Quality of Life related to Eruption Hematoma in a Twenty Months Old Infant.

AIM: This paper describes a case of an eruption hematoma in a 20-month-old boy and the impact of this hematoma on the quality of life (QoL) related to oral health of this infant and his family. BACKGROUND: Eruption hematoma is a soft benign cyst that contains blood and overlie a tooth that are about to erupt. Oral health conditions can affect the QoL and bring psychological impacts. CASE REPORT: The proposed treatment was based on oral hygiene instruction, normal diet and massage on the lesion area. A weekly follow-up visits up to the spontaneous regression at the 6 weeks of the lesion was conducted. The impact on QoL was assessed though the Brazilian version of the early childhood Oral Health Impact Scale (B-ECOHIS) questionnaire before and after 2 months of the hematoma regression. CONCLUSION: The presence of eruption hematoma impacted, physically and emotionally, the QoL related to oral health of the child and his family, and this impact decreased when the eruption hematoma disappeared. CLINICAL SIGNIFICANCE: It is important the knowledge of the dentists about eruption cyst/hematoma to make the correct decisions to improve the QoL of their patients and families.

In vitro effect of paediatric liquid medicines on deciduous enamel exposed to biofilm.

OBJECTIVE: This study aimed to assess the in vitro effects of paediatric liquid medicines on deciduous enamel exposed to biofilms. METHODS: Fragments (n = 25) of first primary molars were covered by nail varnish, leaving a 22 mm(2) exposure area. Specimens were fixed in polystyrene plates containing BHI broth media. Pooled human saliva was added to form a mature biofilm on fragments over a 10-day period in microaerophilic conditions. Specimens were divided into groups (n = 5 per group) and treated (50 µL) daily for 1 min over 1 week as follows: G1 = 10% sucrose solution (positive control); G2 = Dimetapp Elixir® (antihistamine); G3 = Claritin® (antihistamine); and G4 = Klaricid® (antibiotic). Five other fragments, without treatment and inoculum represented the blank controls. The covered area for each specimen represented the negative control. Cross-sectional hardness of the enamel was used as a demineralization indicator. RESULTS: All treatment groups showed hardness loss compared to the corresponding negative controls (p < 0.05). Among the treatment groups, G2 exhibited the greatest demineralization pattern (p < 0.05) followed by G3, G1 and G4. CONCLUSION: All medicines caused deciduous enamel demineralization in the presence of biofilm. The greatest hardness loss was observed after treatment with Dimetapp Elixir®.

Systematic reviews in dental research. A guideline.

BACKGROUND: A systematic review aims to combine outcome data from published studies in a population. It is based on a number of steps and although there are numerous advantages in systematic review studies, dentists have been finding difficulties in performing them. OBJECTIVE: Taking into account the misconceptions and difficulties in conducting this kind of study, this article aims to guide readers for understanding, performing, and interpreting comprehensive systematic reviews in dental research.

Caries preventive effects of xylitol-based candies and lozenges: a systematic review.

OBJECTIVE: A systematic review of published data was conducted with the aim of assessing the caries preventive effect of consuming xylitol-based candies and lozenges. METHODS: Electronic and hand searches were performed to find clinical trials concerning the consumption of products containing xylitol, published up to November 2009. The studies must have had the following characteristics: (a) a comparison of caries progression in subjects who either did or did not consume candies or lozenges containing xylitol during a minimum follow-up period of 1 year; and (b) a concurrent comparison of the percentage of caries progression according to the World Health Organization criteria. The caries preventive effect of xylitol was assessed by calculating the prevented fraction. RESULTS: The initial search identified 127 references. Six studies met the initial eligibility criteria, but three were excluded after thorough analysis. Two more articles were selected after hand searching, but they were excluded due to the presence of chewing gum in the experimental group. Of the three selected studies, two found a lower caries increment in the treatment groups. Although the findings of the analyzed studies suggest that the use of xylitol-based candies and lozenges could favor a reduction in caries increment, in general, their consumption did not seem to be effective on the proximal surfaces. Nevertheless, these findings are not supported by strong evidence. CONCLUSION: This research demonstrates the need for well-designed randomized clinical studies with adequate control groups and high compliance by the subjects.

Model resin composites incorporating ZnO-NP: activity against S. mutans and physicochemical properties characterization.

