms in ameloblastin (AMBN; rs4694075), enamelin (ENAM; rs3796704, rs7664896), and kallikrein (KLK4; rs2235091) were evaluated. These genes were analyzed by real-time polymerase chain reaction using TaqMan chemistry. The software PLINK was used to compare allele and genotype distributions of the groups and to assess the interaction between environmental variables and genotypes (p < .05). RESULTS: The variant allele KLK4 rs2235091 was associated with MH in some children (odds ratio [OR]: 3.75; 95% confidence interval [CI] = 1.65-7.81; p = .001). Taking medications in the first 4 years of life was also associated with MH (OR: 2.94; 95% CI = 1.02-6.04; p = .041) and specifically in association with polymorphisms in ENAM, AMBN, and KLK4 (p < .05). The use of medications during pregnancy was not associated with MH (OR: 1.37; 95% CI = 0.593-3.18; p = .458). CONCLUSION: The results of this study suggest that taking medication in the postnatal period appears to contribute to the etiology of MH in some evaluated children. There may be a possible genetic influence of polymorphisms in the KLK4 gene with this condition.

Global research trends of studies related to mouthguards and dental injuries in sports activities: a bibliometric analysis.

Mouthguards (MGs) are essential devices for the protection of sports-related orofacial injuries. Mapping of the literature on this subject may help to guide future studies; therefore, this review aimed to characterize the research trends of studies related to MGs and dental injuries in sports activities through bibliometric analysis of in vivo studies concerning the frequency of MG use; knowledge, awareness, perception, and/or attitude about MGs; and adaptation (fit) of MGs in the mouth and/or prevention of traumatic dental injuries (TDIs). A literature search was performed in 6 databases for studies published up to April 2022. Text mining and analysis software was used to extract and evaluate data related to the study author, country, keywords, journal of publication, and year. Additionally, data related to the type of study, outcome, study population, age group, evaluation method, type of MG, sport classification, and sport category were extracted and analyzed. Of 6140 records identified, 222 were included in the analysis. Most of the articles came from the United States (n = 39; 17.5%) and dentistry journals (n = 145; 65.3%). The journal Dental Traumatology (n = 60; 27.0%) presented the highest number of publications. Most studies were observational (n = 195; 87.8%) and evaluated the frequency of MG use (n = 163; 44.4%). Studies were carried out in athletes (n = 181; 82.6%) and adults (n = 169; 49.1%) using questionnaires or interviews for assessment (n = 206; 84.1%). Only 89 (40.1%) studies evaluated the type of MG, mostly involving contact sports. Custom-made MGs were most commonly studied. More studies involving coaches, dentists, and child and teenaged athletes are warranted to help prevent sportsrelated TDIs in young teeth, mainly through interventional studies on the perceptions of and knowledge about MGs among these populations.

Critical appraisal of the information available on traumatic dental injuries found in applications.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health problem and the search for information becomes essential to help in their management. The aim of this study was to search existing TDI applications (Apps) to critically describe the characteristics and main information found in them regarding TDI. METHODOLOGY: Searches were performed in the Play Store (Android) and App Store (iOS), using MeSH terms, synonyms and terms related to dental emergencies and TDI, in English, Spanish and Portuguese. Apps with information on the management of post-TDI emergencies or TDI prevention were included. The type of operating system (Android/iOS), cost (free/paid), target audience (dentist/patient), age of classification (free/>17 years old), language, star rating (1★ to 5★), number of downloads and post-download ratings, type of dentition (primary/permanent), reference used for classification according to TDI type and management (International Association for Dental Traumatology/Andreasen/others/not reported), and available content (prevention/emergency management/preservation/illustrations) were evaluated. RESULTS: Among 486 apps, 13 were eligible: 11 for Android and 2 for iOS. Most were free (92.3%), for patients (38.4%) and had a free age classification (90.9%). The main language was English (53.8%), and most of the Apps either had no information on star ratings (46.1%) or received 4★ (23.1%). The number of downloads was not reported (23.1%) or was fewer than 100 (23.1%). Most of the Apps were for permanent teeth (61.5%) and had explanations about dental management for TDI emergencies (92.3%) and multiple TDIs (61.5%). Most Apps addressed the importance of monitoring TDIs (76.9%) and contained illustrative images (76.9%). However, many did not report the TDI classification (46.1%), and 38.5% reported TDI prevention. CONCLUSIONS: Information on dental trauma management according to dental injury, inclusion of images, target audience, type of TDI and their prevention varied in the available Apps. However, most were focused on permanent teeth and addressed several TDI in English language only.

