Effect of two irrigating solutions on antimicrobial activity and clinical and radiographic success after endodontic treatment in primary teeth: a randomized clinical trial.

OBJECTIVES: This study evaluated the antimicrobial activity, clinical and radiographic outcome of pulpectomy in primary teeth using either 1% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) as irrigants. MATERIALS AND METHODS: A randomized double-blind controlled clinical study in which primary teeth were allocated to 1% NaOCl (n = 20) and 2% CHX (n = 20) groups. Microbiological collections were performed before and after irrigation for agar culture and real-time polymerase chain reaction (qPCR). Clinical and radiographic success was assessed at different times. Data were submitted to descriptive analysis, chi-square, Mann-Whitney, and Wilcoxon tests (p  < .05). RESULTS: For 1% NaOCl, the following clinical and radiographic success rates were observed: 7 days (93%/80%); 30 days, 3 and 6 months (100%). For 2% CHX: 7 days (73%/53%); 30 days (93%); 3 months (100%/93%); 6 months (100%) (p > .05). One percent NaOCl and 2% CHX effectively reduced total microorganisms (p < .05) but not mutans streptococci (p > .05). In qPCR analysis, the solutions promoted a reduction of total bacteria and Streptococcus mutans, and no difference was observed between times and groups (p > .05). CONCLUSIONS: One percent NaOCl and 2% CHX were effective for clinical and radiographic success and antimicrobial activity in primary teeth submitted to pulpectomy. CLINICAL RELEVANCE: Studying the antimicrobial activity and clinical and radiographic outcomes of pulpectomy in primary teeth using NaOCl and CHX as irrigants is clinically relevant because it provides information for optimizing treatment protocols and improving the quality of care for pediatric patients. It contributes to evidence-based practice and can potentially lead to better outcomes, reduced complications, and enhanced patient experiences.

Host-microbiome interactions regarding peri-implantitis and dental implant loss.

In the last decades, the ortho-aesthetic-functional rehabilitation had significant advances with the advent of implantology. Despite the success in implantology surgeries, there is a percentage of failures mainly due to in loco infections, through bacterial proliferation, presence of fungi and biofilm formation, originating peri-implantitis. In this sense, several studies have been conducted since then, seeking answers to numerous questions that remain unknown. Thus, the present work aims to discuss the interaction between host-oral microbiome and the development of peri-implantitis. Peri-implantitis was associated with a diversity of bacterial species, being Porphiromonas gingivalis, Treponema denticola and Tannerella forsythia described in higher proportion of peri-implantitis samples. In a parallel role, the injury of peri-implant tissue causes an inflammatory response mediated by activation of innate immune cells such as macrophages, dendritic cells, mast cells, and neutrophils. In summary, the host immune system activation may lead to imbalance of oral microbiota, and, in turn, the oral microbiota dysbiosis is reported leading to cytokines, chemokines, prostaglandins, and proteolytic enzymes production. These biological processes may be responsible for implant loss.

Contribution of Streptococcus Mutans Virulence Factors and Saliva Agglutinating Capacity to Caries Susceptibility in Children: A Preliminary Study.

BACKGROUND: Many factors contribute to caries development in humans, such as diet, host factors - including different saliva components - and the presence of acidogenic bacteria in the dental biofilm, particularly Streptococcus mutans (S. mutans). Despite the influence of S. mutans in caries, this bacterium is also prevalent among healthy individuals, suggesting the contribution of genetic variation on the cariogenic potential. Based on this hypothesis, the present work investigated the influence of S. mutans virulence factors and saliva agglutinating capacity on caries susceptibility in children. STUDY DESIGN: Saliva samples of 24 children from low income families (13 caries-free and 11 caries-active individuals) were collected and tested for their ability to agglutinate S. mutans. The bacteria were isolated from these samples and analyzed for the presence of the gene coding for mutacin IV (mut IV). Biofilm formation and acid tolerance were also investigated in both groups (caries-free and caries-active). RESULTS: Saliva samples from caries-free children showed an increased capacity to agglutinate S. mutans (p=0.006). Also, bacteria isolated from the caries-free group formed less biofilm when compared to the caries-active group (p=0.04). The presence of mut IV gene did not differ between bacteria isolated from caries-free and caries-active individuals, nor did the ability to tolerate an acidic environment, which was the same for the two groups. CONCLUSIONS: Altogether, the results suggest that the adhesive properties of S. mutans and the agglutinating capacity of the saliva samples correlated with the presence of caries lesions in children.

