What Are the Effects on Palate of Early Lip Surgery in Children With Cleft Lip and Palate? Cross-Sectional Evaluation From 5-Year-Old.

This study aimed to evaluate the postsurgical effects from 5 years on the palate after surgical repair of the lip at 3 or 9 months of age in children with cleft lip and palate. Eighty-four digitized dental impressions were divided into the following groups: group 1 (G1): lip surgery at 3 months of life; group 2 (G2): lip surgery at 9 months of life; group 3 (G3): without orofacial cleft. Five angular (C'IC, ICM, IC'M', CMM', and C'M'M) and 3 linear parameters (C-C', c-c', and M-M') were evaluated. Statistical analysis was applied with α=5%. Intraclass Correlation Coefficient was significantly smaller in G1 than in G3 ( P =0.005), while IC'M' was significantly smaller in G3 than in G1 ( P <0.001). C'M'M was significantly smaller in G1 than in G2 and G3 ( P <0.001). The distances C-C' and c-c' were significantly smaller in G1 than in G2 and G3 ( P <0.001). There was a statistically significant difference in both G1 and G2 ( P <0.001, in all) in the analysis of palatal symmetry. Linear regression analysis showed that the, 11.2% of outcomes determined by c-c' distance can be explained by the age of lip repair ( P =0.013). In conclusion, lip surgery at 3 months of life showed a tendency toward more restriction in 5-year postsurgery palate development. The age of cheiloplasty is one of the factors that can influence palatal development; however, other factors may be associated and should be studied.

Sensitivity Treatments for Teeth with Molar Incisor Hypomineralization: Protocol for a Randomized Controlled Trial.

BACKGROUND: The sensitivity of teeth with molar incisor hypomineralization (MIH) can affect children's quality of life and is a challenging problem for dentists. Remineralizing agents such as sodium fluoride varnish seem to reduce the sensitivity of teeth with MIH, but long-term clinical trials with large samples are still needed for more evidence about its effectiveness as a desensitizing agent before its clinical recommendation. OBJECTIVE: This randomized clinical trial aims to compare three treatment interventions for teeth with MIH and hypersensitivity. METHODS: A total of 60 children aged 6-10 years presenting with at least one first permanent molar with sensitivity and no loss of enamel will be randomly assigned to three groups: the control group (sodium fluoride varnish; Duraphat, Colgate); experimental group I (4% titanium tetrafluoride varnish); and experimental group II (a coating resin containing surface prereacted glass-ionomer filler; PRG Barrier Coat, Shofu). The sodium fluoride varnish and 4% titanium tetrafluoride varnish will be applied once per week for 4 consecutive weeks and the PRG Barrier Coat resin will be applied in the first session and the application will be simulated the following 3 weeks to guarantee the blinding of the study. The primary outcome will be sensitivity level measured at different moments (before each material application, immediately after application or simulation, and 1, 2, 4, and 6 months after the last application/simulation) by one examiner using the Wong-Baker FACES Pain Rating Scale, the Schiff Cold Air Sensitivity Scale, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale. As secondary outcomes, parental satisfaction and child self-reported discomfort after the treatment will be measured with a questionnaire prepared by the researcher. The data will undergo statistical analysis and the significance level will be set at 5%. RESULTS: The project was funded in 2018, and enrollment was completed in November 2019. The recruitment of participants is currently underway and the first results are expected to be submitted for publication in 2022. CONCLUSIONS: If found effective in reducing the patient's sensitivity long term, these agents can be considered as a treatment choice, and the findings will contribute to the development of a treatment protocol for teeth with sensitivity due to MIH. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials Universal Trial Number U1111-1237-6720; https://tinyurl.com/mr4x82k9. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27843.

Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood.

