ARE PIT AND FISSURE SEALANTS EFFECTIVE IN PREVENTING AND ARRESTING OCCLUSAL CARIES IN PRIMARY AND PERMANENT TEETH? AN OVERVIEW OF SYSTEMATIC REVIEWS.

OBJECTIVES: To compile the evidence from systematic reviews (SRs) about the use of sealants for preventing and arresting pit and fissure occlusal caries in primary and permanent teeth. MATERIALS AND METHODS: A search was performed in six databases and gray literature up to May 2023. Systematic reviews (SRs) that included randomized trials (RCTs) and nonrandomized clinical trials (n-RCTs) aiming to answer the PICO-based focused question "are pit and fissure sealants (I) more effective than other interventions, control or no treatment (C) in preventing and arresting occlusal caries (O) in primary and permanent teeth (P)?", were included. The methodological quality was assessed using the AMSTAR-2. The overlap between reviews was calculated (corrected covered, CCA). RESULTS: Among the 25 included SRs, 18 underwent meta-analysis. Eighteen SRs considered sealing enamel caries lesions, one considered sealing dentine caries, and six considered both. Seventeen SRs were devoted to preventive sealing (RCT only, n = 12; RCT and n-RCT, n = 5), while eight were devoted to prevention and arrest of dental caries (RCT only, n = 5; RCT and n-RCT, n = 3). Nine SRs showed positive results for the primary dentition, and the most frequent periods of follow-up were at least 6 (n = 5) and 12 months (n = 4). According to our meta-analysis, a significant association between resin-based sealants (RBS) and dental caries prevention was detected at 6 months (n = 1) and over longer follow-up periods (n = 4), and the DMFT and dmft indices decreased (n = 2). RBS was better than fluoride varnish at preventing dentine caries (n = 1). A lower caries incidence rate was observed in the resin-modified glass ionomer group at 6 months (n = 1). Overall, the sealants were superior (n = 11), similar (n = 21), or inferior (n = 1) to the other treatments. The AMSTAR-2 scores for studies on preventive sealing were critically low (n = 8), low (n = 6), moderate (n = 1) and high (n = 2) for studies on preventive sealing and critically low (n = 5), low (n = 2) and high (n = 1) for studies on the prevention and arrest of caries lesions. The overlap was low (CCA = 3%). CONCLUSION: This overview suggests that pit and fissure sealants are not inferior to other interventions in preventing and arresting dental caries lesions in primary and permanent teeth.

Are low serum levels of Vitamin D associated with dental developmental defects in primary teeth? A systematic review.

OBJECTIVE: To identify, qualify and synthesize all studies that assessed if low serum level of 25(OH)D (<50 nmol/L) is associated with dental developmental defects (DDD) in primary teeth. MATERIALS AND METHODS: Observational studies or clinical trials were included if measured 25(OH)D serum levels in pregnant women and/or in their children (up to 3 years old) and evaluated the occurrence of DDD in the primary dentition of offspring associated with the low 25(OH)D levels. Literature reviews, case reports, laboratory and/or animals' studies, conference abstracts, letters to the editor, book chapters and clinical protocols were excluded. Searches were carried out in 6 electronic databases and in the gray literature until March 2023, without restrictions. The study quality was assessed by the Newcastle-Ottawa Scale and the certainty of the evidence by GRADE. Data were descriptively synthesized considering the association between DDD and 25(OH)D levels. RESULTS: Seven studies were included. Only developmental enamel defects (DED) were observed after examination of 6651 children. The incidence of DED ranged from 8.9% to 66%. Six studies found no association between low levels of 25(OH)D and DED. However, one reported correlation between hypomineralization of the primary second molar (HSMD) and low levels of 25(OH)D at birth. Methodological flaws were observed in all studies and the certainty of the evidence was very low. CONCLUSION: Although HSMD was the only DDD associated with low levels of 25(OH)D in children, the available evidence is still not conclusive. More robust studies are needed to endorse the biological plausibility of DDD in primary teeth due to low serum levels of 25(OH)D in pregnant women or in their children. FAPERJ financed this study, which was registered in PROSPERO (CRD42022357511).

Salivary Metabolites in Patients with Mucopolysaccharidosis

ABSTRACT Objective: To identify the salivary metabolites profile of Mucopolysaccharidosis (MPS) types I, II, IV, and VI patients. Material and Methods: The participants were asked to refrain from eating and drinking for one hour before sampling, performed between 7:30 and 9:00 a.m. Samples were centrifuged at 10.000 × g for 60 min at 4°C, and the supernatants (500µl) were stored at −80°C until NMR analysis. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a 500 MHz spectrometer, and TOCSY experiments were used to confirm and assign metabolites. Data were analyzed descriptively. Results: Differences in salivary metabolites were found among MPS types and the control, such as lactate, propionate, alanine, and N-acetyl sugar. Understanding these metabolite changes may contribute to precision medicine and early detection of mucopolysaccharidosis and its monitoring. Conclusion: The composition of low molecular weight salivary metabolites of mucopolysaccharidosis subjects may present specific features compared to healthy controls.