Children with a Higher Activity of Carbonic Anhydrase VI in Saliva Are More Likely to Develop Dental Caries.

OBJECTIVE: This study aimed to analyze the concentration and activity of carbonic anhydrase (CA) VI in the saliva of school children. We investigated the relationship among caries, CA VI concentration/activity, flow rate, pH, and buffering capacity. MATERIALS AND METHODS: Seventy-four school children were divided into a caries-free group and a caries group. Clinical examinations were conducted by one examiner according to World Health Organization criteria + early caries lesions. Salivary flow rate, pH, and buffering capacity were analyzed. Salivary CA VI concentration and activity were evaluated by ELISA and zymography, respectively. The data were analyzed using Student's t test and the Mann-Whitney test, and Pearson and Spearman correlation analyses were also done. In multivariate modeling, associations between variables were expressed as odds ratios. RESULTS: The results showed that salivary flow rate, salivary pH, and BC were significantly higher in the saliva of caries-free children. Also, the salivary CA VI concentration was significantly higher in the saliva of caries-free children. The salivary CA VI activity was higher in children with caries. We found a negative correlation between BC and dental caries. Also, in the caries group we found a positive correlation between the concentration and the activity of CA VI and a negative correlation between BC and CA VI activity. A negative correlation between salivary pH and CA VI concentration was observed in the caries-free group. A high activity of CA and a low salivary flow rate were associated with dental caries. CONCLUSION: These results support the conclusion that dental caries is highly affected by the activity of CA VI in saliva as well as by the salivary flow rate.

Sucrose rinse modulates the salivary behavior of carbonic anhydrase VI and its buffering capacity: a longitudinal study in 4 to 6.5-year-old children.

Background: Carbonic anhydrase VI (CA VI) is crucial in regulating oral pH and predicting susceptibility to dental caries. The hypothesis posits that caries activity may alter the CA VI function, diminishing its capacity to regulate pH effectively and potentially exacerbating cariogenic challenges. This 1-year cohort study sought to investigate the enzymatic activity of salivary CA VI and buffering capacity following a 20% sucrose rinse in 4 to 6.5-year-old children. Method: This research involved 46 volunteers categorized into three groups based on their caries status after follow-up: caries-free (CFee), arrested caries (CArrested), and caries active (CActive). Children underwent visible biofilm examination and saliva collection for salivary flow rate, buffering capacity, and CA VI analyses before and after a 20% sucrose rinse. Results: A reduction in the buffering capacity was observed after sucrose rinse in all groups. The CA VI activity decreased significantly in CFee and CArrested groups after sucrose rinse, although it did not change in the CActive group. An improvement in the buffering capacity and salivary flow rate was found at follow-up when compared with the baseline. After 1-year follow-up, buffering capacity and salivary flow rate increased in all groups, whilst the CA VI activity reduced only in CFree and CArrested children. Conclusion: Sucrose rinse universally reduces the salivary buffering capacity, while caries activity may disrupt CA VI activity response during a cariogenic challenge. After a year, increased salivary flow enhances buffering capacity but not CA VI activity in caries-active children.

Carbon dioxide laser and bonding materials reduce enamel demineralization around orthodontic brackets.