AIM: This study aimed to clarify whether dental plaque disclosing before professional prophylaxis would improve the visualization of dental plaque, therefore optimizing the procedure. MATERIALS AND METHODS: The sample comprised both the smooth and occlusal surfaces of the teeth of 25 children from 18 to 36 months. A randomized crossover clinical trial was conducted with two groups: GI-with disclosing and GII-without disclosing (washout/1 month). The teeth were stained with 1% malachite green solution to assess the amount of dental plaque on smooth and occlusal surfaces. RESULTS: Dental plaque removal was more effective and statistically faster (391.27 seconds ±142.2) in GI. The plaque index and the prophylaxis duration were inversely related in GI. The child's behavior did not affect the plaque removal effectiveness, regardless of plaque disclosure (p > 0.05). CONCLUSION: Dental plaque disclosing in young children is an effective and less time-consuming method that improves the quality of the professional dental prophylaxis. CLINICAL SIGNIFICANCE: Biofilm control is important for the success of programs for prevention of early childhood caries (ECC) and considering the particularities inherent to the dental care of infants, it is necessary that periodic professional prophylaxis is effective in eliminating the oral biofilm, ideally reducing chair time. Although dental plaque disclosing has been traditionally performed on educational basis during oral hygiene instruction, this resource can be safely employed to help professional prophylaxis in infants. HOW TO CITE THIS ARTICLE: de Alencar CRB, de Oliveira GC, et al. Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood. Int J Clin Pediatr Dent 2019;12(3):189-193.

Novel rare variations in IRF6 in subjects with non-syndromic cleft lip and palate and dental agenesis.

OBJECTIVE: Subjects with cleft lip and palate (CLP) present high prevalence of dental agenesis. Among candidate genes for these phenotypes is IRF6. However, genetic studies do not analyze dental agenesis as a phenotype associated with cleft. Therefore, we investigated the frequency of rare and novel variations in IRF6 in subjects with non-syndromic unilateral cleft lip and palate (NSUCLP), with and without dental agenesis. SUBJECTS AND METHODS: Genomic DNA samples of 100 subjects with NSUCLP with and without dental agenesis and 50 controls were sequenced. IRF6 mutational screening was conducted by direct sequencing. RESULTS: Ten new and rare missense variations were identified, two in the group cleft with agenesis and eight in the group cleft without agenesis, and none were found in control group. In silico analysis revealed four variations as potentially deleterious, being two in the group with cleft and agenesis and two in the group with cleft without agenesis. CONCLUSION: The study identified novel IFR6 variations in subjects with NSUCLP with or without associated dental agenesis. The hypothesis of a higher frequency of deleterious variations in the subjects with cleft associated with dental agenesis, when compared to the group of cleft without agenesis and control without cleft, was not supported.

The Brazilian version of the 20-item rapid estimate of adult literacy in medicine and dentistry.

BACKGROUND: The misunderstanding of specific vocabulary may hamper the patient-health provider communication. The 20-item Rapid Estimate Adult Literacy in Medicine and Dentistry (REALMD-20) was constructed to screen patients by their ability in reading medical/dental terminologies in a simple and rapid way. This study aimed to perform the cross-cultural adaptation and validation of this instrument for its application in Brazilian dental patients. METHODS: The cross-cultural adaptation was performed through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. After that, 200 participants responded the adapted version of the REALMD-20, the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), ten questions of the Brazilian National Functional Literacy Index (BNFLI), and a questionnaire with socio-demographic and oral health-related questions. Statistical analysis was conducted to assess the reliability and validity of the REALMD-20 (P < 0.05). RESULTS: The sample was composed predominantly by women (55.5%) and white/brown (76%) individuals, with an average age of 39.02 years old (±15.28). The average REALMD-20 score was 17.48 (±2.59, range 8-20). It displayed a good internal consistency (Cronbach's alpha = 0.789) and test-retest reliability (ICC = 0.73; 95% CI [0.66 - 0.79]). In the exploratory factor analysis, six factors were extracted according to Kaiser's criterion. The factor I (eigenvalue = 4.53) comprised four terms- "Jaundice", "Amalgam", "Periodontitis" and "Abscess"-accounted for 25.18% of total variance, while the factor II (eigenvalue = 1.88) comprised other four terms-"Gingivitis", "Instruction", "Osteoporosis" and "Constipation"-accounted for 10.46% of total variance. The first four factors accounted for 52.1% of total variance. The REALMD-20 was positively correlated with the BREALD-30 (Rs = 0.73, P < 0.001) and BNFLI (Rs = 0.60, P < 0.001). The scores were significantly higher among health professionals, more educated people, and individuals who reported good/excellent oral health conditions, and who sought preventive dental services. Distinctly, REALMD-20 scores were similar between both participants who visited a dentist <1 year ago and ≥1 year. Also, REALMD-20 was a significant predictor of self-reported oral health status in a multivariate logistic regression model, considering socio-demographic and oral health-related confounding variables. CONCLUSION: The Brazilian version of the REALMD-20 demonstrated adequate psychometric properties for screening dental patients in relation to their recognition of health specific terms. This instrument can contribute to identify individuals with important dental/medical vocabulary limitations in order to improve the health education and outcomes in a person-centered care model.

