Aesthetic perception, acceptability and satisfaction in the treatment of caries lesions with silver diamine fluoride: A scoping review.

BACKGROUND: Silver diamine fluoride (SDF) causes dental black staining after its application. AIM: Evaluate the aesthetic perception, acceptability, and/or satisfaction of patients, parents, and professionals to the treatment of caries lesions with SDF through a scoping review. DESIGN: A search was performed in seven databases and two key journals with no language or date restrictions. Studies that evaluated the aesthetic perception, satisfaction, and/or acceptability of patients, parents, and professionals to the treatment of carious lesions with SDF were considered eligible. RESULTS: From a total of 1177 articles, 10 studies were full text assessed for eligibility, with nine included in this scoping review. In general, the studies varied by population, study design, and methodologic evaluation. The type of tooth (anterior or posterior), family income, parental schooling, ethnicity, and need for advanced behaviour control methods were factors that influenced the results. The acceptability level increased as the child required more advanced methods of behaviour guidance. In general, the pigmentation caused by SDF did not interfere with the parents' acceptability of the treatment; however, professionals believe that this could have influence. Regarding satisfaction, pigmentation did not influence parental satisfaction. CONCLUSION: Parents were satisfied with and found SDF acceptable, whereas professionals did not.

Comparison Between Radiographs, White and Fluorescent Images in the Diagnosis and Treatment Decisions for Occlusal Caries: An Ex Vivo Study

ABSTRACT Objective: To compare the agreement of images in white light (WL), fluorescence (FL), and digital radiographs (DR), on the diagnosis and treatment decisions for occlusal caries lesions against a micro-CT gold standard. Material and Methods: Ten extracted third molars, with enamel and/or dentin caries (ICDAS 2-4), were included. Occlusal surface images were acquired with an intraoral camera (SoproLife®) in WL and FL modes. DR was obtained using an intraoral X-ray and a semi-direct digital system. A total of 780 images were needed, organized in a template, to be later examined by twenty-six dentists invited to compose the study. The Generalized Estimation Equations model was used to compare the proportions of the correct answers between the three methods and the gold standard. When significant, Bonferroni post-hoc test was used to identify differences (α=5%). Results: Most of the examiners were specialists (76.9%) with 14.5 years of experience. All diagnostic methods were similar and showed low agreement (DR 12.7%, WL 16.5%, and FL 16.5%) compared with gold standard caries diagnostic scores. Regarding treatment decisions, mean agreement for all diagnostic methods was higher (43.2%; p<0.001), and among all methods, WL (48.1%) and FL (51.2%) modes performed better than DR (30.4%, p<0.001). Conclusion: SoproLife® images could help clinicians to propose rational, minimally invasive treatments for occlusal caries lesions.

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

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

Estudo comparativo dos efeitos de selantes hemostáticos no reparo ósseo de tíbia de ratos / Comparative study of the effects of hemostatic sealants in the repair of rat tibias

Objetivo: Verificar por meio de análise histológica os efeitos de agentes hemostáticos na reparação óssea, colocados em defeitos ósseos nas tíbias direita e esquerda de ratos jovens. Métodos: Foram utilizados 32 ratos machos (Holtzman). Após assepsia e anestesia, foi realizada incisão de 1cm em cada perna, expondo a região anterior da tíbia. Utilizando um micromotor e broca esférica, foram preparadas cavidades, expondo a medula óssea, as quais foram irrigadas com ácido épsilon-aminocapróico (EACA) ou preenchidas com gelatina absorvível Gelfoam. Nos períodos de sete, 14, 30, 45 dias, os animais foram sacrificados segundo o protocolo bioético, as tíbias removidas e fixadas em formol a 10% para inclusão em parafina e análise em microscopia de luz. Resultados: A análise dos cortes histológicos demonstrou que em todos os grupos (controle e tratados) os fenômenos biológicos da reparação óssea estiveram presentes, com diferença apenas na cronologia. As reações da reparação óssea confirmaram a biocompatibilidade dos materiais; o grupo tratado com Gelfoam apresentou discreta aceleração no processo de reparação tecidual em relação aos demais grupos, principalmente nos períodos de 14, 30 e 45 dias pós-cirurgia. O Gelfoam foi totalmente reabsorvido; a remoção dos agentes hemostáticos das lojas cirúrgicas acelera o processo de reparação tecidual. Conclusão: Em todos os grupos experimentais, a seqüência de fenômenos biológicos que compõem a reparação óssea esteve presente, havendo diferença na cronologia. As reações apresentadas no reparo ósseo confirmaram a biocompatibilidade dos materiais. A remoção total dos agentes hemostáticos nas lojas cirúrgicas acelera o processo de reparação tecidual...