Is There a Relationship between Laser Therapy and Root Canal Cracks Formation? A Systematic Review.

Introduction: Crack formation has become an important issue for endodontists, as it can be decisive for the long-term prognosis of the endodontically treated tooth. Since the applicability of laser in endodontics has become frequent, this systematic review aimed to evaluate the association between laser therapy and the formation of cracks in the dentinal structure of the root canal. Materials and Methods: A search was performed in PubMed, Scopus, Web of Science, and Virtual Health Library, as well as in the gray literature, on September 24, 2021. Studies that evaluated the formation of cracks in human root dentin due to different types of lasers were included. The risk of bias was assessed following the modified version of the Consolidated Standards of Reporting Trials (CONSORT) checklist tool. A meta-analysis was performed to evaluate (i) the total number of crack incidences; (ii) complete crack formation; (iii) incomplete crack formation; (iv) intra-dentinal crack formation between ultrasonic tips and laser use. The mean difference was calculated with a 95% confidence interval in a fixed-effect model, the heterogeneity was tested using the I2 index with level of significance of 5%. Results: Of the 22 studies included in this review, 15 have shown that lasers can form cracks in root dentin, including those that performed baseline assessment of samples. The meta-analysis confirmed no difference in crack formation between ultrasonic tips and laser devices. Conclusions: Laser therapy has been gaining prominence in endodontics and that irradiation can form and propagate cracks in the dentinal structure of the root canal assessed by in vitro studies. This is a critical concern for endodontists as it affects the strength and longevity of the tooth. Future research is encouraged to seek the standardization of good methodological practices and achieve establishing parameters to minimize harmful effects of laser on dentin.

Relationship between Malocclusion, Bullying, and Quality of Life in Students from Low Social Development Area: A Cross-Sectional Study

ABSTRACT Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one's oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life.

Oral manifestations arising from oral piercings: A systematic review and meta-analyses.

OBJECTIVE: The aim of this study was to perform a systematic review of oral manifestations arising from oral piercings. STUDY DESIGN: Literature was searched through January 2022 in PubMed, Scopus, Embase, Web of Science, Cochrane Library and Virtual Health Library, OpenGrey, and Google Scholar to address the question, "Is there an association between oral piercings and oral alterations, complications, or lesions?" Quality was assessed using the Joanna Briggs Institute appraisal tools. Meta-analyses were performed, and certainty of evidence was assessed through Grading of Recommendations Assessment, Development and Evaluation (GRADE). Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Fifty-four studies were included, with 15 achieving good methodological quality. Periodontal and tooth damage were the most reported, followed by soft tissue/mucosal injuries, speech disorders, chewing, soft plaque, and saliva. Pain was the most reported complication, followed by infection, swelling, bleeding, inflammation, allergy, and adornment aspiration. Meta-analyses revealed that 33% of participants with piercings had gingival recession (GR) (event rate [ER] = 0.329). In participants with piercings, ER values for nonspecified dental damage (NSDD), tooth chipping, wear/abrasion, and dental fracture (DF) were 27% (ER = 0.270), 22% (ER = 0.219), 34% (ER = 0.344), and 34% (ER = 0.338), respectively. Certainty of evidence was very low. CONCLUSIONS: Alterations, complications, and lesions were associated with oral piercings and adornments, of which GR, DF, and NSDD were the most prevalent.

Micro-CT evaluation of root canal preparation with rotary instrumentation on prototyped primary incisors.

This study aimed to evaluate the endodontic instrumentation outcomes with asymmetrical files compared to reciprocating and hand files (HFs) in 3D-printed prototypes of upper primary incisors using micro-computed tomography (micro-CT). For this purpose, 50 prototypes were randomly divided (n = 10) according to the instrumentation technique as follows: HFs, a reciprocating file (WaveOne® Gold [WOG]), and three asymmetrical movement files: XP-Endo® Shaper (XPS), XP-Endo® Finisher (XPF), and XP Clean (XPC). The specimens were scanned and, after registration of the baseline and instrumented volumes, changes in the root canal volume (RCV), debris accumulation, removed root material volume (RRMV), non-instrumented areas, and the presence of cracks/perforations were quantified. Data were analyzed by analysis of variance and Student's t-test, while the effect size was calculated for statistically significant outcomes. All groups showed an increase in RCV after instrumentation (p < 0.05), but this was higher with HFs (p < 0.05). Accumulated debris was higher for WOG and XPS (p < 0.05), but WOG exhibited more in the medium and apical third areas. HFs showed the highest RRMV (p < 0.05), especially at the apical third. The non-instrumented areas were lower for HFs and XPC than for the other systems (p < 0.05). Cracks were present in a few WOG (n = 2) and HF specimens (n = 3) and in this group, one of the cracked specimens and two others showed perforations. The asymmetric systems resulted in conservative dentin removal and fewer cracks/perforations as compared to HFs and a reciprocation file in prototyped primary upper incisors. XPC showed the best compromise between RRMV and non-instrumented areas with a low accumulation of debris.