Altering the structure of the enamel surface around the orthodontic bracket by reducing its content of carbonate and phosphate resulting from application of CO(2) laser may represent a more effective strategy in preventing caries in this region. This study aimed at determining whether irradiation with a CO(2) laser combined with fluoride-releasing bonding material could reduce enamel demineralization around orthodontic brackets subjected to cariogenic challenge. Ninety bovine enamel slabs were divided into five groups (n = 18): non-inoculated brain-heart infusion broth group, non-fluoride-releasing composite resin (NFRCR--control group), resin-modified glass ionomer cement (RMGIC), CO(2) laser + Transbond (L+NFRCR) and CO(2) laser + Fuji (L+RMGIC). Slabs were submitted to a 5-day microbiological caries model. The Streptococcus mutans biofilm formed on the slabs was biochemically and microbiologically analysed, and the enamel Knoop hardness number (KHN) around the brackets was determined. The data were analysed by ANOVA and Tukey tests (α = 0.05). Biochemical and microbiological analyses of the biofilm revealed no statistically significant differences among the groups. Lased groups presented the highest KHN means, which statistically differed from NFRCR; however, no difference was found between these lased groups. RMGIC did not differ from NFRCR which presented the lowest KHN mean. The CO(2) laser (λ = 10.6 µm; 10.0 J/cm(2) per pulse) use with or without F-bonding materials was effective in inhibiting demineralization around orthodontic brackets. However, no additional effect was found when the enamel was treated with the combination of CO(2) laser and an F-releasing material.

Relationship between cariogenic bacteria and molar incisor hypomineralization in Brazilian schoolchildren.

Background: Teeth with defects in their structure, such as the ones affected by molar-incisor hypomineralization (MIH), are more susceptible to carious lesions. Caries is a complex and multifactorial disease highly prevalent in childhood. The present research evaluated the relationship between the stages of MIH and cariogenic bacteria in children. Methods: After examining 566 schoolchildren, four groups of 10 children each were formed: healthy (G1), mild MIH (G2 and G3), and severe MIH + caries (G4). Dental biofilm was assessed to quantify Streptococcus mutans (SM) and Lactobacillus spp. (LB) using real-time polymerase chain reaction (RT-PCR). Results: LB counting in biofilm samples of healthy children (G1) and those with mild MIH characterized by white opacities (G2) were not significantly different. The same happened when the ones with yellow opacities (G3) were compared with severe MIH + caries (G4) (P>0.05). The post hoc Tukey test proved that G4 had greater levels of SM and LB when compared with G2 (P<0.05); however, the control group did not diverge from the others considering SM (P>0.05). Increased LB enhanced the severity of MIH [rate ratio (RR): 7.706; P=0.035]. Conclusions: LB was influenced by different degrees of MIH and the presence of caries and could guide clinical decisions and patients' recommendations to prevent carious lesions in MIH children.

Understanding the Predictive Potential of the Oral Microbiome in the Development and Progression of Early Childhood Caries.

BACKGROUND: Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to the destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools, including next-generation sequencing methods and proteomic approaches, have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC. CONCLUSION: The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.

Possible Relationship Between the Oral and Gut Microbiome, Caries Development, and Obesity in Children During the COVID-19 Pandemic.

The COVID-19 pandemic has brought health damage and socioeconomic disruptions, together with lifestyle disorders around the world. Children are one of the most commonly affected, mainly due to social isolation and changes in eating habits and physical activities. This way, the risk of weight gain and obesity is possibly enhanced, as well as poor oral hygiene conditions and early childhood caries (ECC) development during the lockdown. In children under 6 years of age, ECC is defined as carious lesions in one or more primary teeth, with or without cavitation. Importantly, alterations in the oral microbiome caused by changes in children lifestyles have much more than a local impact on oral tissues, interplaying with the gut microbiome and influencing systemic environments. Recent studies have been exploring the oral health conditions, eating habits, and weight gain in the childhood population during the COVID-19 pandemic; however, there is a lack of information concerning the association among oral and gut microbiome, dental caries, and obesity in the COVID-19 era. In this context, this review aimed at analyzing a possible relationship between the oral and gut microbiome, caries, and obesity in children during the COVID-19 pandemic.

Early childhood caries, obesity and anthropometric measurements: Is there a relationship?