Although resin composites are widely used in the clinical practice, the development of recurrent caries at composite-tooth interface still remains as one of the principal shortcomings to be overcome in this field. Objectives To evaluate the activity against S. mutans biofilm of model resin composites incorporating different concentrations of ZnO-nanoparticles (ZnO-NP) and characterize their physicochemical properties. Materials and Methods Different concentrations of ZnO-NP (wt.%): E1=0, E2=0.5, E3=1, E4=2, E5=5 and E6=10 were incorporated into a model resin composite consisting of Bis-GMA-TEGDMA and barium borosilicate particles. The activity against S. mutans biofilm was evaluated by metabolic activity and lactic acid production. The following physicochemical properties were characterized: degree of conversion (DC%), flexural strength (FS), elastic modulus (EM), hardness (KHN), water sorption (Wsp), water solubility (Wsl) and translucency (TP). Results E3, E4, E5 and E6 decreased the biofilm metabolic activity and E5 and E6 decreased the lactic acid production (p<0.05). E6 presented the lowest DC% (p<0.05). No significant difference in FS and EM was found for all resin composites (p>0.05). E5 and E6 presented the lowest values of KHN (p<0.05). E6 presented a higher Wsp than E1 (p<0.05) and the highest Wsl (p<0.05). The translucency significantly decreased as the ZnO- NP concentration increased (p<0.05). Conclusions The incorporation of 2 - 5 wt.% of ZnO-NP could endow antibacterial activity to resin composites, without jeopardizing their physicochemical properties.

The role of Carisolv and different auxiliary chemical substances in the removal of bovine root canal smear layer.

UNLABELLED: To evaluate the effectiveness of Carisolv and different auxiliary chemical substances in root canal smear layer (SL) removal. SL was produced in the centre of 40 hemi-disks of bovine root dentine. The samples were divided into four irrigation groups (G): GI (control) - 0.9% NaCl; GII - 1% NaOCl + 0.9% NaCl; GIII - Carisolv + 0.9% NaCl; GIV - 1% NaOCl + 10% citric acid solution + 0.9% NaCl. The photomicrographs (SEM analysis) were coded (0 - absence of SL; 1 - moderate SL; 2 - dense SL with visible tubules; 3 - dense SL with no visible tubules). GIV was more effective in SL removal (P < 0.01). It should be noted that GI and GIII obtained score 3 in 100% of the samples (P > 0.01). CONCLUSION: NaOHCl, citric acid and NaCl solutions, when used together, presented a better performance in the removal of SL when compared to the other solutions.

Bruxism in children: a warning sign for psychological problems.

Bruxism is nonfunctional clenching or grinding of the teeth. It is a destructive habit that may result in tooth wear. Although research on bruxism is extensive, its etiology remains debatable. The literature suggests that bruxism is correlated with both experienced and anticipated life stress. The purpose of this report is to describe 2 cases of severe bruxism in children of similar age with different life histories and to discuss the factors that could have triggered this parafunctional condition.

Influence of a Brazilian wild green propolis on the enamel mineral loss and Streptococcus mutans' count in dental biofilm.

OBJECTIVE: This study investigated the anti-demineralizing and antibacterial effects of a propolis ethanolic extract (EEP) against Streptococcus mutans dental biofilm. DESIGN: Blocks of sound bovine enamel (n=24) were fixed on polystyrene plates. S. mutans inoculum (ATCC 25175) and culture media were added (48 h-37 °C) to form biofilm. Blocks with biofilm received daily treatment (30 µL/1 min), for 5 days, as following: G1 (EEP 33.3%); G2 (chlorhexidine digluconate 0.12%); G3 (ethanol 80%); and G4 (Milli-Q water). G5 and G6 were blocks without biofilm that received only EEP and Milli-Q water, respectively. Final surface hardness was evaluated and the percentage of hardness loss (%HL) was calculated. The EEP extract pH and total solids were determined. S. mutans count was expressed by log10 scale of Colony-Forming Units (CFU/mL). One way ANOVA was used to compare results which differed at a 95% significance level. RESULTS: G2 presented the lowest average %HL value (68.44% ± 12.98) (p=0.010), while G4 presented the highest (90.49% ± 5.38%HL) (p=0.007). G1 showed %HL (84.41% ± 2.77) similar to G3 (87.80% ± 6.89) (p=0.477). Groups G5 and G6 presented %HL=16.11% ± 7.92 and 20.55% ± 10.65; respectively (p=0.952). G1 and G4 differed as regards to S. mutans count: 7.26 ± 0.08 and 8.29 ± 0.17 CFU/mL, respectively (p=0.001). The lowest bacterial count was observed in chlorhexidine group (G2=6.79 ± 0.10 CFU/mL) (p=0.043). There was no difference between S. mutans count of G3 and G4 (p=0.435). The EEP showed pH 4.8 and total soluble solids content=25.9 Brix. CONCLUSION: The EEP seems to be a potent antibacterial substance against S. mutans dental biofilm, but presented no inhibitory action on the de-remineralization of caries process.