Protocolo de pulpectomia para dentes decíduos: um guia clínico e prático baseado em evidências científicas / Pulpectomy protocol for primary teeth: a clinical and practical guide based on scientific evidence

O procedimento de pulpectomia em dentes decíduos consiste na remoção total do tecido pulpar com inflamação irreversível ou com necrose, preparo químicomecânico e obturação com material reabsorvível, com o intuito de manter o dente o maior tempo possível na cavidade bucal, devolvendo função e saúde para o paciente infantil. Existem vários protocolos descritos na literatura, no entanto, não há consenso entre eles e poucos possuem acesso livre. Sendo assim, observa-se carência de um guia clínico e prático para nortear o cirurgião-dentista na realização desse procedimento durante o atendimento odontopediátrico. Portanto, o intuito deste trabalho é apresentar aos clínicos um protocolo de pulpectomia com altas frequências de sucesso clínico e radiográfico, baseado em evidências científicas, desenvolvido e aplicado pelo Grupo de Pesquisa de Endodontia em Odontopediatria da Universidade Federal do Rio de Janeiro (GEDOPED-UFRJ). O presente protocolo contempla indicações, contraindicações, tática operatória, materiais necessários e orientações para acompanhamento. Com esta publicação de maneira gratuita, de acesso livre e no idioma dominante do país, espera-se ampliar o alcance de odontopediatras e clínicos gerais que atendem crianças a um tratamento eficaz.

Pulpectomy in primary teeth consists of the complete removal of the irreversibly affected pulp or necrotic pulp tissue, chemical-mechanical preparation of the root dentin and filling root canals with a resorbable material, to keep the tooth as long as possible in the oral cavity, restoring function and health. There are several pulpectomy protocols described in the literature, however, there is no consensus among them and only few of them are open access. Therefore, there is a lack of clinical and practical guides to the practitioner in performing this procedure during pediatric dental care. The aim of this article is to present a clinically and radiographically successful pulpectomy protocol, based on scientific evidence, developed, and applied by the Research Group on Endodontics in Pediatric Dentistry at the Universidade Federal do Rio de Janeiro. This protocol includes indications, contraindications, operative techniques, materials, and guidelines for follow-up appointments. With this open access publication in Portuguese, we hope to disseminate an effective treatment and expand the outreach of a pulpectomy technique protocol to pediatric dentists and clinicians who treat children.

Resin infiltration for approximal caries lesions in primary and permanent teeth: case reports

Introduction: Minimally invasive dentistry aims to preserve the tooth structure and to achieve this, improved dental materials can be used. Among these, Icon®was developed for infiltration of non-cavitated enamel carious lesions or those located in the external third of dentin. Objective: To report two clinical cases in which Icon® was used to treat interproximal caries lesions in primary and permanent teeth. Case report: Two patients (10 and 13 years) attended the Pediatric Dental Clinic and the clinical and radiographic examination revealed non-cavitated enamel carious lesions and outer third of dentin on teeth 54 distal (D) and 55 mesial (M) (Patient 1), and teeth 24D and 25M (Patient 2), respectively. To restore the lesions, a resin infiltrant (Icon®) was used under rubber dam isolationand according to the manufacturer's recommendations. Results: The patients were assessed immediately after restoration, when complete sealing of the lesion was observed. Patient 1 returned for clinical and radiographic evaluation after 3 months and patient 2 returned after one month, where arrest of the carious lesions was detected. Conclusion: It is concluded that Icon® can be a good option of minimally invasive restorative material, with good applicability in Pediatric Dentistry.

Introdução: A odontologia minimamente invasiva visa maior preservação da estrutura dentária e novos materiais odontológicos vêm sendo utilizados para este fim. Dentre esses, o Icon® foi desenvolvido para infiltração de lesões de cárie não cavitadas localizadas em esmalte e/ou no terço externo de dentina. Objetivo: Relatar dois casos clínicos em que se utilizou o Icon® para tratamento de lesões de cárie interproximais em dentes decíduos e permanentes. Relato do caso: Dois pacientes (10 e 13 anos) compareceram à clínica de Odontopediatriada FO-UFRJ e ao exame clínico e radiográfico foram diagnosticadas lesões cariosas não cavitadas no terço externo de dentina e no esmalte dentário, nos dentes 54 distal (D) e 55 mesial (M) (Paciente 1) e dentes 24D e 25M (Paciente 2), respectivamente. Para restauração das lesões, foi utilizado o infiltrante de resina Icon® sob isolamento absoluto e de acordo com as recomendações do fabricante. Resultados: Os pacientes foram avaliados imediatamente após a restauração e observou-se um completo selamento da lesão. O paciente 1 retornou para avaliação clínica e radiográfica após 3 meses e o paciente 2 após 1 mês. Em ambos foi detectada paralisação da lesão cariosa. Conclusão: Conclui-se que o Icon® representa uma boa opção de material restaurador minimamente invasivo e com boa aplicabilidade em Odontopediatria.