This brief research report explored the relationship among obesity, anthropometric measurements, and early childhood caries (ECC), in 3-5 years-old children. Three hundred and ninety-one Brazilian preschoolers were given anthropometric examinations for the assessment of general, peripheral, and central adiposity, by the following measures: body mass index (BMI), hip circumference, and waist circumference. Obesity status was determined by BMI according to WHO standards. Parent's age and BMI were assessed by questionnaire, and sucrose exposure was tracked by means of a food diary. For the assessment of ECC, dental examinations were performed according to modified WHO criteria. Also, the presence of dental biofilm in maxillary incisors was detected. A direct association between BMI and ECC was found in the bivariate analysis and the best possibility of logistic regression model showed that hip circumference (HC) values ≥62 centimeters (OR = 1.63; p = 0.033) jointly with the presence of dental biofilm (OR = 2.38; p = 0.000), children's ages ≥37 months (OR = 5.09; p = 0.012), and mothers younger than 35 years (OR = 1.96; p = 0.004) were significantly connected with ECC. In conclusion, peripheral adiposity (represented by HC) in young children was in fact associated with ECC. Thus, hip circumference might be a valuable tool for exploring the relationship between caries and obesity in the early years of life.

Firmicutes Levels in the Mouth Reflect the Gut Condition With Respect to Obesity and Early Childhood Caries.

The present cross-sectional study investigated whether Firmicutes (F) and Bacteroidetes (B) levels in the mouth reflected the gut condition in obesity and early childhood caries (ECC). Eighty preschoolers (3-5 years) were equally assigned into four groups: 1. obese + ECC, 2. obese + caries-free (CF), 3. eutrophic + ECC, and 4. eutrophic + CF. Nutritional status and ECC were assessed based on the WHO criteria. Dental biofilm and fecal samples were collected for F and B quantification using RT-PCR analysis. Data were evaluated using three-way-ANOVA and Pearson's correlation (α = 0.05). Regardless of the anatomical location effect (p = 0.22), there were higher values for F in the obese children + ECC compared with those in obese + caries-free (CF) in both mouth and gut (p < 0.05). The correlation for F at these sites was negative in obese children + ECC (r = -0.48; p = 0.03) and positive in obese children + CF (r=0.50; p = 0.03). Bacteroidetes were influenced by ECC (p = 0.03) and the anatomical location (p = 0.00), and the levels tended to be higher in the mouth of the obese children + ECC (p = 0.04). The F/B ratio was higher in the gut and was affected by the anatomical location (p = 0.00). This preliminary study suggested that modulated by ECC, counts of oral Firmicutes reflected corresponding condition in the gut of obese preschoolers. In addition, we first evidenced that the Firmicutes phylum behave differently according to the nutritional status and caries experience and that supragingival biofilm and gut could share levels of similarity.

Firmicutes Dysbiosis After Chlorhexidine Prophylaxis in Healthy Patients Submitted to Impacted Lower Third Molar Extraction.

Prophylaxis with antiseptic and antibiotic therapy is common in impacted lower third molar surgeries, despite the lack of consensus among professionals and researchers in the indication for healthy patients. The aim of the present preliminary study was to verify the impact of prophylaxis therapy with antiseptic and antibiotic in healthy patients submitted to impacted lower third molar extraction, according to oral microorganism quantification. Eleven patients submitted to impacted lower third molar extraction, under prophylactic therapy with 0.12% chlorhexidine and amoxicillin in four experimental phases, were evaluated. Our results showed no significant reduction in total bacteria load, as well as in Bacteroidetes and C. albicans loads in the oral cavity, after prophylactic therapy with antiseptic and antibiotic. On the other hand, there was a significant difference between the Firmicutes levels across the follow-up, and this effect seems to be large (ηp²=0.94). Post-hoc test demonstrated that the levels of Firmicutes in T1 were higher than T0, T2, and T3, suggesting a microbiota dysbiosis, when 0.12% chlorhexidine use, which may be responsible for selection of antibiotic-resistant microorganisms. Our results alert for an overuse of antiseptic and antibiotics by dentists and for a better evaluation of the available protocols.