Immunolocalization of dentin matrix protein-1 in human primary teeth treated with different pulp capping materials.

The aim of this study was to evaluate the immunolocalization of dentin matrix protein (DMP)-1 in human primary teeth treated with different pulp capping materials. Twenty-five primary molars were divided into the following groups: formocresol (FC), calcium hydroxide (CH), mineral trioxide aggregate (MTA), corticosteroid/antibiotic solution + CH (O + CH), and Portland cement (PC), and all received conventional pulpotomy treatment. The teeth at the regular exfoliation period were extracted for histological analysis and immunolocalization of DMP-1. Statistical analysis was performed using the χ(2) test (p < 0.05). Histological analysis revealed statistically significant differences in the comparison among the groups through the use of a score system regarding the presence of hard tissue barrier, odontoblastic layer, and internal resorption, but not regarding pulp calcification. Immunohistochemical analysis showed immunostaining for DMP-1 in groups CH, MTA, O + CH, and PC. Internal resorption was observed in the groups FC and CH. MTA and PC showed pulp repair without inflammation and with the presence of hard tissue barrier. DMP-1 immunostaining was higher for MTA and PC, confirming the reparative and bioinductive capacity of these materials.

Automedicação em acadêmicos do curso de medicina / Self-medication in academics from medical school

Objetivo: Avaliar a automedicação em estudantes do curso de Medicina da Universidade de RibeirãoPreto (UNAERP) no ano de 2008. Métodos: Estudo transversal quantitativo, realizado no ano de 2008, no qual 200 alunos do curso de Medicina da UNAERP responderam a um questionário autoaplicado, contendo questões de múltipla escolha sobre a prática da automedicação, no intuito de conhecer aspectos do consumo de medicamentos. Para análise estatística foi empregado o teste de correlação de Pearson. Considerou-se como base o intervalo de confiança de 95%. O estudo foi aprovado pelo Comitê de Ética da UNAERP. Resultados: Observaram-se 58,5% de participantes do sexo feminino. A média de idade foi de 21,5 anos. A prevalência da automedicação foi de 92,0%. As prevalências entre os alunos das diferentes etapas do curso não foram significativamente diferentes: 86,6%, 90,0%, 93,3%,94,4% e 97,1%, respectivamente, entre os alunos do 1º ao 4º ano e internato. A aquisição de medicamentos controlados, sem apresentação da prescrição, ocorreu entre 6,5% dos alunos e 69,5% responderam já terem indicado medicamentos para outras pessoas...

Objective: Evaluate the self-medication by students of University of Medicine of Ribeirão Preto (UNAERP) in 2008. Methods: A quantitative cross-sectional study conducted throughout 2008 in with 200 medicine students, who answered a self-administered questionnaire containing multiple choice questions regarding self-medication and consumption of medicines. Statistical analysis was employed to test Pearson correlation. The confidence interval considered was of 95%. The study was approved by UNAERP Ethics Committee. Results: There were 58.5% of female participants. The age average was 21.5 years old. The prevalence of self-medication was 92.0%. The prevalence among students from different stages of the course was not significantly different: 86.6%, 90.0%, 93.3%, 94.4% and 97.1%, among the students from, respectively, the 1st to 4th year and from the internship...

Reconstruction of bony facial contour deficiencies with polymethylmethacrylate implants: case report.

Facial trauma can be considered one of the most serious aggressions found in the medical centers due to the emotional consequences and the possibility of deformity. In craniofacial surgery, the use of autologous bone is still the first choice for reconstructing bony defects or irregularities. When there is a shortage of donor bone or a patient refuses an intracranial operation, alloplastic materials such as polymethylmethacrylate (PMMA) can be used. The PMMA prosthesis can be pre-fabricated, bringing advantages such as reduction of surgical time, easy technical handling and good esthetic results. This paper describes the procedures for rehabilitating a patient with PMMA implants in the region of the face, recovering the facial contours and esthetics of the patient.