Premature loss of primary teeth associated with congenital syphilis: a case report.

Congenital syphilis is an infectious disease transmitted by an infected mother to her fetus. Several reports in the literature have focused on oral manifestations of congenital syphilis, mainly about Hutchinson's teeth and dysplastic molars, which are more common. However, this paper describes an unusual feature of congenital syphilis in a four-year-old child. A case of premature loss of primary teeth associated with congenital syphilis is reported.

Influence of oral rehabilitation on the oral health-related quality of life of a child with ectodermal dysplasia.

Ectodermal dysplasia (ED) is a rare congenital hereditary disorder among a group of syndromes characterized by abnormalities of ectodermic structures. The purpose of this report is to compare the oral health-related quality of life (OHRQoL) before and after complete oral rehabilitation of a five-year-old boy with ED. Delivery of upper and lower dentures resulted in immediate improvement of the child's OHRQoL. Although ED affects patients physically and emotionally, the early oral rehabilitation of young patients is crucial to improve their social interaction and restore their speech and masticatory function.

Does the presence of sucrose in pediatric antibiotics influence the enamel mineral loss and the Streptococcus mutans counts in dental biofilm?

The role of antibiotics containing sucrose on the formation of dental caries is still controversial. This study aimed to investigate the effect of two antibiotics (amoxicillin and potassium clavulanate suspension), with and without sucrose, on human dental hardness and Streptococcus mutans counts in dental biofilm. Primary tooth fragments (n=72) were coated with nail varnish leaving a window of 2.25 mm diameter. Specimens were fixed in 24-well polystyrene plates, containing BHI medium. S. mutans (clinical strains) represented the inoculum to form biofilm on the fragments for 24 h. Twelve fragments were separated for the initial count of microorganisms (baseline). The other fragments were divided into 4 groups (n=12) of treatment: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (chlorhexidine 0.12%), G4 (sucrose 10%). All specimens had their self-control area (covered area). The cross-sectional microhardness (CSMH) was evaluated for each specimen. All the treated groups had a loss of hardness compared to their self-controls (p<0.05). Both drugs inhibited the S. mutans growth and promoted no CSMH difference among them. Both antibiotics eliminated all formed biofilm and did not cause mineral loss from the enamel, regardless the presence of sucrose in its formulation.

Oral bacteria adherence to suture threads: an in vitro study.

PURPOSE: This study investigated the adherence of oral microorganisms to different types of suture threads. METHODS: Pieces of thread were distributed on 24-well plates, according to the following groups: (G1) nylon, (G2) silk, (G3) polyglactin 910, (G4) polyglactin 910 with triclosan. Blank control (G5) consisted of one thread from each group. Adherence to thread tests was performed to observe adhesion of total microorganisms from saliva or two isolates of Prevotella intermedia (ATCC49046) and Fusobacterium nucleatum (ATCC51190). Brain-heart infusion (BHI) medium with or without bacterial inoculum (1.8 × 10(7) CFU/mL) was added to each well of microplates. The microplates were incubated in an anaerobic chamber at 37 °C, for 5 days for biofilm formation. RESULTS: There was no difference between the groups as regard to adhesion of F. nucleatum (p > 0.05). For P. intermedia, the threads in G1 and G4 showed a lower level of adhesion (p < 0.05), with no difference between them. Against total microorganisms, G1 presented a lower level of adherence (p < 0.05), followed by G4; and no difference was observed between G2 and G3. CONCLUSIONS: Total microorganisms and P. intermedia have different affinities to the tested suture threads, whereas F. nucleatum presented a similar adherence level. Among the threads, nylon (G1), followed by polyglactin 910 with triclosan (G4) presented the lowest microbial adherence level.

Clinical and genetic analysis of a nonsyndromic oligodontia in a child.

The etiology of tooth agenesis may be related to several factors, among them, the genetic alterations that play a fundamental role in the development of this dental anomaly, so that knowledge about it helps the clinician to have a greater understanding of their patients. Thus, the aim of this study was to report the case of a nonsyndromic child, with tooth agenesis of one premolar, three first permanent molars, and all second permanent molars. In addition, a genetic research between polymorphic variants in genes MMP3 and BMP2 was performed in order to observe the association between changes in these genes and congenital tooth absences. For this purpose, DNA from child was extracted and polymorphisms were investigated. It was clinically and radiographically observed that this was a case of oligodontia, in which the authors suggested an association between the polymorphisms found and tooth agenesis diagnosed in that child.

