Crown Fracture of an Unerupted Incisor in a Young Child: Case Report and Restorative Protocol.

Aim: This case report describes a protocol for restoring a crown fracture of an unerupted permanent incisor in a child. Background: Crown fractures are an important concern in pediatric dentistry due to the negative impact on oral health-related quality of life (OHRQoL) in children and adolescents resulting from functional limitations as well as consequences related to social and emotional well-being. Case description: An enamel and dentin fracture of the crown of unerupted tooth 11 due to direct trauma is being presented in a 7-year-old girl. The restorative treatment involved minimally invasive dentistry, including computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and direct resin restoration. Conclusion: The treatment decision was essential for maintaining pulp vitality and continued root development, as well as ensuring esthetic and functional results. Clinical significance: Crown fracture of an unerupted incisor may occur in childhood, requiring a long-term clinical and radiographic follow-up. Predictable, positive, and reliable esthetic outcomes can be achieved using CAD/CAM technology combined with adhesive protocols. How to cite this article: Kamanski D, Tavares JG, Weber JBB, et al. Crown Fracture of an Unerupted Incisor in a Young Child: Case Report and Restorative Protocol. Int J Clin Pediatr Dent 2022;15(5):636-641.

Green teeth associated with neonatal hyperbilirubinemia caused by biliary atresia: review and case report.

Green pigmentation in teeth is an uncommon condition associated with bilirubin deposits in dental hard tissues. Its occurrence causes anxiety to both child and family. The purpose of this paper is to present a case involving an eleven-year-old girl with green pigmentation of permanent teeth who underwent a liver transplant due to biliary atresia when she was one year old. The reported case confirms the relevance of past medical history in establishing the diagnosis and treatment plan of green teeth.

Spatial distribution of dental caries among preschool children in Canoas, Southern Brazil.

The aims of this study were to analyze the spatial distribution of dental caries among preschool children and create equiprobable scenarios of its occurrence in the city of Canoas, Southern Brazil. Trained, calibrated dentists examined 1,100 children enrolled at public preschools to determine dental caries experience following World Health Organization criteria. The ArcGis 10.0 Geographic Information System was used to analyze spatial and non-spatial data. Geostatistical Modeling Software was used in geostatistical analyses to detect spatial continuity and create maps using stochastic simulation. Overall prevalence of dental caries was 25% with intraurban differentials in distribution. The findings enabled the generation of 100 equiprobable scenarios and maps with the best and worst scenarios. The highest concentration of dental caries occurrence was found in the western portion of the city, while the lowest probability of occurrence was found in the northern and southern portions. Identifying spatial inequalities in health conditions and visualizing them through the creation of maps can help to qualify and organize public health interventions and provide information to gain better understanding of the influence of the surrounding environment on adverse health conditions.

O objetivo do estudo foi analisar a distribuição espacial de cárie dentária entre crianças préescolares e criar cenários equiprováveis da ocorrência deste agravo na cidade de Canoas, sul do Brasil. Exame clínico para detecção da experiência de cárie dentária de acordo com o critério da Organização Mundial da Saúde foi realizado por cirurgiõesdentistas treinados e calibrados em uma amostra de 1.100 crianças matriculadas em escolas de educação infantil. Utilizouse o Sistema de Informação Geográfica ArcGis 10.0 para a inserção de dados espaciais e não espaciais. O programa GeoMS foi utilizado nas análises geoestatísticas para a detecção da continuidade espacial e construção de mapas através da simulação estocástica. A prevalência de cárie dentária foi 25%, com diferenciais intraurbanos na sua distribuição. Os resultados permitiram a construção de 100 cenários equiprováveis e de mapas com os melhores e piores cenários no município. Uma maior concentração de ocorrên cias foi encontrada na região oeste da cidade, enquanto que as regiões norte e sul tiveram a menor probabilidade de ocorrência de cárie dentária. A identificação de desigualdades espaciais em condições de saúde e a sua visualização por meio de mapas pode auxiliar na qualificação e organização de intervenções de saúde pública, assim como fornecer subsídios que ajudem no entendimento da influência do meio ambiente sobre as condições adversas de saúde.

Pre-emptive Intracoronal Radiolucency in First Permanent Molar.

Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed. How to cite this article: Ilha MC, Kramer PF, Ferreira SH, Ruschel HC. Pre-eruptive Intracoronal Radiolucency in First Permanent Molar. Int J Clin Pediatr Dent 2018;11(2):151-154.

Evaluation of fracture torque resistance of orthodontic mini-implants.

This study sought to assess the fracture torque resistance of mini-implants used for orthodontic anchorage. Five commercially available brands of mini-implants were used (SIN®, CONEXÃO®, NEODENT®, MORELLI®, andFORESTADENT®). Ten mini-implants of each diameter of each brand were tested, for a total 100 specimens. The mini-implants were subject to a static torsion test as described in ASTMstandard F543. Analysis of variance (ANOVA) with the Tukey multiple comparisons procedure was used to assess results. Overall, mean fracture strength ranged from 15.7 to 70.4 N·cm. Mini-implants with larger diameter exhibited higher peak torque values at fracture and higher yield strength, regardless of brand. In addition, significant differences across brands were observed when implants were stratified by diameter. In conclusion, larger mini-implant diameter is associated with increased fracture torque resistance. Additional information on peak torque values at fracture of different commercial brands of mini-implants may increase the success rate of this orthodontic anchorage modality.