Early childhood caries and mutans streptococci: a systematic review.

PURPOSE: The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on the current quality of the literature regarding the relationship between early childhood caries (ECC) and these microorganisms. MATERIALS AND METHODS: The authors searched PubMed, Scopus and Cochrane Library databases for papers from 1951 to 2007. The minimal inclusion requirements were assessment of preschool children reporting mutans streptococci counts, mainly in saliva and biofilm samples, and caries assessment. Since the heterogeneity of the studies did not allow a meta-analysis (chi(2) test), a qualitative analysis was conducted. RESULTS: The electronic search yielded 120 articles, but only 16 scientific papers were critically appraised. Of the 16 scientific papers included in the review, only one cross-sectional study achieved a high value of evidence. CONCLUSIONS: It was concluded that mutans streptococci levels are a strong risk indicator for ECC. However, further well designed longitudinal studies with high evidence values are required to confirm mutans streptococci levels as a significant ECC risk factor.

Oral rehabilitation of primary dentition affected by amelogenesis imperfecta: a case report.

AIM: The purpose of the case report was to describe the treatment of a 4(1/2)-year-old boy with amelogenesis imperfect (AI) in the primary dentition. BACKGROUND: AI is a hereditary condition that affects the development of enamel, causing quantity, structural, and compositional anomalies involving all dentitions. Consequently, the effects can extend to both the primary and secondary dentitions. CASE REPORT: A 4(1/2)-year-old boy was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of amelogenesis imperfecta. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms of both maxillary and mandibular primary incisors and canines. Improvements in the patient's psychological behavior and the elimination of tooth sensitiveness were observed, and the reestablishment of a normal occlusion resulted in improved eating habits. The child was monitored in the Pediatric Dentistry Clinic at four-month intervals until the mixed dentition stage. SUMMARY: The oral rehabilitation of young children with AI is necessary to reestablish the stomatognathic system function, so important for a child's systemic health. An adequate medical history and a careful clinical examination were essential for a correct diagnosis. Treatment was rendered that was appropriate for the child's age and clinical/psychological characteristics. CLINICAL SIGNIFICANCE: Cost-effective restorative techniques involving stainless steel and composite-resin crowns are shown for the restoration of a young patient with amelogensis imperfecta.

Plaque Fluoride Levels as a Predictor of Caries Development in Early Childhood with High Sugar Exposure - A Preliminary Study.

OBJECTIVE: This longitudinal study aimed to investigate if the plaque fluoride (PF) concentration can predict the early childhood caries onset. Design: As part of a larger study, 188 preschoolers were clinically evaluated for early childhood caries diagnosis, at baseline and after 1-year follow-up. After that, the final sample comprised: 1. children who had already caries at baseline (decayed, missing or filled surfaces, as well as white chalky white spot lesions adjacent to gingival margins) and developed at least one more cavitation after one year (n=16), and 2. children who never had or developed any caries lesions, including active white spots lesions (n=15). Before the clinical examinations, dental plaque was collected. PF concentration was determined with an ion-specific electrode. A chart was used to estimate the mean daily sugar exposure. The results were statistically analyzed by Spearman correlation and logistic regression analyses (α=0.05). RESULTS: After one year, a positive significant correlation between caries development and liquid sucrose, total sugar and total sucrose consumption increments was found (p<0.05). Moreover, the solid sugar, solid sucrose and total sugar exposure at baseline were positively correlated with the presence of dental plaque at follow-up (p<0.05). To top it all, children with PF concentrations ≤0.1 µg/mg at baseline were 10 times more likely to develop caries. CONCLUSION: In conclusion, this study demonstrated for the first time in vivo that low PF concentration is a predictor of caries development in primary teeth.

A high salivary calcium concentration is a protective factor for caries development during orthodontic treatment.