Model resin composites incorporating ZnO-NP: activity against S. mutans and physicochemical properties characterization

Abstract Although resin composites are widely used in the clinical practice, the development of recurrent caries at composite-tooth interface still remains as one of the principal shortcomings to be overcome in this field. Objectives To evaluate the activity against S. mutans biofilm of model resin composites incorporating different concentrations of ZnO-nanoparticles (ZnO-NP) and characterize their physicochemical properties. Materials and Methods Different concentrations of ZnO-NP (wt.%): E1=0, E2=0.5, E3=1, E4=2, E5=5 and E6=10 were incorporated into a model resin composite consisting of Bis-GMA-TEGDMA and barium borosilicate particles. The activity against S. mutans biofilm was evaluated by metabolic activity and lactic acid production. The following physicochemical properties were characterized: degree of conversion (DC%), flexural strength (FS), elastic modulus (EM), hardness (KHN), water sorption (Wsp), water solubility (Wsl) and translucency (TP). Results E3, E4, E5 and E6 decreased the biofilm metabolic activity and E5 and E6 decreased the lactic acid production (p<0.05). E6 presented the lowest DC% (p<0.05). No significant difference in FS and EM was found for all resin composites (p>0.05). E5 and E6 presented the lowest values of KHN (p<0.05). E6 presented a higher Wsp than E1 (p<0.05) and the highest Wsl (p<0.05). The translucency significantly decreased as the ZnO- NP concentration increased (p<0.05). Conclusions The incorporation of 2 - 5 wt.% of ZnO-NP could endow antibacterial activity to resin composites, without jeopardizing their physicochemical properties.

The importance of dental care for a child with severe congenital neutropenia: a case report.

Congenital neutropenia is characterized by a decrease in the absolute number of circulating neutrophils and an increased susceptibility to infections. This paper describes the case history of a child with severe congenital neutropenia who had aggressive periodontitis associated with generalized carious lesions. She had Kostmann syndrome, which is associated with recessive mutation of the HAX-1 gene. She had extensive dental caries, which is not common in patients with Kostmann syndrome. The caries caused oral pain and loss of weight and could have been avoided if the parents had received early oral hygiene instructions, and if the child had received regular, professional dental care.

Does the Presence of Sucrose in Pediatric Antibiotics Influence the Enamel Mineral Loss and the Streptococcus mutans Counts in Dental Biofilm?

The role of antibiotics containing sucrose on the formation of dental caries is still controversial. This study aimed to investigate the effect of two antibiotics (amoxicillin and potassium clavulanate suspension), with and without sucrose, on human dental hardness and Streptococcus mutans counts in dental biofilm. Primary tooth fragments (n=72) were coated with nail varnish leaving a window of 2.25 mm diameter. Specimens were fixed in 24-well polystyrene plates, containing BHI medium. S. mutans (clinical strains) represented the inoculum to form biofilm on the fragments for 24 h. Twelve fragments were separated for the initial count of microorganisms (baseline). The other fragments were divided into 4 groups (n=12) of treatment: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (chlorhexidine 0.12%), G4 (sucrose 10%). All specimens had their self-control area (covered area). The cross-sectional microhardness (CSMH) was evaluated for each specimen. All the treated groups had a loss of hardness compared to their self-controls (p<0.05). Both drugs inhibited the S. mutans growth and promoted no CSMH difference among them. Both antibiotics eliminated all formed biofilm and did not cause mineral loss from the enamel, regardless the presence of sucrose in its formulation.

O papel dos antibióticos contendo sacarose na formação de cárie dentária é ainda controverso. Este estudo teve como objetivo investigar o efeito de dois antibióticos (amoxicilina / clavulanato de potássio suspensão oral), com e sem sacarose, na dureza do esmalte dental humano e na contagem de Streptococcus mutans no biofilme dental. Fragmentos de dentes decíduos (n = 72) foram revestidos com verniz deixando uma janela de exposição de 2,25mm de diâmetro. Os espécimes foram fixados em placas de poliestireno de 24 poços, contendo meio de cultura BHI. S. mutans (estirpes clínicas) representaram o inoculo para formar biofilmes sobre os fragmentos por 24 h. Doze fragmentos foram separados para a contagem inicial de microrganismos (baseline). Os restantes dos fragmentos foram divididos em 4 grupos (n = 12) de tratamento: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (clorexidina 0,12%), G4 (sacarose a 10%). Todas as amostras tiveram sua área de controle (área coberta). A microdureza transversal (CSMH) foi avaliada para cada espécime. Todos os grupos tratados tiveram uma perda de dureza quando comparados com os seus respectivos controles (p <0,05). Ambos os fármacos inibiram o crescimento de S. mutans e não promoveram diferença da CSMH entre eles. Ambos os antibióticos eliminaram todo o biofilme formado, não promovendo assim, perda mineral do esmalte, independente da presença de sacarose na sua formulação.

