Multidisciplinary approach to multiple dental anomalies in pediatric patients: a case report with 4-year follow-up.

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a orthodontic mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients.

Custo benefício do ionômero de vidro encapsulado usado como material restaurador para Tratamento Restaurador Atraumático (ART): relato de caso / Cost-effective of the glass ionomer cement encapsulated used as filling material for Atraumatic Restorative Treatment (ART): case report

Objetivo ­ Relatar o caso clínico de uma criança submetido ao Tratamento Restaurador Atraumático (ART) utilizando como material restaurador o CIV nas duas versões (pó-líquido e encapsulado). Além disso, promover uma discussão a respeito das vantagens e desvantagens relacionadas a manipulação manual e mecânica do material restaurador. Paciente de 7 anos de idade portador de cárie dentária foi tratado de acordo com ART e recebeu uma restauração com CIV de alta viscosidade do tipo pó-líquido e um selante com CIV encapsulado. O material encapsulado apresenta custo inicial mais elevado entretanto, as propriedades físicas e mecânicas ficam asseguradas e esperase um reflexo positivo na longevidade clínica das restaurações. Desta maneira, os reparos podem ser menos frequentes diminuindo o custo a longo prazo. O Cimento de Ionômero de Vidro encapsulado facilita o processo restaurador e minimiza os erros de dosagem e manipulação. Entretanto, o custo é elevado quando comparado ao mesmo material do tipo pó-líquido. Estudos clínicos randomizados longitudinais são necessários para esclarecer se a diferença inicial de custo da versão encapsulada é compensada a longo prazo.

Objective ­ Report a case of a child submitted to ART using GIC as restorative material in both versions (powder-liquid and encapsulated). Moreover, promote a discussion of the advantages and disadvantages related to manual and mechanical manipulation of the restorative treatment. Patient 7-year-old with dental caries was treated according to ART and received a restoration with CIV high viscosity powderliquid type and a sealant with encapsulated CIV. The encapsulated material has higher initial cost however, the physical and mechanical properties are guaranteed and a positive reflection on the clinical performance of restorations is expected. Thus, repairs can be less frequent reducing the long term cost. The glass ionomer cement encapsulated facilitates the restorative process and minimizes the dosage and manipulation mistakes. However, the cost is high when compared to the same material as the powder-liquid type. Longitudinal randomized clinical studies are expected to clarify whether the initial cost difference of the encapsulated version is compensated over time.

Rare sequelae in the permanent successor due to trauma in the primary incisor: a case report.

Severe dental trauma-such as intrusion or avulsion-to the primary dentition in infants and toddlers may cause developmental disturbances in the permanent successor. In this case, a 9-year-old boy was referred for treatment due to the absence of his permanent maxillary right central incisor. The mother reported avulsion of the corresponding primary tooth when the patient was 2 years old. The radiographic examination revealed impaction and root dilaceration of the permanent tooth; therefore, the treatment plan was tooth extraction. The extracted tooth presented multiple abnormalities, including enamel discoloration, enamel hypoplasia, root dilaceration, and root duplication. Several factors need to be considered when treatment of traumatic sequelae to a permanent successor is planned, including the age of the patient, the developmental stage of the permanent successor at the time of trauma, and the type of trauma to the primary tooth.

Reflexão sobre o comportamento dos bebês durante atendimento odontológico: relato de caso clínico / Reflection on the behavior of infants during dental care: clinical case report

O presente trabalho teve como objetivo realizar uma discussão sobre o comportamento dos bebês durante o atendimento odontológico e relatar o caso clínico de um bebê que teve seu comportamento monitorado por meio de uma escala comportamental durante o atendimento. Um paciente de três anos, portador de cárie, teve seu tratamento monitorado utilizando o índice modificado de Venham, em três momentos distintos da sessão. O paciente obteve os seguintes escores de Venham: 4 e 5 na primeira e segunda sessão, 1 e 2 na terceira e quinta sessão, 5 na quarta e sexta sessão. O comportamento do bebê frente ao atendimento odontológico tende a melhorar conforme o tratamento avança, entretanto, algumas vezes, o bebê tem reações inesperadas, intercalando bons e maus momentos, que não são justificados pelo nível de complexidade dos procedimentos clínicos aos quais está sendo submetido. O uso do índice modificado de Venham para o monitoramento do comportamento durante o atendimento odontológico de bebês tem sua efetividade limitada em função das reações conflitantes dos bebês e subjetividade do avaliador. Sendo assim, é fundamental que o profissional domine as questões técnicas para atender de forma eficaz e rápida e que mantenha a tranquilidade independentemente do comportamento apresentado pelo paciente