The relationship between special needs and dental trauma. A systematic review and meta-analysis.

BACKGROUND/AIMS: Understanding the risk factors for dental injuries is essential to develop prevention strategies. The aim of this study was to perform a systematic review and meta-analysis to determine whether people with special needs (SN) have a higher incidence of traumatic dental injury (TDI). MATERIALS AND METHODS: Electronic searches were performed with no language or date restrictions in the following databases: PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and Open Gray. According to the PECOS strategy, observational studies that investigated subjects with and without SN and its association with TDI episodes were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies according to the type of SN, with the odds ratio (OR) also being calculated (P ≤ .05). The evidence was quality tested using the GRADE approach. RESULTS: After titles and abstracts were examined, and full texts were read, 28 studies were included in the qualitative synthesis and 27 in the meta-analysis. Three studies were classified with high methodological quality and the others had methodological problems. No associations were determined between TDI and autism spectrum disorder, epilepsy and mental disability (OR 1.12 [0.70, 1.78], OR 1.28 [0.13, 12.27] and OR 1.04 [0.20, 5.35], respectively, P > .05). A positive association (P < .05) was found between TDI and hyperactivity disorder, cerebral palsy, 21 trisomy, various conditions of SN and in pooled results (OR 2.67 [1.22, 5.87], OR 1.89 [1.06, 3.37], OR 6.18 [2.24, 17.05], OR 1.69 [1.18, 2.41], OR 1.61 [1.16; 2.22], respectively).The certainty of evidence ranged from very low to low. CONCLUSIONS: In general, people with SN had a higher chance of having TDI with very low certainty of evidence. People with ADHD and cerebral palsy had a higher chance of TDI.

Oral status, sense of coherence, religious-spiritual coping, socio-economic characteristics, and quality of life in young patients.

BACKGROUND: Several factors can influence the oral health. AIM: To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). DESIGN: This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. RESULTS: For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (ß = 0.382, ß = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (ß=-0.201). The higher the age of the C/A, the lower the NDT (ß=-0.235), and the higher the family income the lower, the need for social benefit (ß = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. CONCLUSIONS: Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.

Profiles of Trauma in Primary and Permanent Teeth of Children and Adolescents.

This retrospective study aimed to evaluate the dental trauma profile in primary and permanent teeth from patients between 0 and 15 years old who attended the Faculty of Dentistry of the Federal University of Rio de Janeiro. Data regarding gender, age, trauma classification, tooth type, and affected tissues were obtained from dental records. The data were analyzed descriptively and by the χ2 test (p < 0.05). Data associated with 333 traumatized teeth (70% primary and 30% permanent teeth) were included. The mean ages of children with affected primary and permanent teeth were 3.35 ± 2.02 and 9.09 ± 2.43 years, respectively. Males presented more permanent teeth with trauma (64.4%) than primary ones (55.6%; p = 0.085). The upper central incisors, both primary (68.9%) and permanent (69.4%), were the teeth most commonly affected. Primary teeth showed a higher frequency (p < 0.001) of supportive tissue trauma (73.3%) and lower frequency (p = 0.001) of hard tissue trauma (40.7%) than those in permanent ones (51.5% and 60.6%, respectively). The most frequent trauma in the supportive tissue was subluxation (27.2%) and permanent lateral luxation (42.0%). In the hard tissues, permanent teeth presented a higher prevalence of trauma than primary ones (p = 0.001), however this difference was not statistical significant when each type of fracture injury was evaluated individually (p > 0.005). With affected primary teeth, there was a greater frequency of trauma in the gingival mucosa (31.0%; p = 0.022); in the permanent ones, traumatic lesions in the chin region were the most prevalent (20.8%; p = 0.009). Trauma was recurrent in 26.3% of primary teeth and in 20.2% permanent teeth. Therefore, primary and permanent teeth showed distinct trauma profiles, suggesting that distinct preventive and therapeutic approaches are needed for these two groups.