Reconstruction of bony facial contour deficiencies with polymethylmethacrylate implants: case report

Facial trauma can be considered one of the most serious aggressions found in the medical centers due to the emotional consequences and the possibility of deformity. In craniofacial surgery, the use of autologous bone is still the first choice for reconstructing bony defects or irregularities. When there is a shortage of donor bone or a patient refuses an intracranial operation, alloplastic materials such as polymethylmethacrylate (PMMA) can be used. The PMMA prosthesis can be pre-fabricated, bringing advantages such as reduction of surgical time, easy technical handling and good esthetic results. This paper describes the procedures for rehabilitating a patient with PMMA implants in the region of the face, recovering the facial contours and esthetics of the patient.

Uso de restaurações indiretas na correção da infra-oclusão: relato de caso / Use of indirect restorative technique for the correction of retained primary molar: case report

A infraoclusão de molares decíduos é uma situação clínica que pode causar prejuízos ao desenvolvimento da oclusão do paciente, mas com o desenvolvimento das técnicas e materiais odontológicos nos últimos anos, esse quadro clínico pode ser solucionado através de uma terapia mais conservadora. Este trabalho tem como objetivo apresentar a reabilitação de um dente em infraoclusão através da utilização de uma restauração indireta em resina composta. Esta técnica permite restabelecer as dimensões anatômicas, o equilíbrio oclusal e a estética da criança. Ao final pôde-se concluir que as restaurações indiretas em resina são uma boa opção de tratamento conservador para os casos de infraoclusão na dentição decídua.

Infraoccluded primary molars is a common clinical situation that can cause several damages for the development of occlusion, but with today?s development of the techniques and dental materials these clinical situation has several ways to be resolved, returning the oclusal balance for the patient. This article had as aim present a clinical report of a rehabilitation of an infraoccluded primary molar with the use of an indirect restoration in composite resin, designed to restore the anatomical size, the occlusion and esthetics of the child. At the end we can conclude that this technique presents several advantages, especially in Pediatric Dentistry.

Comparative study between homeopathy and nimesulide on the prevention of bone resorption in experimental periodontitis in rats / Estudo Comparativo entre Homeopatia e Nimesulida na Prevenção da Reabsorção Óssea em Periodontite Experimental em Ratos

Periodontitis is a chronic disease characterized by bone loss and inflammatory changes. We studied the effect of a homeopathic agent (Mercúrios Corrosivos 6 CH) and a non-steroidal anti-inflammatory drug (nimesulide) on the alveolar bone loss progression in experimentally induced periodontitis in rats. Sixty (60) Wistar rats were separated into group 1 (homeopathy), group 2 (nimesulide) and group 3 (saline solution). Silk ligatures were placed at the gingival margin level of the lower right first molar of all rats. Alveolar bone loss was evaluated by light microscopic analysis and analyzed using software Image J. The results were submitted to the analysis of variance (ANOVA) and Tukey’s posttest (p<0.05). The analysis revealed that there was a higher bone loss in diseased sites as compared with healthy sites. A significant reduction in the alveolar bone resorption was observed in group 2 (nimesulide) as compared with group 1 (homeopathy) 7 days after the induction of periodontitis. Our data provided evidence that homeopathy does not decrease alveolar bone loss as opposed to nimesulide in experimentally induced periodontitis.

In vivo effects on the expression of vascular endothelial growth factor-A165 messenger ribonucleic acid of an infrared diode laser associated or not with a visible red diode laser.