Cytocompatibility of filling pastes by primary teeth root simulating model.

Evaluate the cytocompatibility of Calen®/ZO, Calcicur®, Vitapex®, Endoflas®, and zinc oxide/eugenol-based (ZOE) root canal pastes (RCP) to human primary osteoblasts (HPO) through a simplified model for primary teeth. The model employed pipette tips filled with 0.037 g of paste, exposed to 185 µL of culture medium for 24 h (n = 6). Release of components was analysed by Proton Nuclear Magnetic Resonance Spectroscopy (1H-NMR). HPO were exposed to conditioned media for 24 h. Cell viability was assessed by cell density and metabolic activity, and release of interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast growth factor (bFGF) by immunological assay. Physicochemical properties and antimicrobial efficacy were also evaluated. 1H-NMR spectra analysis showed similarity between ZOE, Endoflas®, Calcicur®, and Vitapex® compared to Calen®/ZO and positive control, which showed distinct released components. Calen®/ZO and Calcicur® exhibited high alkaline pH in all periods and showed similar solubility. Calen®/ZO, ZOE, and Vitapex® showed similar flow rate. Calen®/ZO, Calcicur®, and Vitapex® did not exhibit antimicrobial efficacy. Calen®/ZO presented cytotoxicity (p < 0.05). Pastes did not increase IL-6 release compared to control. Apart from Vitapex®, all pastes significantly induced VEGF/bFGF release. Interactive effects among released products may affect biological response to filling pastes. Calcicur®, ZOE, Endoflas® and Calen®/ZO presented good to moderate cytocompatibility, with low impact on pro-inflammatory cytokine release and induction of growth factors of interest to tissue repair. This simplified model, specific for the evaluation of the cytocompatibility of RCPs on primary teeth, suggests how these pastes might contribute to bone repair in clinical situations of apical periodontitis in children.

Empreender para inovar: oportunidades para atuação na ciência / Entrepreneurship to innovate: opportunities for action in science

Empreender para inovar abre novas possibilidades de aplicação dos conhecimentos adquiridos na academia para o desenvolvimento econômico e social no país. Para isso, é importante que todos os atores do ecossistema relacionados com a Tríplice Hélice da Inovação se integrem para a criação de um ambiente de inovação com mecanismos que auxiliem e acelerem o desenvolvimento sustentável do Brasil. O presente comentário pretende divulgar políticas e iniciativas relevantes dos setores públicos e privados para sua interlocução com vistas a fomentar o empreendedorismo e a inovação; bem como contribuir para a ampliação do conhecimento acerca das oportunidades para a atuação de cientistas nesse contexto.

Entrepreneurship to innovate opens new possibilities for applying knowledge acquired in academia for economic and social development in the country. For this, it is important that all actors in the ecosystem related to the Triple Helix of Innovation integrate to create an innovation environment with mechanisms that help and accelerate the sustainable development of Brazil. This commentary intends to disseminate relevant policies and initiatives from the public and private sectors for their dialogue with a view to fostering entrepreneurship and innovation; as well as contributing to the expansion of knowledge about the opportunities for the work of scientists in this context.

Molar-incisor malformation: a narrative review

Introduction: "Molar-incisor malformation" (MIM) or "Molar root-incisor malformation" is a recently reported dental anomaly of unknown etiology, possibly associated with systemic complications, which affects the development of first permanent molar roots and dental enamel of central incisors. Objective: To conduct a literature review on "Molarincisor malformation", also known as "Molar root-incisor malformation", discussing its clinical, radiographic/tomographic and microscopic aspects; differential diagnosis and treatment possibilities. Sources of data: Electronic search was performed on the MEDLINE database in March 2021, without limit regarding the year of publication. The terms used were "molar-incisor malformation", "molar-root incisor malformation", "root malformation", "root development", "tooth roots", "abnormalities". Synthesis of data: Fifteen articles, most of them case series, were included. In general, medical historyrevealed clinical complications during pregnancy and / or the first years of life. Clinical features included tooth enamel defects in the cervical region of incisors and marked mobility of permanent molars and incisors. Radiographically, partially obliterated pulp chambers, short, thin and incomplete roots of first permanent molars and incisors, were observed. Microscopically, the occurrence of a hypercalcified dentin layer, in the form of a lens, inside the pulp chamber, at the level of the cementum-enamel junction, called"mineralized cervical diaphragm", was reported. Conclusion: "Molar-incisor malformation" is an anomaly characterized by changes in root development, pulp chamber and enamel in permanent molars and incisors. The differential diagnosis includes Dentin Dysplasia type I and Regional Odontodysplasia. Medical and familyhistories are essential for the final diagnosis, and treatment, which despite not having an established protocol, requires a multidisciplinary approach and conventional treatments such as tooth extraction, endodontics, orthodontics, and dental implants.