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study.

OBJECTIVE: This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors. METHODS: The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors. RESULTS: The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05). CONCLUSION: Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

Risk factors for traumatic dental injuries in the Brazilian population: A critical review.

BACKGROUND/AIMS: Strategies for the prevention of traumatic dental injuries (TDI) should consider the risk factors involved for each population studied. The aim of this study was to perform a critical review regarding the risk factors for TDI in the Brazilian population. MATERIALS AND METHODS: A systematic literature search was performed in the MEDLINE, Scopus, Web of Science, Lilacs, and BBO databases using MeSH terms, synonyms, and keywords, with no language or date restrictions. In the first step, all relevant studies identified, regardless of the type of statistical analysis performed, were grouped according to their geographic location. In a second step, the studies using Andreasen's criteria to classify the injuries and multivariate analysis to identify the risk factors for TDI in Brazilian subjects were included for data extraction. RESULTS: The search strategy initially identified 3373 articles. However, only 108 articles assessed TDI with predisposing factors and were included in the first step. From those, 28 were deemed eligible for inclusion in the second step. No consensus related to the relationship between gender and TDI in the primary dentition was achieved. Nonetheless, males were found to be more prone to trauma in the permanent dentition. Overjet, inadequate lip sealing and anterior open bite increased the risk for TDI, both in primary and permanent dentitions. Social environment was related to trauma only in primary dentition. For permanent dentition, dental caries, obesity, binge drinking, and drug use were identified as considerable risk factors for TDI. CONCLUSION: The risk factors for TDI in the Brazilian population are similar to those found worldwide. However, some differences can be observed, such as gender and socioeconomic indicators as predisposing factors.

Is caries a risk factor for dental trauma? A systematic review and meta-analysis.

BACKGROUND/AIM: The association between trauma and caries is still controversial in the literature. The aim of this study was to evaluate the possible association between caries and dental trauma through a systematic review with meta-analysis. DESIGN: A systematic literature search was performed in PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Open Grey databases. The MeSH terms used were 'Tooth injuries', 'Tooth fractures', 'Tooth avulsion', 'Tooth movement'; 'Dental caries'; 'DMF index'; and 'Tooth demineralization'. MeSH synonyms, related terms, and free terms were included. The inclusion criteria comprised clinical investigations of subjects with and without caries that had suffered dental trauma. Quality assessment and bias control were carried out. Meta-analysis was performed using the comprehensive meta-analysis software (version 3.2). Heterogeneity was assessed using the I2 index, and the odds ratio was also calculated (P < 0.05). RESULTS: From 1290 abstracts, seven met the inclusion criteria. All studies had high methodological quality and five were included in the meta-analysis. The results demonstrated a positive association (P < 0.001) between dental trauma and dental caries in permanent teeth [OR: 1.490, 95%, CI: 1.209-1.835]. However, for children with primary teeth, the results showed a negative association (P = 0.006) between dental trauma and caries [OR: 0.706, 95%, CI: 0.550-0.906]. CONCLUSIONS: The results demonstrated positive and negative association between the presence of caries and dental trauma in permanent and primary teeth, respectively.

Prevalence of soft tissue injuries in pediatric patients and its relationship with the quest for treatment.

BACKGROUND/AIM: Soft tissue injuries (STI) are common in children and adolescents. This retrospective study evaluated the frequency of STI, gender, type of injury, and its location in pediatric patients, comparing the different age groups and how the presence of these lesions influences the pursuit for immediate care. MATERIAL AND METHODS: Medical records of patients 0-15 years old who had been treated between 2005 and 2013 at the Dental Trauma Surveillance Center, School of Dentistry, Universidade Federal do Rio de Janeiro were included in this study. Records with incomplete data and those in which the patient took more than 2 weeks to seek attendance were excluded. The data collected included the age and gender of the patient, the frequency, type and location of the injury, and immediate treatment (<24 h). Data were analyzed descriptively and with the chi-square test (P ≤ 0.05). RESULTS: Of the 543 patients who met the eligibility criteria, 56.2% had STI, and males (65.6%), and the age group of 0-3 years (39.7%) were the most affected. The concomitant presence of lesions in the intra- and extra-oral region was the most frequent in all age groups. In the extra-oral region, contusion (20.7%) and abrasion (19.3%) were more common to the upper lip and laceration to the lower lip (18.4%). In the intra-oral region, the injury was more frequent to the gums (41%), while the lips were the most affected by abrasion (12.2%) and laceration (24.9%). Regardless of the age groups, the pursuit for immediate care was statistically influenced by the presence of soft tissue lesions (P < 0.05). CONCLUSION: We conclude that there is a high prevalence of STI in the study sample; the lesions were more common in boys and in patients aged 0-3 years. The presence of STI proved to be a determining factor for the pursuit for immediate care.