Self-inflicted oral injury in an infant with transverse myelitis.

Acute transverse myelitis (ATM) is an inflammatory disorder that affects the spinal cord. It is characterized by signs and symptoms of neurologic dysfunction in the motor and sensory tracts of the spinal cord bilaterally, resulting in weakness, sensory loss, and autonomic dysfunction with acute or subacute onset. We report on a child who had ATM and respiratory distress requiring ventilatory assistance who presented with severe self-mutilation involving his lips. Other findings included bruxism that had caused mobility of the primary teeth. Comprehensive dental care was carried out under sedation. The management of the lip trauma was achieved by the use of a soft, plastic mouth guard, and corticosteroid ointment.

Knowledge and practices of parents and guardians regarding the oral health of children from a shelter and a university in Rio de Janeiro, Brazil

Objective: to evaluate the knowledge of parents and guardians of school-age children about oral hygiene and diet in a shelter and in a higher education institution. Material and Methods: a study with 82 parents and guardians of school-age children in the Teresa de Jesus Shelter (ATJ; n = 47) and the Veiga de Almeida University (UVA; n = 35) was conducted. A questionnaire with objective questions about hygiene and diet was used. The data were compiled in a database and analyzed using the SPSS 20.0 software (SPSS Inc, Il, USA). Descriptive analysis of data was conducted and normality was verified using the Shapiro-Wilk test (p <0.05). Categorical variables were compared using the χ2 test (p <0.05). Results: the mean age of children at ATJ was 4.9 (ñ 2.5) and those at UVA was 7.1 (ñ 2.7) (p <0.01). There was no difference between groups in relation to age (p = 0.71) and educational level of parents and/or guardians (p = 0.93); however, parents of children at UVA showed higher income (p = 0.02). Parents of children at ATJ had more information on oral health care (p <0.01). Most of the ATJ group (98.7%) claimed that visiting the dentist is also an important factor for the prevention of oral diseases compared to the UVA group (25.7) (p <0.01) and showed higher number of visits to the dentist (p = 0.03). ATJ parents associate more bacteria (p <0.01) and not going to the dentist as causal factors for dental caries (p = 0.03). Conclusion: despite the worse socio-economic conditions, parents and guardians of children at ATJ had more knowledge about oral hygiene and diet than respondents of UVA. It is likely that the educational activities held at ATJ have influenced this result.

Pseudomonas aeruginosa in the Early Childhood: A Case Report.

Pseudomonas aeruginosa is an opportunistic bacterium that usually affects immunocompromised patients, causing infections whose signals and symptoms are related to the affected organ. The patient presented in this article was infected when he was 9 months old. Such condition led to certain alterations like dental improperly positioned teeth, retained deciduous teeth, hipodonty of permanent teeth, atrophy of the upper jaw and dental crowding. Therefore, the purpose of this article is to report the case of a patient affected by Pseudomonas aeruginosa infection in the early childhood and to describe the dental development disorders as consequence of this fact.

Cárie oculta: diagnóstico e alternativa para tratamento - relato de casos clínicos / Hidden caries: diagnosis and an alternative for treatment – case report

O termo cárie oculta vem sendo utilizado para descrever lesões de cárie em dentina sob superfícies de esmalte aparentemente hígidas ou minimamente desmineralizadas. Considerando a dificuldade de diagnóstico e como essas lesões possuem progressão silenciosa, muitas vezes não são detectadas no exame clínico de rotina. O objetivo deste trabalho é relatar, baseado na literatura, dois casos clínicos de cárie oculta, ressaltando a importância da radiografia interproximal para o seu diagnóstico, bem como descrever o tratamento restaurador através da técnica da matriz oclusal individual de acrílico...

The term hidden caries is used to describe carious lesions in dentine under apparently sound enamel surface or minimum desmineralized one. Considering the difficult in its diagnosis and as these injuries have slow progression, many times they are not detected in the clinical examination of routine. The objective of this work is to discuss two clinical cases of hidden caries, standing out the importance of the interproximal radiography for the diagnosis, as well as to describe the restoring treatment carried through the use of individual occlusal acrylic matrix technique...