BACKGROUND: This research aimed to evaluate the salivary concentrations of fluoride (F-), calcium (Ca2+), and phosphate (Pi) after brackets bonding, and to identify the role of [F-], [Ca2+], and [Pi] on the development of active caries lesion (ACL) in individuals under fixed orthodontic treatment. MATERIAL AND METHODS: A longitudinal investigation with twenty-two individuals from 11 to 22 years of age was performed in four phases (baseline and after 1, 3, and 6 months). Analyses were carried out considering the salivary concentration of [F-], [Ca2+], and [Pi], as well as the caries index. Data were analyzed using the Friedman test, followed by the Wilcoxon test and the multivariate Cox model (p≤0.05). RESULTS: 1 and 3 months after appliance bonding, the [Ca2+] was statistically lower than after 6 months (p<0.0083). On the other hand, salivary [F-] and [Pi] did not show any significant difference during the follow-up. The Cox model demonstrated that the increase of 1 µg/mL in Ca2+ decreased the risk of ACL development by 27%. In conclusion, the levels of Ca2+ changed during orthodontic treatment. CONCLUSIONS: A high Ca2+ level in the saliva is a protective factor for ACL development over time. Key words:Adolescents, bioinorganic chemistry, dental caries, orthodontic appliances.

Relationship Between Mutans Streptococci and Lactobacilli in the Oral Cavity and Intestine of Obese and Eutrophic Children With Early Childhood Caries-Preliminary Findings of a Cross-Sectional Study.

This brief communication assessed whether there was any relationship between the counts of lactobacilli (LB) and mutans streptococci (MS) in the oral cavity and intestine of obese and eutrophic children with early childhood caries (ECC). Seventy-eight preschoolers were assigned into the following groups: 1. obese children with ECC (OECC), 2. eutrophic children with ECC (EECC), 3. obese caries-free children (OCF), and 4. eutrophic caries-free children (ECF). The diagnosis of obesity and ECC was based on the World Health Organization criteria. Dental plaque and fecal samples were collected to assess the counts of MS and LB using selective media. Data were evaluated by Poisson regression analysis, Wilcoxon test, and Sign test. Microbial indicators of ECC in obese children were MS counts in the intestine [rate ratio (RR): 4.38] and presence of LB in the oral cavity (RR: 2.12). The indicators in eutrophic children were MS levels and the presence of LB, both in the oral cavity (RR: 6.35/1.50) and intestine (RR: 2.35/2.38) (p < 0.05). The comparison between MS levels in the mouth and in the intestine revealed significant differences only in the ECF group (p = 0.04). Regarding LB presence in the mouth vs. in the intestine, except for the OCF group (p = 0.03), no other statistical differences were found. Our preliminary findings highlighted that the levels of MS and the presence of LB in the oral cavity, as well as in the lower gastrointestinal tract were associated with ECC. Moreover, obesity was found to influence this relationship.

Prosthetic rehabilitation in a four-year-old child with severe early childhood caries: a case report.

AIM: The purpose of this case report was to describe the oral rehabilitation of a 4-year-old girl presenting early childhood caries (ECC). BACKGROUND: ECC is highly prevalent in developing countries and its severity increases with age. This disease implies serious consequences for the development of the stomatognathic system and for the child's quality of life. As young children are usually anxious about dental treatment, their level of co-operation is limited, leading to a challenging situation. CASE REPORT: A 4-year-old girl was brought by her mother for dental treatment with the complaint of pain. The clinical examination revealed extensive carious coronary destructions. After preventive and curative measures, the oral rehabilitation was performed; it included the use of stainless steel crowns, resin filled celluloid crowns with previous cementation of glass post pins when necessary, an amalgam restoration, orthodontic treatment, and a partial removable prosthesis. The child has been monitored in the Pediatric Dentistry Clinic at 4-monthly intervals. SUMMARY: The oral rehabilitation was able to reestablish the oral health in the primary arches mutilated by early childhood caries. This is important for the establishment of an adequate mixed and permanent dentition, for proper facial and maxillary growth, and to the child's psychological and social development. CLINICAL SIGNIFICANCE: The full management, including preventive, psychological, and curative measures of a young child with severe ECC was found successful after 8 months of follow up. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, resin filled celluloid crowns, and partial removable prosthesis to reestablish the oral functions and improve the child's psycho-social development.