Development, validation and application of a Brazilian knowledge scale about sports doping in dentistry.

To evaluate the knowledge of Brazilian dentists of sports doping through the development, validation and application of the Brazilian Knowledge Scale about Sports Doping in Dentistry (B-KSSDD). A scale with 12 items was developed to assess a dentist's ability to determine whether the use of a medication characterised sports doping according to the World Anti-Doping Agency. A preliminary study to validate the B-KSSDD was carried out with 135 dentists, allowing the evaluation of ceiling and floor effects, convergent and discriminant validity, test-retest reliability and internal consistency of the instrument. A sample size calculation using the results of the preliminary study and the B-KSSDD was completed online using SurveyMonkey® by 270 participants from all regions of the country. The B-KSSDD showed evidence of convergent and discriminant validity, good temporal stability (ICC = 0.75) and internal consistency (alpha = 0.89). In the main study, the participants obtained an average score of 4.19/12 points on the B-KSSDD, suggesting that these professionals have insufficient knowledge about sports doping. The age of participants showed a negative association with knowledge about doping, while frequency of treating athletes and frequency of performing surgeries showed positive associations with knowledge about doping. The dentists had insufficient knowledge of the subject. Age of participants and frequency with which they attend to athletes are associated with knowledge about sports doping. Professional updating and education policies on doping are necessary for dentists, as athlete patients are at risk for severe sporting and financial penalties.

A 14-Year Follow-Up Study of Sequelae in Primary Teeth and Permanent Successors After Dental Trauma

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth.

Management of a Permanent Maxillary Lateral Incisor with Vital Pulp and Necrotic Dens Invaginatus Type III.

This is a case report on the management of a vital lateral incisor with a radiolucent cervical area associated with the presence of necrotic pulp due to a dens invaginatus (DI) type III. A nine-year-old boy presented to a university pediatric dental clinic with dental trauma. The examination showed poor oral hygiene, an uncomplicated fracture in the permanent maxillary left central incisor, and a fistula near the permanent maxillary right lateral incisor. A radiograph showed that the right lateral incisor had incomplete root development and a type III DI. Although sensitive to thermal pulp testing, tracing of the fistula indicated that the radiolucent area was associated with the DI, extending laterally to the periodontal ligament. Endodontic treatment was performed only in the invagination, keeping the root canal of the lateral incisor vital. After two years of follow-up, complete root formation and injury repair associated with invagination were observed.

Development, validation and application of a Brazilian knowledge scale about sports doping in dentistry

Abstract To evaluate the knowledge of Brazilian dentists of sports doping through the development, validation and application of the Brazilian Knowledge Scale about Sports Doping in Dentistry (B-KSSDD). A scale with 12 items was developed to assess a dentist's ability to determine whether the use of a medication characterised sports doping according to the World Anti-Doping Agency. A preliminary study to validate the B-KSSDD was carried out with 135 dentists, allowing the evaluation of ceiling and floor effects, convergent and discriminant validity, test-retest reliability and internal consistency of the instrument. A sample size calculation using the results of the preliminary study and the B-KSSDD was completed online using SurveyMonkey® by 270 participants from all regions of the country. The B-KSSDD showed evidence of convergent and discriminant validity, good temporal stability (ICC = 0.75) and internal consistency (alpha = 0.89). In the main study, the participants obtained an average score of 4.19/12 points on the B-KSSDD, suggesting that these professionals have insufficient knowledge about sports doping. The age of participants showed a negative association with knowledge about doping, while frequency of treating athletes and frequency of performing surgeries showed positive associations with knowledge about doping. The dentists had insufficient knowledge of the subject. Age of participants and frequency with which they attend to athletes are associated with knowledge about sports doping. Professional updating and education policies on doping are necessary for dentists, as athlete patients are at risk for severe sporting and financial penalties.