Introdução: "Malformação molar-incisivo" (MIM) ou "Malformação radicular molarincisivo" é uma anomalia dental recém-reportada de etiologia desconhecida, possivelmente associada a complicações sistêmicas, que afeta o desenvolvimento de raízes dos primeiros molares permanentes e esmalte dentário de incisivos centrais. Objetivo: Realizar uma revisão da literatura sobre "Malformação molar incisivo", também conhecida como "Malformação raiz-molar incisivo", discutindo seus aspectos clínicos, radiográficos/tomográficos, diagnóstico diferencial e possibilidades de tratamento. Fonte dos dados: Busca eletrônica foi realizada na base MEDLINE, em março de 2021, sem limite quanto ao ano de publicação. Os termos pesquisados foram "molarincisor malformation", "molar-root incisor malformation", "root malformation", "root development", "tooth roots", "abnormalities". Síntese dos dados: Quinze artigos, na maioria série de casos, foram incluídos. Em geral, a história médica revelou complicações clínicas durante a gestação e/ou primeiros anos de vida. As características clínicas incluíram defeitos de esmalte dentário na região cervical de incisivos e mobilidadeacentuada de molares e incisivos permanentes. Radiograficamente, observou-se a presença de câmaras pulpares parcialmente obliteradas, raízes de molares e incisivos permanentes curtas, finas e incompletas. Microscopicamente, reportou-se a ocorrência de camada de dentina hipercalcificada, em forma de lente, no interior da câmara pulpar, ao nível da junção cemento-esmalte, denominada de "diafragma cervical mineralizado". Conclusão: A "Malformação molar-incisivo" é uma anomalia caracterizada por alterações do desenvolvimento radicular, da câmara pulpar e do esmalte em molares e incisivos permanentes. O diagnóstico diferencial inclui Displasia dentinária tipo I e Odontodisplasia regional. Históricos médico e familiar são essenciais para o diagnóstico final, e o tratamento, o qual apesar de não ter protocolo estabelecido requer abordagem multidisciplinar e tratamentos convencionais como exodontia, endodontia, ortodontia e implantes dentários.

Antimicrobial activity of antibiotic pastes used in pulp therapy through direct contact with a multispecies biofilm: a pilot study

Objective: To evaluate the antimicrobial activity of antibiotic pastes used in lesion sterilization and tissue repair (LSTR) technique, through a novel membrane direct contact methodology against a multispecies biofilm and to establish appropriate dilutions for this method. Methods: CTZ (chloramphenicol, tetracycline, zinc oxide) and two formulations of 3Mix pastes (ciprofloxacin, metronidazole, and minocycline), 3Mix1 and 3Mix3, were evaluated with negative (0.9% saline) and positive (chlorhexidine 0.2%) control groups. Candida albicans and Enterococcus faecalis (24-hour) biofilms (n=10) grown on cellulose membranes were directly exposed to standardized amounts of fresh pastes and control solutions (n=2) for 24h. Membranes were immersed in 900 µl of saline solution, and seven serial dilutions were made for each sample. Plating for each dilution (n=2) was performed on culture media for microbial colony-forming unit (CFU) counting of total microorganisms, Candida spp. and Enterococcus spp. Aiming the comparison between groups, CFU quantification data were transformed into log10 CFU / mL and the Mann-Whitney test was applied (p<0.05). Results: Inhibition of CFU was observed for all pastes, with greatest effects for CTZ paste in medium selective for Candida spp. (p<0.001) and 3Mix1 in non-selective (p<0.000) and selective for Enterococcus spp. (p<0.004). Conclusion: The pastes showed antimicrobial activity against the tested multispecies biofilm, and the proposed direct contact methodology was efficient. Moreover, the dilutions used proved to be appropriate for this methodology.