O objetivo do presente estudo foi avaliar a resistência de fratura ao torque de miniimplantes ortodônticos. Foram utilizadas cinco marcas comerciais (SIN®, CONEXÃO®, NEODENT®, MORELLI® e FORESTADENT®). Para cada diâmetro, de cada marca comercial, foram testados 10 miniimplantes, totalizando 100 amostras. Os miniimplantes foram submetidos a um Ensaio Estático de Torção, conforme a norma técnica ASTM F543. Os resultados foram submetidos à Análise de Variância (ANOVA) complementado pelo teste de comparações múltiplas de Tukey. Os valores médios de resistência de fratura ao torque variaram de 15,7 a 70,4 N·cm e miniimplantes de maior diâmetro apresentaram maiores valores de torque máximo de fratura e de limite de escoamento, independente da marca comercial. Além disso, foram observadas diferenças significativas entre as marcas comerciais quando agrupadas de acordo com o diâmetro. Conclui seque miniimplantes de maior diâmetro apresentaram maiores valores de resistência de fratura ao torque. Informações sobreo torque máximo de fratura das diferentes marcas comerciais podem aumentar o índice de sucesso deste método de ancoragem ortodôntica.

Titanium alloy orthodontic mini-implants: scanning electron microscopic and metallographic analyses.

Anchorage control is one of the determining factors of successful orthodontic mechanics. In mini-implants, fractures due to placement and removal have been related to implant design and titanium alloy quality. This study assessed the topography and microstructure of five brands of mini-implants (Neodent, SIN, Morelli, Conexao, Foresta Dent). Scanning electron microscopic analyses of the head, transmucosal neck, threaded body, and tip were performed to assess implant design and manufacturing defects (n=3/group). Metallographic analysis of longitudinal sections (n=15) and cross-sections (n=15) was performed under conventional light microscopy according to international standards of "American Society for Testing and Materials". The results showed significant differences in miniimplant design. Surface irregularities in the threaded body and tip were observed. Microstructural analyses revealed an alpha/beta-phase grain structure, in compliance with the ETTC-2 ("Technical Committee of European Titanium Producers" -2nd edition). No structural defects were detected. We conclude that differences in mini-implant design and the presence of surface irregularities may influence the effectiveness of orthodontic anchorage.

Socioeconomic and clinical factors associated with caregivers' perceptions of children's oral health in Brazil.

OBJECTIVES: We assessed how socioeconomic and clinical conditions could affect parents' perceptions of their child's oral health. METHODS: A cross-sectional study was conducted in a sample of 455 children, aged 1-5 years, representative of Santa Maria, a southern city in Brazil. Participants were randomly selected among children attending a National Day of Children's Vaccination. Clinical examinations provided information on the prevalence of caries, dental trauma, and occlusion. The caregivers' perception of children's oral health and socioeconomic status were assessed by means of a questionnaire. A Poisson regression model using robust variance (Prevalence ratio: PR; 95% CI, P ≤ 0.05) was performed to assess the association between the predictor variables and outcomes. RESULTS: Parents were more likely to rate their child's oral health as 'poor' if the former earned a lower income and the latter had anterior open bite and dental caries. Parents of black children with anterior open bite and dental caries were more likely to rate their child's oral health as 'worse than that of other children'. CONCLUSIONS: Clinical and socioeconomic characteristics are significantly associated with parents' perceptions of their child's oral health. Understanding the caregivers' perceptions of children's oral health and the factors affecting this could be useful in the planning of public health polices, in view of the inequity in the oral health pattern.

Evaluation of fracture torque resistance of orthodontic mini-implants / Resistência de fratura ao torque de mini-implantes ortodônticos

This study sought to assess the fracture torque resistance of miniimplants used for orthodontic anchorage. Five commercially available brands of miniimplants were used (SIN®, CONEXÃO®, NEODENT®, MORELLI®, and FORESTADENT®). Ten miniimplants of each diameter of each brand were tested, for a total 100 specimens. The miniimplants were subject to a static torsion test as described in ASTM standard F543. Analysis of variance (ANOVA) with the Tukey multiple comparisons procedure was used to assess results. Overall, mean fracture strength ranged from 15.7 to 70.4 N·cm. Miniimplants with larger diameter exhibited higher peak torque values at fracture and higher yield strength, regardless of brand. In addition, significant differences across brands were observed when implants were stratified by diameter. In conclusion, larger miniimplant diameter is associated with increased fracture torque resistance. Additional information on peak torque values at fracture of different commercial brands of miniimplants may increase the success rate of this orthodontic anchorage modality.