OBJECTIVE: This study investigated and correlated the kinetic expression of vascular endothelial growth factor (VEGF)-A(165) messenger ribonucleic acid (mRNA) with the associated use or not of an infrared laser and a visible red laser during the wound healing in rats. BACKGROUND DATA: There is a lack of scientific evidence demonstrating the influence of low-level laser therapy (LLLT) on the expression of VEGF mRNA in vivo. MATERIALS AND METHODS: Forty-five Wistar rats were randomly allocated to one of three groups: I (n = 5, nonoperated animals), II (n = 25, operated animals), and III (n = 25, animals operated and subjected to laser irradiation). A surgical wound was performed using a scalpel in the right side of the tongue of operated animals. In group III, two sessions of laser irradiation were performed, one right after the surgical procedure (infrared laser, 780 nm, 70 mW, 35 J/cm(2)) and the other 48 h later (visible red laser, 660 nm, 40 mW, 5 J/cm(2)). Five animals each were sacrificed 1, 3, 5, and 7 days postoperatively in groups II and III, and samples of tongue tissue were obtained. The animals of group I were sacrificed on day 7. Total RNA was extracted using guanidine-isothiocyanate-phenol-chloroform method. The results of horizontal electrophoresis after reverse transcription polymerase chain reaction permitted the ratio of VEGF-A(165) mRNA and glyceraldehyde 3-phosphate dehydrogenase mRNA expression for groups I, II, and III to be assessed (two-way analysis of variance and Tukey test, p < 0.05). RESULTS: The expression of VEGF-A(165) mRNA in group II (0.770 +/- 0.098) was statistically greater than that observed in groups I (0.523 +/- 0.164) and III (0.504 +/- 0.069) in the first day after surgery (p < 0.05). Significant differences between the groups were not observed in other time periods. CONCLUSION: LLLT influenced the expression of VEGF-A(165) mRNA during wound healing after a surgical procedure on the tongue of Wistar rats.

Knowledge and attitude of parents or caretakers regarding transmissibility of caries disease.

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.

Clinical management for epidermolysis bullosa dystrophica.

Epidermolysis bullosa (EB) consists of a group of genetic hereditary disorders in which patients frequently present fragile skin and mucosa that form blisters following minor trauma. More than 20 subtypes of EB have been recognized in the literature. Specific genetic mutations are well characterized for most the different EB subtypes and variants. The most common oral manifestations of EB are painful blisters affecting all the oral surfaces. Dental treatment for patients with EB consists of palliative therapy for its oral manifestations along with typical restorative and periodontal procedures. The aim of this article is to describe two dental clinical treatments of recessive dystrophic EB cases and their specific clinical manifestations. The psychological intervention required during the dental treatment of these patients is also presented.

Repair of furcal perforation treated with mineral trioxide aggregate in a primary molar tooth: 20-month follow-up.

Furcal perforations may occur during access opening of the pulp chamber or cavity preparation. The perforation can cause an inflammatory reaction in the periodontal ligament. Management of these iatrogenic accidents can pose a significant clinical challenge, mainly when they occur in primary teeth. Current developments in the techniques and materials utilized for root perforation repair have enhanced this procedure's prognosis. Recently, mineral trioxide aggregate (MTA) has been used for several dental purposes. This biocompatible material promotes bone healing and elimination of clinical symptoms. The purpose of this case report was to describe the treatment of a furcal perforation using mineral trioxide aggregate (MTA) in a primary molar tooth. After 20 months, the tooth was asymptomatic. The radiolucent image had disappeared and bone formation at the furcation area had been observed, suggesting healing of the underlying periodontal tissues. Therefore, MTA may be considered an alternative option for the repair of furcal perforation in primary teeth, prolonging the longevity of these dental elements.

COX-2 inhibition decreases VEGF expression and alveolar bone loss during the progression of experimental periodontitis in rats.

BACKGROUND: Vascular endothelial growth factor (VEGF) is a macromolecule of importance in inflammation that has been implicated in periodontitis. The aims of this study were to investigate VEGF expression during the progression of periodontal disease and to evaluate the effect of a preferential cyclooxygenase (COX)-2 inhibitor meloxicam on VEGF expression and alveolar bone loss in experimentally induced periodontitis. METHODS: A total of 120 Wistar rats were randomly separated into groups 1 (control) and 2 (meloxicam, 3 mg/kg/day, intraperitoneally, for 3, 7, 14, or 30 days). Silk ligatures were placed at the gingival margin level of the lower right first molar of all rats. VEGF expression was assessed by reverse transcription-polymerase chain reaction (RT-PCR), Western blot (WB), and immunohistochemical (IHC) analyses. The hemiarcades were processed for histopathologic analysis. RT-PCR and WB results were submitted to analysis of variance, the Tukey test, and Pearson correlation analysis (P <0.05). RESULTS: A reduction in alveolar bone resorption was observed in the meloxicam-treated group compared to the control group at all periods studied. There was a positive correlation between COX-2 mRNA and VEGF mRNA in the gingival tissues and periodontal disease (R = 0.80; P = 0.026). Meloxicam significantly reduced the increased mRNA VEGF expression in diseased tissues after 14 days of treatment (P = 0.023). Some alterations in VEGF receptor 1 mRNA expression were observed, but these were not statistically significant. VEGF protein expression in WB experiments was significantly higher in diseased sites compared to healthy sites (P <0.05). After 14 days of treatment with meloxicam, an important decrease in VEGF protein expression was detected in diseased tissues (P = 0.08). Qualitative IHC analysis revealed that VEGF protein expression was higher in diseased tissues and decreased in tissues from rats treated with meloxicam. CONCLUSIONS: The present data suggest an important role for VEGF in the progression of periodontal disease. Systemic therapy with meloxicam can modify the progression of experimentally induced periodontitis in rats by reducing VEGF expression and alveolar bone loss.