Objetivo: Avaliar a atividade antimicrobiana de pastas antibióticas utilizadas na técnica Lesion Sterilization and Tissue Repair (LSTR), através de nova metodologia de contato direto com membrana contra um biofilme multiespécies e estabelecer diluições adequadas para avaliação. Métodos: CTZ (cloranfenicol, tetraciclina,óxido de zinco) e duas formulações de pastas 3Mix (Ciprofloxacina, Metronidazol e Minociclina), 3Mix1 e 3Mix3, foram avaliadas, além dos grupos controle, negativo (solução salina a 0,9%) e positivo (clorexidina 0,2%). Biofilmes de Candida albicans e Enterococcus faecalis cultivados sobre membranas de celulose (n=10) durante24 h foram expostos diretamente em contato com quantidades padronizadas de pastas frescas e controles (n = 2) por 24 h. As membranas foram imersas em 900µL de solução salina e sete diluições seriadas foram obtidas por amostra. O plaqueamento para cada diluição (n = 2) foi realizado em meios de cultura para microrganismos totais e seletivos para Candida spp. e Enterococcus spp. para contagem de unidades formadoras de colônias (UFC). Para comparação entre grupos, os dados da contagem de UFC foram convertidos em log10 UFC / mL e o teste Mann-Whitney foi aplicado (p<0,05). Resultados: Observou-se inibição de UFC para todas as pastas, maior para CTZ no meio seletivo para Candida (p<0,001)e 3Mix1 nos demais meios (p<0,004). Conclusão: Concluiu-se que as pastas apresentaram atividade antimicrobiana contra o biofilme multiespécies testado e que a nova metodologia de contato direto proposta foi eficiente. Além disso, as diluições utilizadas mostraram-se adequadas para essa metodologia.

Is there a relationship between malocclusion and bullying? A systematic review.

BACKGROUND: Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social perceptions. However, its association with bullying is still controversial. OBJECTIVES: To evaluate the relationship between malocclusion and bullying in children and adolescents. SEARCH METHODS: The databases used for the electronic researches were PubMed, Scopus, Lilacs/BBO, Web of Science, and Cochrane Library. Grey literature was reviewed through Open Grey literature with no language or date restrictions. Selection criteria, based on the PECO strategy, were considered eligible observational studies that included schoolchildren or adolescents (P) with malocclusion (E), compared to those with normal occlusion (C), in which the relationship between malocclusion and bullying was determined (O). DATA COLLECTION AND ANALYSIS: Risk of bias evaluation was made for the qualitative synthesis by the Fowkes and Fulton criteria. Data regarding the age of participants and types of malocclusion and of bullying were extracted among other reported data. The quality of the evidence analyzed was evaluated through the GRADE approach. RESULTS: From 2744 articles identified in databases, nine met the eligibility criteria and were included in present systematic review, of which two studies were judged with methodological soundness. The quality of the evidence was classified as very low due to very serious problems for "risk of bias" and "other considerations" and serious problems of "indirectness". The age of participants ranged from 9 to 34 years considering a cohort study, with a bullying recalling perspective. Malocclusion was both evaluated by researchers and self-reported by participants addressing dentofacial characteristics mostly related to the incisors relationship. All studies evaluated the verbal type of bullying, while 3 also considered physical type. Both types were reported as related to malocclusion, although the results showed that extreme maxillary overjet (> 4 mm, > 6 mm, > 9 mm), extreme deep overbite, and having space between anterior teeth or missing teeth were the types of malocclusion with the strongest relations to bullying. CONCLUSIONS: With very low certainty of evidence, the results of this systematic review suggest that conspicuous extreme malocclusion may be related to the occurrence of bullying among children and adolescents.

Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses.

OBJECTIVE: To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth. MATERIALS AND METHODS: Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE. RESULTS: Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6 months (RR = 0.99, 95% CI, 0.94-1.04, p = 0.67; I2 = 0%), 12 months (RR = 0.97, 95% CI, 0.90-1.04, p = 0.34; I2 = 0%), and 18 months (RR = 0.89, 95% CI, 0.77-1.04, p = 0.14; I2 = 0%) and radiographic findings at 6 months (RR = 0.91, 95% CI, 0.78-1.06, p = 0.23; I2 = 9%), 12 months (RR = 0.87, 95% CI, 0.65-1.18, p = 0.38; I2 = 64%), and 18 months (RR = 0.84, 95% CI, 0.69-1.02, p = 0.08; I2 = 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low. CONCLUSIONS: No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low. CLINICAL RELEVANCE: The present meta-analyses could not demonstrate the superiority of one treatment over the other.