Management of an unerupted tooth and odontoma after trauma in predecessor

The purpose of this case report was to describe the surgical exposure and orthodontic management of an unerupted and ectopic maxillary right central incisor after trauma to the primary predecessor. Case report: An 11-year-old girl was referred to the Pediatric Dentistry Clinic due to eruption failure of the maxillary right central incisor. Radiographs showed the impacted central incisor located below the anterior nasal spine and its apex parallel to the palatal plane and the presence of an odontoma. General surgery was performed to remove the odontoma and two perforations in the crown of the impacted tooth were made to carry out orthodontic traction. Correct alignment was achieved after 18 months and no significant clinical or radiographic alterations were founded. Conclusion: The orthodontic management was performed successfully, and a positive esthetic outcome combined with adequate occlusion demonstrated the satisfactory results of this case.

Objetivo: O objetivo deste relato de caso foi descrever a exposição cirúrgica e o tratamento ortodôntico de um incisivo central superior direito ectópico e não irrompido após trauma do predecessor decíduo. Relato do caso: Uma menina de 11 anos de idade foi encaminhada à Clínica de Odontopediatria devido ao atraso na erupção do incisivo central superior direito. As radiografias mostraram o incisivo central impactado localizado abaixo da espinha nasal anterior e seu ápice paralelo ao plano palatino e a presença de um odontoma. A cirurgia para remoção do odontoma foi realizada sob anestesia geral e duas perfurações na coroa do dente impactado foram realizadas para a tração ortodôntica. O alinhamento correto foi alcançado após 18 meses e não foram encontradas alterações clínicas ou radiográficas significativas. Conclusão: O manejo ortodôntico foi realizado com sucesso, e um resultado estético positivo combinado à oclusão adequada demonstrou os resultados satisfatórios deste caso.

Risk Factors for Different Types of Traumatic Injuries in Primary Teeth

Abstract Objective: To evaluate traumatic dental injuries (TDI) in primary teeth and the association of gender and age with different injuries. Material and Methods: Records of patients with TDI in primary teeth were included. The following parameters were registered: gender and age, place of trauma, cause of trauma, affected tissue and tooth, number of injured teeth, type of injury, and gingival and bone damage. A logistic regression analysis was performed to explore the interaction between gender and age on the occurrence of types of injuries (p≤0.05). Results: The total of 721 records were evaluated and 370 records were included, being 61.6% boys and 60.5% children aged 0-3 years old, with 658 primary teeth affected. The support tissue was most affected (496/658), followed by dental tissue (139/658). Enamel/dentine fracture with pulp exposure (n=51) and intrusion (n=131) were the most common injuries of dental and support tissues, respectively. In general, boys suffered more traumas than girls, regardless of the age range. As for concussion, logistic regression confirms that gender and age are also influencers. Girls (OR=1.822, CI = 1.050-3.164, p=0.033) in the 4-6 year age group (OR=2.15, CI = 1.239-3.747, p=0.007) are more likely to have concussions. Children age 4-6 years were less likely to suffer an intrusion (OR=0.496; CI = 0.278-0.886; p=0.018). Conclusion: Gender and age influence concussion and intrusion in the primary teeth.

Impaction of mandibular canine associated with a dentigerous cyst: a 2. 5 - year follow-up report

Introduction: Dentigerous cyst is an odontogenic cyst lesion surrounding the crown of an unerupted or impacted tooth in the jaw. Objective: The aim of this case report is to describe the treatment planning and follow-up of a dentigerous cyst associated with the impaction of the permanent mandibular right canine tooth in an 11-year-old female. Case report: Radiographic assessment revealed a radiolucent unilocular round-shaped lesion localized in the mandibular symphysis. Enucleation was performed and the affected tooth was removed under general anesthesia. The patient is under follow-up due to orthodontic treatment. The affected area healed without complications. Conclusion: Two and a half years after the enucleation, the cyst had totally disappeared, and no recurrences were observed. Bone remodeling and neoformation were noticed.