Eruption cysts in the neonate.

Disturbances of the dental development may result in anomalies, which may be apparent as soon as the child is born. Eruption cysts are rarely observed in neonates considering that at this stage of the child's life teeth eruption is uncommon. Thus, the aim of this report is to describe a case of eruption cysts in a neonate. A male neonate was brought to the emergency service with the chief complaint of an elevated area on the anterior region of the inferior alveolar ridge. The lesion was clinically characterized as a compressive and floating swelling. Through a radiographic exam two mandibular primary incisors could be seen superficially located. Due to the patient's age and the initial diagnosis of eruption cysts the conduct adopted was clinical surveillance. Forty-five days after the first visit the lesions had significantly decreased in size, and completely disappeared after 4 months. At that age, both mandibular central incisors were already in the oral cavity exhibiting small hypoplastic areas in the incisal edges. The clinical and radiographic follow-up of eruption cysts in neonates appears to be an adequate conduct without differing from that recommended for older children.

A higiene bucal de bebês edêntulos e sua influência na microbiota bucal: os profissionais de saúde devem preconizá-la? ­ revisão crítica / Oral hygiene in edentulous infants and its influence on oral microbiota: should the health professionals recommend it? ­ a critical review

Introdução: A indicação de higiene bucal em bebês edêntulos entre os profissionais de saúde ainda é controversa, sendo necessária a busca científica sobre esta indicação e a padronização da informação. Objetivo: Investigar criticamente as evidências relacionadas a indicação da higiene bucal para bebês edêntulos. Métodos: A busca de artigos foi realizada nas bases de dados PubMed, LILACS e Google Scholar, de modo a avaliar a seguinte pergunta: "A higienização da cavidade bucal de bebês edêntulos pode influenciar a microbiota bucal?". Uma busca em 8 livros de Odontopediatria também foi realizada. Resultados: Foram encontrados 317 artigos (167-PubMed, 146-Google Scholar e 4-LILACS). Não foram encontrados estudos primários que avaliaram o efeito da higiene bucal em bebês edêntulos na microbiota, impossibilitando a condução de revisão sistemática. Assim, para a revisão foram incluídos 6 estudos que investigaram micro-organismos na cavidade bucal de bebês edêntulos e o papel das imunoglobulinas salivares. Dentre os livros avaliados, somente 4 indicaram a higiene bucal em bebês edêntulos. Conclusão: Diante dos dados analisados, não existem estudos primários que avaliaram o efeito da higienização na microbiota bucal de bebês edêntulos. Torna-se relevante a condução de estudos clínicos para obtenção de evidências científicas sobre a indicação ou não da higienização da cavidade bucal de bebês edêntulos.

Introduction: The indication of oral hygiene in edentulous babies is still controversial among health professionals, being necessary the search of this recommendation and the standardization of information. Objective: To inves-tigate critically the evidence related to the indication of oral hygiene for edentulous babies. Methods: The search for articles was performed in the PubMed, LILACS and Google Scholar databases, in order to assess the following question: "Can oral cavity hygiene of edentulous babies influence oral microbiota?" A search in 8 books of Pediatric Dentistry was also performed. Results: 317 articles were found (167-PubMed, 146-Google Scholar and 4-LILACS). There were no primary studies that evalu-ated the effect of oral hygiene of edentulous infants on microbiota, which impair the conduction of a systematic review. Thus, it was included for this review six studies that investigated microorganisms in the oral cavity of edentulous infants and the role of salivary immunoglo- bulins. Among the textbooks evaluated, only 4 indicated the oral hygiene in edentulous infants. Conclusion:According to the data, there are no primary studies that assessed the effect of oral hygiene in the oral microbiota of edentulous babies. It is relevant to conduct clinical studies in order to obtain scientific evidence about the indication or no of the oral hygiene in edentulous babies