This study aimed to review the literature regarding the babies' behavior during dental treatment and report a case of a baby who had his behavior monitored during the treatment through a behavioral scale. A patient three years and seven months old, with caries had his treatment monitored using the modified Venham Index in three different moments of the session. The patient received the following scores: 4 and 5 in the first and second sessions, 1 and 2 in the third and fifth sessions, 5 in the fourth session. The babv's behavior during dental care tends to improve as the treatment progresses, however, sometimes the baby has unexpected reactions, alternating good and bad moments, which are not justified by the levei of complexity of clinical procedures which are being submitted. The use of the modified Venham Index to monitoring babies' behavior during treatment has limited effectiveness due to the babies conflicting reactions and the evaluator subjectivity. Therefore, it is essential that the professional knows how to properly perform the techniques to care safely and and being able to maintain tranquility regardless of the behavior exhibited by the patient

Impacto das novas tecnologias de informação e comunicação, através do blended learning, aplicadas aos graduandos em Odontopediatria / The impact of new information and communications technology, through blended learning, applied to undergraduates in Pediatric Dentistry

Este estudo descreve a experiência inicial de integração do sistema de gestão de aprendizagem Moodle, para apoiar o processo de ensino-aprendizagem na Disciplina de Odontopediatria da Faculdade de Odontologia da Universidade de São Paulo. Os alunos de pós-graduação (11) foram capacitados em tutoria para construir um curso complementar à grade curricular e gerenciar 2 grupos do último ano de graduação (n=132). Após um mês de aula teórica, os graduandos realizaram uma prova (P1), responderam um questionário inicial e em seguida participaram das atividades no ambiente virtual de aprendizagem (AVA), durante o restante do curso. Realizaram 3 provas presenciais (P2, P3 e P4) durante a aprendizagem baseada na Web, gerando assim uma nota final (NF). Também responderam outro questionário sobre a experiência com a plataforma e foram avaliados através de uma nota de participação (NP) no Moodle. Observou-se uma correlação entre NP e NF. E comparando as notas finais das duas coortes do estudo, que participaram do Moodle, com outras 2 coortes que não participaram das atividades, observou-se diferença significante (p<0,001). Os alunos que mais participaram das atividades no Moodle obtiveram notas melhores. Além disso, houve uma diferença significativa entre as notas das coortes que tiveram a participação dos alunos no Moodle em comparação aos que não tiveram o aprendizado híbrido, sugerindo que a flexibilização através do AVA favorece o acréscimo de conhecimento.

This study describes our initial experience of integrating an open-source course management system (CMS) called Moodle (the modular object-oriented dynamic learning environment) to support teaching and learning in pediatric dentistry applied to 2 groups of last-year undergraduate dentistry students (n=134) from University of São Paulo. It is a longitudinal case study of two prospective cohorts (undergraduate students) and it includes the creation of two courses in a virtual learning environment - moodle (version 1.9). The integration of the Moodle course into our teaching was assessed using online grades activity, student examination marks and feedbacks from students. The freely available Moodle platform was simple to use, helped to effectively deliver course materials, and has features that allowed cooperative learning. Students who used the CMS throughout their academic year commented favorably regarding its use as a complement to the face-to-face classroom sessions. The group of students that used the CMS obtained significantly higher scores in the final examination compared with the previous class that did not use the CMS. In addition, there was a significant correlation between student participation and performance in their final examination marks.

Frenectomia lingual em bebê utilizando eletrocautério e tetracaína: relato de caso / Electrocautery and tetracaine in baby lingual frenectomy: case report

O artigo relata o caso clínico de frenectomia lingual em bebê, utilizando eletrocautério e anestesia tópica oftálmica (cloridrato de tetracaína). O uso de eletrocautério proporciona diminuição do tempo de trabalho, maior conforto e segurança do procedimento cirúrgico para o bebê e para o profissional. Já a utilização de anestesia tópica oftálmica, é recomendada para procedimentos de controle da dor, tendo melhor absorção em mucosa umedecida, maior profundidade e maior tempo de ação. Esta técnica segue os princípios da odontologia minimamente invasiva.

The article reports a case of lingual baby frenectomy, using electrocautery and topical ophthalmic anesthetic (tetracaine hydrochloride). The use of electrocautery provides reduction of working time, increased comfort and safety of surgery for the baby and the professional. And the use of topical ophthalmic anesthetic is recommended for pain control procedures, and better absorption in the mucosa, deeper and longe r action. This technique follows the principies of minimally invasive dentistry.

Diagnóstico da síndrome da apnéia obstrutiva do sono na infância: como o profissional da odontologia pode contribuir? / Diagnosis of obstructive sleep apnea syndrome in infants: how can dentistt contribute?