Introdução: O cisto dentígero é uma lesão odontogênica ao redor da coroa de um dente não irrompido ou impactado na mandíbula. Objetivo: O objetivo deste relato de caso é descrever o plano do tratamento e o acompanhamento de um cisto dentígero associado à impactação do canino permanente inferior direito em uma criança do gênero feminino de 11 anos de idade. Relato do caso: A avaliação radiográfica revelou lesão unilocular radiolúcida de forma arredondada, localizada na sínfise mandibular. A enucleação foi realizada e o dente afetado foi removido sob anestesia geral. A paciente encontra-se em acompanhamento devido o tratamento ortodôntico. A área afetada curou sem complicações. Conclusão: Dois anos e meio após a enucleação, o cisto desapareceu totalmente e não houve recidivas. Remodelação óssea e neoformação foram observadas.

Multidisciplinary conservative management of dental fracture in young patient: case report

The management of fractured permanent teeth due to dental trauma in young patients is a challenge that requires an efficient approach. Objective: Describe a conservative and multidisciplinary treatment of a case of dental trauma in a 13 years-old boy. Case report: At clinical examination was verified enamel and dentin fracture in the left upper central incisor and a fracture with pulp exposure in the right upper lateral incisor, with subgingival extension of its margin at lingual surface, and no swelling or tooth displacement was observed. At radiographic evaluation, no pulp or periradicular disturbances were verified. It was proposed the surgical lengthening of the clinical crown of the right upper lateral incisor for later performing endodontic treatment. It was decided to make direct composite resin restorations in both fractured teeth, instead of doing a prosthetic treatment in the affected lateral incisor, such as the placement of a full ceramic crown, in an attempt to perform a less invasive treatment, mainly due to the age of the patient. At a two years follow-up visit was observed the maintenance of the health of periapical tissues and the absence of clinical alterations. Conclusion: The restorations were kept in good conditions and aesthetics was considered satisfactory by professionals, patient and parents.

Introdução: O manejo de dentes permanentes fraturados por traumatismo dentário em pacientes jovens é desafiador e requer uma abordagem eficiente. Objetivo: Descrever o tratamento conservador e multidisciplinar em um caso de traumatismo dentário de um menino de 13 anos de idade. Relato do caso: Ao exame clínico foi verificada uma fratura de esmalte e dentina no incisivo central superior esquerdo e uma fratura complicada no incisivo lateral superior direito, com extensão subgengival da margem na face palatina, e não foram observados edema ou deslocamento dentário. Ao exame radiográfico, não foram verificadas alterações pulpares ou perirradiculares. Foi proposta realização de aumento da coroa clínica do incisivo lateral superior direito para posterior realização do tratamento endodôntico. Para os dois dentes traumatizados foi proposta a realização de restauração direta com resina composta, proporcionando um tratamento menos invasivo ao incisivo lateral superior direito, ao invés de submetê-lo a um tratamento protético, como a colocação de uma coroa total cerâmica, principalmente devido à pouca idade do paciente. Na visita de dois anos de acompanhamento, observou-se a manutenção da saúde dos tecidos periapicais e ausência de alterações clínicas. Conclusão: As restaurações se mantiveram em boas condições e a estética foi considerada satisfatória pelos profissionais, paciente e pais.

The use of hypnosis in dental care: a literature review

Introduction: Hypnosis is a technique that involves inducing a special state of consciousness in which the conscious mind relaxes while the unconscious mind manifests itself by working the imagination. Objective : To perform a literature review to evaluate the different techniques used to induce hypnosis and the need for its use in dental care, as well as, its results. Sources of data: A bibliographic search was performed in the Google Academic and PubMed databases to identify studies for review. There was no restriction on language or year. Inclusion criteria were studies that addressed the topic of interest. Synthesis of data : Hypnosis aims to improve care by controlling patients' anxiety, fear and phobias. However, its use is little known by patients and professionals in the context of dental treatment. There are two techniques of hypnosis, namely essential hypnosis and hypnosis by object fixation. The main indications are the need to control the patient's fear and anxiety during dental treatment and to prepare the patients before performing surgical procedures. It can be used in association with local anesthetics, but this combination is not essential. Conclusion : Hypnosis can be effective at controlling patients' feelings related to dental care, being the hypnosis by object fixation the most used technique with this purpose. It is considered easy, quick, painless, with low costs and accessible to any dentist who has completed specific training in this field.