CONTROLE DO BRUXISMO DO SONO NA INFÂNCIA: REVISÃO DE LITERATURA / CONTROL OF SLEEPING BRUXISM IN CHILDHOOD: LITERATURE REVIEW

O bruxismo em crianças tem se tornado uma preocupação crescente nos últimos anos. É definido como uma atividade involuntária dos músculos mastigatórios caracterizada por apertar ou ranger os dentes e pode ser de dois tipos, do sono (BS) ou da vigília (BV). A prevalência do BS na população infantil varia de 5,9% a 49,6%.Fatores funcionais, estruturais e psicológicos podem estar envolvidos com a presença do bruxismo. O diagnóstico é feito por meio de questionários, exame clínico e exame de polissonografia, que é o padrão ouro. Por ser uma desordem de origem central e não periférica, o BS não tem cura. Logo, faz-se o controle, que abrange prevenção, abordagem e gerenciamento de consequências. Atualmente, são citadas na literatura inúmeras técnicas de manejo para oBS. Este trabalho tem o objetivo de revisar a literatura atual referente ao controle do BS em crianças e confeccionar uma cartilha informativa direcionada aos pais, expondo os benefícios da higiene do sono como controle basal do BS. Conclui-se que a higiene do sono, apesar de baixa evidência científica, é considerada a primeira linha de abordagem para o bruxismo do sono infantil.

Children bruxism has become a growing worry in the last years. It is defined as an involuntary activity of masticatory muscles characterized by tightening or gritting the teeth and can be of two types, sleep (SB) or wake (WB). The prevalence of SB in infant population varies from 5,9% to 49,6%. Functional, structural and psychological factors may be involved in the presence of bruxism. The diagnosis is made through questionnaires, clinical examination and polysomnography, which is the gold standard. Because it is a central and non-peripheral origin disorder, SB has no cure. Therefore, control is made, which includes prevention, approach and consequence management. Currently, numerous management techniques for SB are cited in the literature. This work aims to review the current literature regarding the control of SB in children and to make an informative booklet directed to parents, exposing the benefits of sleep hygiene as basal control of BS. It is concluded that sleep hygiene, despite low scientific evidence, is considered the first line of approach for children sleep bruxism.

Impact of oral health on the quality of life and personal satisfaction of adolescents from urban and rural areas from a city in brazil: a cross-sectional study

Objective: Evaluate the impact of oral health status on the quality of life and personal satisfaction among adolescents from urban and rural areas, in Nova Friburgo, Brazil. Methods: Adolescents between 11 and 14 years, enrolled in the schools participating in the Health in School Program (HSP) of rural and urban of this city (n = 509), received the consent form for the participation in this study, along with the economic questionnaire to be handed to the responsible. Adolescent´s oral health status was evaluated clinically, through the Decayed, Missing and Filled Teeth (DMFT); pulpal involvement, ulceration, fistula and abscess criteria (PUFA); and Dental Treatment Needs Index (DTNI). The quality of life was measured through the Child Perception Questionnaire (CPQ11-14), while personal satisfaction´s evaluation, through the Subjective Happiness Scale (SHS), both as interview. Statistical tests were performed (Chi-Square; Fisher's exact; Mann-Whitney) with level of significance of 5%. Results: The final sample comprised 161 adolescents. The impact of oral health status on the quality of life of adolescents from both areas was not significantly different, although the aggravation of the oral condition showed a tendency to worse the quality of life. Similarly, there was no relation of the oral status with personal satisfaction, without differences between the groups. It was observed that rural adolescents presented better quality of life (p<0.010), while the urban ones had higher degree of personal satisfaction (p<0.001). Conclusion: Oral health status had a negative impact on the quality of life, but had no relation to personal satisfaction, regardless of the demographic area.

Objetivo: Avaliar o impacto do estado de saúde bucal na qualidade de vida e na satisfação pessoal de adolescentes das áreas urbana e rural de Nova Friburgo, Brasil. Métodos: Adolescentes entre 11 e 14 anos, matriculados nas escolas participantes do Programa Saúde na Escola (PSE) da zona rural e urbana desta cidade (n = 509), receberam o Termo de Consentimento Livre e Esclarecido para a participação neste estudo,juntamente ao questionário econômico a ser entregue para o responsável. O estado de saúde bucal do adolescente foi avaliado clinicamente, por meio dos índices Cariados, Perdidos e Obturados (CPOD); critérios de envolvimento pulpar, ulceração, fístula e abscesso (PUFA); e Índice de Necessidades de Tratamento Odontológico (INTO). A qualidade de vida foi mensurada por meio do Child Perception Questionnaire (CPQ11- 14), enquanto a avaliação da satisfação pessoal, por meio da Subjective Happiness Scale (SHS), ambos na forma de entrevista. Foram realizados testes estatísticos (Qui-Quadrado; Exato de Fisher; Mann-Whitney) com nível de significância de 5%. Resultados: A amostra final foi de 161 adolescentes. O impacto do estado de saúde bucal na qualidade de vida dos adolescentes de ambas as áreas não foi significativamente diferente, embora o agravamento da condição bucal tenha apresentado tendência a piorar a qualidade de vida. Da mesma forma, não houve relação da condição oral com a satisfação pessoal, sem diferenças entre os grupos. Observou-se que os adolescentes rurais apresentaram melhor qualidade de vida (p<0,010), enquanto os urbanos apresentaram maior grau de satisfação pessoal (p<0,001). Conclusão: O estado de saúde bucal teve impacto negativo na qualidade de vida, mas não teve relação com a satisfação pessoal, independente da área demográfica.