O objetivo do presente estudo foi avaliar a resistência de fratura ao torque de miniimplantes ortodônticos. Foram utiliza das cinco marcas comerciais (SIN®, CONEXÃO®, NEODENT®, MORELLI® e FORESTADENT®). Para cada diâmetro, de cada marca comercial, foram testados 10 miniimplantes, totalizando 100 amostras. Os miniimplantes foram submetidos a um Ensaio Estático de Torção, conforme a norma técnica ASTM F543. Os resultados foram submetidos à Análise de Variância (ANOVA) complementado pelo teste de compa rações múltiplas de Tukey. Os valores médios de resistência de fratura ao torque variaram de 15,7 a 70,4 N·cm e miniimplantes de maior diâmetro apresentaram maiores valores de torque máximo de fratura e de limite de escoamento, independente da marca comercial. Além disso, foram obser vadas diferenças significativas entre as marcas comerciais quando agrupadas de acordo com o diâmetro. Concluise que miniimplantes de maior diâmetro apresentaram maiores valores de resistência de fratura ao torque. Informações sobre o torque máximo de fratura das diferentes marcas comerciais podem aumentar o índice de sucesso deste método de ancoragem ortodôntica.

Titanium alloy orthodontic mini-implants: scanning electron microscopic and metallographic analyses

Anchorage control is one of the determining factors of successful orthodontic mechanics. In mini-implants, fractures due to placement and removal have been related to implant design and titanium alloy quality. This study assessed the topography and microstructure of five brands of mini-implants (Neodent, SIN, Morelli, Conexao, Foresta Dent). Scanning electron microscopic analyses of the head, transmucosal neck, threaded body, and tip were performed to assess implant design and manufacturing defects (n=3/group). Metallographic analysis of longitudinal sections (n=15) and cross-sections (n=15) was performed under conventional light microscopy according to international standards of "American Society for Testing and Materials". The results showed significant differences in miniimplant design. Surface irregularities in the threaded body and tip were observed. Microstructural analyses revealed an alpha/beta-phase grain structure, in compliance with the ETTC-2 ("Technical Committee of European Titanium Producers" -2nd edition). No structural defects were detected. We conclude that differences in mini-implant design and the presence of surface irregularities may influence the effectiveness of orthodontic anchorage.

O controle da ancoragem e um dos fatores decisivos no sucesso da mecanica ortodontica. Fraturas devido ao estresse de insercao e remocao de mini-implantes sao associadas ao design das pecas e a qualidade da liga de titanio. O presente estudo analisou a topografia e a microestrutura de cinco marcas de mini-implantes (Neodent, SIN, Morelli, Conexao, Foresta Dent). Analise ao microscopio eletronico de varredura da cabeca e perfil transmucoso, porcao rosqueavel e ponta ativa foi realizada com o proposito de avaliar o design e defeitos de fabricacao (n=3/grupo). A analise metalografica baseou-se nas normas internacionais da "American Society for Testing and Materials" e revelou a microestrutura em cortes longitudinais (n=15) e transversais (n=15) por meio do microscopio optico. Os resultados demostraram que os mini-implantes apresentam diferencas significativas no design. Irregularidades superficiais na porcao rosqueavel e na ponta ativa foram tambem observadas. A analise da microestrutura revelou uma estrutura de graos fases alfa e beta distribuidas de acordo com os padroes definidos pelas normas ETTC-2 ("Technical Committee of European Titanium Producers" - 2a edicao). Alem disso, nao foram detectados defeitos na estrutura interna das ligas. Conclui-se que diferencas no design dos mini-implantes e a presenca de irregularidades superficiais podem influenciar na efetividade da ancoragem durante o tratamento ortodontico.

Traumatic dental injuries in the first year of life and associated factors in Brazilian infants.

PURPOSE: The purpose of this study, was to investigate the incidence of traumatic dental injuries in the first year of life and their associated factors. METHODS: Five hundred children were recruited at the outset of the cohort (at birth); 397 had an initial assessment at 6 months (investigation of demographic, socioeconomic, and environmental variables), and 378 were examined for dental trauma at the 1-year assessment (12-16 months); 122 children were lost in the follow-up, and 2 edentulous children were excluded from analysis. RESULTS: Approximately 15% of the children (54/376) had dental trauma, with the most common type of injury being enamel fracture. The main reported causes of dental injuries were falls from the same level, furniture, and strollers or walkers. Logistic regression after adjusting for confounding showed that the odds of dental trauma was 2.6 times higher for children whose mothers with higher education compared to those with a lower education level (odds ratio [OR]=2.61; 95% confidence interval [CI]=1.41-4.84). Family structure was associated with dental trauma, with an adjusted model showing higher odds for children from non-nuclear families compared to those from nuclear families (OR=2.28; 95% CI=1.18-4.39). CONCLUSIONS: These results demonstrated a high incidence of dental trauma in the first year of life, improving knowledge for future development of preventive strategies to reduce risk of dental traumatic injuries.