Introdução: A hipnose é uma técnica que envolve a indução de um estado especial de consciência em que a mente consciente relaxa enquanto a mente inconsciente se manifesta trabalhando a imaginação. Objetivo : Realizar uma revisão de literatura para avaliar as diferentes técnicas utilizadas para induzir a hipnose e a necessidade de seu uso no atendimento odontológico, bem como, seus resultados. Fontes de dados : Uma pesquisa bibliográfica foi realizada nas bases de dados Google Acadêmico e PubMed para identificar estudos para revisão. Não houve restrição de idioma ou ano. Os critérios de inclusão foram os estudos que abordaram o tema de interesse. Síntese dos dados: A hipnose visa melhorar o atendimento, controlando a ansiedade, o medo e as fobias dos pacientes. Entretanto, seu uso é pouco conhecido pelos pacientes e profissionais no contexto do tratamento odontológico. Existem duas técnicas de hipnose, a saber, hipnose essencial e hipnose por fixação objetal. As principais indicações são a necessidade de controlar o medo e a ansiedade do paciente durante o tratamento odontológico e preparar os pacientes antes de realizar procedimentos cirúrgicos. Pode ser usado em associação com anestésicos locais, mas essa combinação não é essencial. Conclusão : A hipnose pode ser eficaz no controle dos sentimentos dos pacientes relacionados ao atendimento odontológico, sendo a hipnose pela fixação do objeto a técnica mais utilizada para esse fim. É considerado fácil, rápido, indolor, com baixos custos e acessível a qualquer dentista que tenha completado o treinamento específico neste campo.

Complicated crown fracture treatment and its impact on quality of life related to oral health: report of two cases

Objective: The purpose of this study was to report on the management of two complicated crown fractures of the permanent incisors and how the treatment of these injuries influences quality of life related to oral health (QHRQoL). Case report : In the first case, pulpectomy was performed because of pulp necrosis and complete rhizogenesis. In the second case, pulpotomy was performed, as the pulp had vitality and the tooth had incomplete rhizogenesis. Fragment bonding was carried out in both cases. QHRQoL was assessed before and one week after treatment. In case 1, scores varied from 32 to 9 in the CPQ 11-14, from 42 to 12 in the P-CPQ, and from 24 to 4 in the FIS. In case 2, scores varied from 38 to 20 in the CPQ 8-10 , from 94 to 28 in the P-CPQ, and from 39 to 10 in the FIS. Conclusion : Fragment bonding is an efficient solution, as well as endodontic therapy. Furthermore, dental trauma treatment improved the quality of life of children and their families and could be observed one week after treatment.

Objetivo: O objetivo do estudo foi relatar o manejo de duas fraturas complicadas de incisivos permanentes e como o tratamento destas lesões dentárias influencia a qualidade de vida relacionada à saúde bucal (QHRQoL). Relato de caso: No primeiro caso, foi realizada pulpectomia devido necrose pulpar e rizogênese completa. No segundo caso, a pulpotomia foi realizada, pois, a polpa apresentava vitalidade e o dente rizogênese incompleta. A colagem dos fragmentos foi realizada emambos os casos. QHRQoL foi avaliada antes e uma semana após o tratamento. No caso 1, os escores variaram de 32 a 9 no CPQ 11-14 , de 42 a 12 no P-CPQ e de 24 a 4 no FIS. No caso 2, os escores variaram de 38 a 20 no CPQ 8-10 , de 94 a 28 no P- CPQ e de 39 a 10 no FIS. Conclusã : A colagem de fragmentos é uma solução eficiente, assim como a terapia endodôntica. Além disso o tratamento do traumatismo dentário promoveu uma melhora na qualidade de vida das crianças e suas famílias, e podendo ser observado uma semana após o tratamento.