Root canal obturation materials and filling techniques for primary teeth: In vitro evaluation in polymer-based prototyped incisors.

BACKGROUND: Achieving a void-free root canal filling is a challenge in current clinical pulpectomy practice. AIM: To compare filling effectiveness and internal voids of root filling materials and obturation techniques in resin-prototyped primary incisors by micro-CT. DESIGN: Fifty prototypes were instrumented and randomly divided (n = 10) according to the filling materials (Vitapex® , ZOE, Calcicur® , Feapex, and Calen® -ZO) and obturation technique: lentulo or pressure syringe (n = 5). The specimens were micro-CT scanned (pixel size = 7.83 µm) and reconstructed, and the total volume of filled canal (%FC) and internal voids (%IV) of the bulk filling material was calculated. Kruskal-Wallis and Mann-Whitney tests were used to detect differences and interactions among groups. RESULTS: Calen® -ZO, Vitapex® , and ZOE showed similar %FC. Calcicur® showed lower %FC compared with Calen® -ZO, Vitapex® , and ZOE (P < .05) but similar to Feapex. No statistically significant differences in %FC between lentulo or pressure syringe were disclosed. Regarding %IV, Vitapex® , and Calen® -ZO performed better with syringe, although Calcicur® was better with lentulo. The number of voids in the obturation bulk was similar among materials, but always lower (P < .05) in syringe filled specimens. CONCLUSION: Vitapex® , Calen® -ZO, and ZOE outperformed Calcicur® and Feapex in %FC and if the syringe technique is used, %IV of the obturation bulk and presence of defects was lower.

Reliability of Two Methods of Evaluation of the Apical Limit of Obturation of Root Canals of Primary Teeth: A Pilot Study

Abstract Objective: To verify the concordance in the evaluation of the apical limit of obturation (ALO) in filled root canals of primary teeth between digital and visual methods. Material and Methods: Twenty periapical radiographs of endodontically treated primary teeth were digitalized and evaluated by an endodontics specialist (E1), a PhD pediatric dentist (E2), and a MSc general dentist (E3). Calibrated evaluators (Kappa = 1.00) analysed the images in a light-isolated environment two times (D1 and D2) with a one-week interval between evaluations. ALO scores were categorized as overfilled, flush-filled and underfilled. Results: The intra-rater reliability between methods was 0.82 (D1) and 0.75 (D2) for E1, 0.93 (D1 and D2) for E2, and 0.94 (D1 and D2) for E3. Inter-rater reliability ranged from 0.71 (E1 × E3) and 1.00 (E1 × E2) for the visual method to 0.76 (E1 × E3) and 0.88 (E1 × E2) for the digital method. Spearman correlation coefficients showed a similar ranking among the evaluators. There was greater disagreement among the underfilled and ideal scores. For all evaluators, the digital method favoured the identification of the ideal score. Conclusion: Both methods are suitable for the determination of the ALO of filled primary teeth and can be used in clinical practice.

Iodoform Vs Calcium Hydroxide/Zinc Oxide based pastes: 12-month findings of a Randomized Controlled Trial.

This study evaluated clinical and radiographic twelve-month outcomes of root canal treatments (CT) with smear layer removal, performed in primary teeth, using two different root canal filling materials. Pulpectomy was performed on 27 primary teeth with necrosis or irreversible pulpitis, caused by dental caries or trauma, in 23 children (2-7 years old). A single trained operator performed the CT in a single visit in cases without periapical or interradicular radiolucency (PIR) or in multiple visits in cases with PIR. Participants were selected based on specific inclusion and exclusion criteria, and randomly allocated into two groups: Group 1 (G1) - iodoform paste (iodoform + camphorated parachlorophenol + ointment comprising prednisolone acetate 5.0 mg and rifamycin 1.5 mg); Group 2 (G2) - Calen®/ZO paste. Treated teeth were restored with composite resin immediately after the root canal filling. The outcomes were evaluated clinically and radiographically according to specific criteria. Two blinded and standardized evaluators assessed the radiographic outcomes. We used descriptive analyses due to the small sample size. CTs were performed due to caries lesions in 70.4% of the cases and due to trauma in 29.6%. Only one tooth of G1 was unsuccessful; hence, pulpectomy performance in both groups was not influenced by the filling material, nor by any other analyzed variable. The level of the root canal filling was better in the Calen®/ZO group. The clinical and radiographic twelve-month outcomes indicated successful treatment, independently of the root filling material used.