Surgical removal of an oral pyogenic granuloma and subsequent root coverage with a pedicle graft.

Pyogenic granuloma (PG) is a lesion characterized by non-neoplastic proliferation of endothelial cells, occurring in gingival tissue and representing an excessive reaction of the connective tissue to stimuli or injuries. The purpose of this report was to describe the treatment of an oral pyogenic granuloma, with emphasis on clinical, histopathological, and radiographic aspects. The surgical therapy comprised lesion excision followed by pedicle graft to cover the exposed root surface. The patient's pyogenic granuloma has been under control for a year, and recurrence has not been observed. The permanent teeth erupted correctly and the gingival tissue of both the receptor and donor sites shows a satisfactory clinical appearance.

Knowledge and attitude of parents or caretakers regarding transmissibility os caries disease

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1 percent) adults reported that their children had already been seen by a dentist, 264 (41.3 percent) answered that their children had never gone to a dentist, and 4 (0.6 percent) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7 percent) answered yes, 489 (76.4 percent) answered no, and 44 (6.9 percent) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.

The importance of radiographic diagnosis of incipient occlusal caries: case report / A importância do diagnóstico radiográfico de cárie oclusal incipiente: relato de caso

The treatment of a large dentine caries, which seemed to be a small pit-and-fissure carious lesion on the occlusal surface of the permanent mandibular right first molar in a 6-year-old boy, is presented. The treatment included the filling of the root canals and the sealing of the cavity with composite resin. Underlying periodontal tissue healing could be radiographically observed at the 14-month follow-up. It is possible that a better visual examination, with careful cleaning and drying of teeth, may improve occlusal caries detection. Dentists should examine bitewing radiographies carefully for occlusal demineralization. As radiographies are probably an effective method of lesions caries diagnosis, they should be recommended at appropriate ages to aid early detection of these lesions.

O tratamento de uma cárie grande do dentine, que pareça ser um lesion carious do poço-e-pit-and-fissure pequeno na superfície occlusal do primeiro molar da direita mandibular permanente em um menino de 6-year-old, é apresentado. O tratamento inclui o enchimento dos canais da raiz e do sealing da cavidade com resina composta. O tecido peridental subjacente que healing podia radiographically ser observado na continuação de 14 mês. É possível que uma examinação visual melhor, com limpeza cuidadosa e secagem dos dentes, pode melhorar a deteção occlusal da cárie. Os dentistas devem examinar radiographies do bitewing com cuidado para o demineralization occlusal. Porque as radiografias são provavelmente um método eficaz do diagnóstico da cárie dos lesions, devem ser recomendados em idades apropriadas ajudar à deteção adiantada desta lesão.

Clinical management for epidermolysis bullosa dystrophica

Epidermolysis bullosa (EB) consists of a group of genetic hereditary disorders in which patients frequently present fragile skin and mucosa that form blisters following minor trauma. More than 20 subtypes of EB have been recognized in the literature. Specific genetic mutations are well characterized for most the different EB subtypes and variants. The most common oral manifestations of EB are painful blisters affecting all the oral surfaces. Dental treatment for patients with EB consists of palliative therapy for its oral manifestations along with typical restorative and periodontal procedures. The aim of this article is to describe two dental clinical treatments of recessive dystrophic EB cases and their specific clinical manifestations. The psychological intervention required during the dental treatment of these patients is also presented.