Síndrome da Apnéia ostrutiva do Sono (SAOS) quando ocorre na infância leva a um comprometimento físico e psicológico, com isso ela deve ser reconhecida e tratada precocemente na tentativa de evitar ou atenuar os consequências deletérias ao desenvolvimento da criança. Características clínicas como face disfórmica, respirador bucal, bruxismo, hipertrofia de amígdalas e adenóides são comuns em crianças com esta síndrome. Desta forma é necessário orientar os cirurgiões-dentistas, particularmente ortodontistas e odontopediatrias quanto à identificação supeitos de SAOS em crianças e encaminhar ao profissional especializado, no caso o otorrinolaringologista, possibilitando o diagnóstico e tratamento precoce. Por meio de revisão de literatura e relato de caso clínico destacaremos importantes aspectos relacionados à sua etiologia, epidemilogia, patogenia e manifestações clínicas.

When obstructive sleep apnea syndrome (OSAS) occurs in infants, it leads to a physical and psycological demagge. Therefore early diagnosis and treatment are needed to prevent or reduce deleterious consequences to children's development. Clinical characteristics such as: dismorfic face, mouth breather, bruxism, hypertrophy of amygdalas and adhenoids are common in children with this syndrome. Thus, it is necessary to inform dentist, specilly orthodontists and pedodontist about OSAS in children and the importance of an early diagnosis and treatment by otorinolaringologist. The aim of this study is to point out some important aspects related to the etiology, epidemiology, pathogens and clinical manifestation of OSAS through a literature review and describe clinical cases.

Diagnóstico e tratamento cirúrgico do freio teto labial persistente em pacientes no período intertransitório da dentição mista: relato de caso / Diagnosis and surgical treatment of an abnormal upper labial frenum at inter-transitory period of mixed dentition: a case report

O freio labial superior é uma estrutura dinâmica sujeito a variações na forma, tamanho e posição durante os diferentes estágios de crescimento e desenvolvimento do indivíduo. No nascimento, o freio é geralmente largo e espesso e se estende até a papila palatina. Com a erupção dos incisivos permanentes e à medida que ocorre o desenvolvimento do processo alveolar, há uma tendência à atrofia fisiológica e ao afastamento apical da inserção do freio. Quando o freio permanece com a inserção na papila palatina ou na margem gengival é então chamado de freio teto labial persistente. Este pode causar diastema mediano, interferir na escovação, causar recessão gengival, provocar a formação de bolsas periodontais, restringir o movimento do lábio, interferir na fonação e produzir efeito estético indesejável. O objetivo deste trabalho consistiu em apresentar um relato de uma paciente do gênero feminino, com dez anos de idade, as principais consequências e o tratamento cirúrgico do freio teto labial persistente. Frente ao relato, pode-se concluir que a frenectomia foi o tratamento que propiciou o reposicionamento e uma nova inserção para o freio labial, deixando que, com o desenvolvimento da oclusão, ocorresse o fechamento do diastema.

The upper labial frenum is a dynamic structure and changeable structure and is subject to variations in shape, size and position during the different stages of growth and development. At birth, the frenum is generally wide and thick and extends to the palatal papillae. The eruption of permanent incisors and the vertical growth of the alveolar process make the insertion of frenum move apically. When the frenum insertion remains at the palatal papillae, its called abnormal upper labial frenum. The abnormal labial frenum, besides creating a diastema, is capable of interfering at oral hygiene, limiting labial movement, causes gingival recession and affects esthetics. The purpose of this study was to present a ten years old female patient report, the main consequences and the surgical treatment of an abnormal labial frenum. In front of this report, it is possible to conclude that frenectomy was the treatment which caused the frenum new position and its new insertion, making possible that, by the occlusion development, it occurred the diastema closing.

Dye-enhanced laser fluorescence detection of caries lesions around brackets.

The aim was to evaluate the performance of DIAGNOdent [laser fluorescence(LF) and LFpen] devices enhanced by fluorescent dye in detecting mineral loss around brackets and comparing the inhibitory effect of bonding material on artificial demineralization, and to verify whether LF methods show the same trends of mineral loss. Brackets were bonded to premolar halves with Fuji Ortho LC, Transbond XT, and Ortho Glass LC cements (n = 15). The teeth were soaked in demineralizing solution (pH = 4.8) for 16 days. Mineral loss was calculated by atomic emission spectrometry, and lesions were measured with LF devices with dye [tetrakis N-methylpyridyl porphyrin (TMPyP)]. Groups were compared with regard to LF readings and mineral loss, and performance of caries detection was calculated. Higher mineral loss and LF-TMPyP values occurred in the resin group. LFpen-TMPyP readings were significantly higher in the demineralized groups. Correlation was observed between mineral loss and LF measurements. LF methods are capable of identifying lower demineralization around brackets bonded with resin-modified glass ionomer cements.