Frontonasal dysplasia: oral features, restorative and orthodontic dental treatment in a child.

BACKGROUND: Frontonasal dysplasia is a complex rare malformation, characterised by abnormalities involving the central portion of the face, especially the eyes, nose and forehead. It can manifest independently or associated with other abnormalities as part of some syndromes. CASE REPORT: The purpose of this case report was to describe a 5-year-old patient, diagnosed with frontonasal dysplasia. Among the abnormalities characterised with this disorder were ocular hypertelorism, broad nose tip with median notch, median facial cleft, bifid anterior skull, low set hairline, Poland's syndactyly and ankyloglossia. TREATMENT: Consisted of behavioural management, oral hygiene instruction, prophylaxis, topical fluoride application, extraction of primary teeth, composite resin restorations and sealants in pits and fissures. Preformed metal crowns were also applied to the right and left primary maxillary second molars. FOLLOW-UP: Currently, the patient is 11 years-old in the permanent dentition and therefore was referred for corrective orthodontic and periodontal treatments due to the persistence of gingival retraction of the permanent mandibular right central incisor. CONCLUSION: The treatment in this case was directed to the promotion of oral health and orthodontic corrections, which are of fundamental importance due to medical, physical and social limitations of children affected by this syndrome, hindering healing and rehabilitative treatment. Paediatric dentists should be included in multidisciplinary teams providing care to patients with special needs, improving their quality of life.

Influence of the Nd:YAG laser pulse duration on the temperature of primary enamel.

The aim of this study is to evaluate the temperature change on specimens of primary enamel irradiated with different pulse duration of Nd:YAG laser. Fifteen sound primary molars were sectioned mesiodistally, resulting in 30 specimens (3.5 × 3.5 × 2.0 mm). Two small holes were made on the dentin surface in which K-type thermocouples were installed to evaluate thermal changes. Specimens were randomly assigned in 3 groups (n = 10): A = EL (extra long pulse, 10.000 µs), B = LP (long pulse, 700 µs), and C = SP (short pulse, 350 µs). Nd:YAG laser (λ = 1.064 µm) was applied at contact mode (10 Hz, 0.8 W, 80 mJ) and energy density of 0.637 mJ/mm(2). Analysis of variance (ANOVA) was performed for the statistical analysis (P = 0.46). Nd:YAG laser pulse duration provided no difference on the temperature changes on primary enamel, in which the following means were observed: A = EL (23.15°C ± 7.75), B = LP (27.33°C ± 11.32), and C = SP (26.91°C ± 12.85). It can be concluded that the duration of the laser pulse Nd:YAG increased the temperature of the primary enamel but was not influenced by different pulse durations used in the irradiation.

CO2 laser and topical fluoride therapy in the control of caries lesions on demineralized primary enamel.

This study evaluated the effect of CO2 laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3 × 3 × 2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n = 10): L: CO2 laser (λ = 10.6 µm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2 laser was applied with 0.5 W power and 0.44 J/cm(2) energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 µm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P ≤ 0.05) that showed the lowest microhardness values. It was concluded that CO2 laser can be an additional resource in caries control progression on primary teeth enamel.