Is Cavity Lining Really Necessary After Selective Caries Removal in Primary Teeth?

ABSTRACT Objective: To evaluate the clinical and radiographic response of pulp-dentin complex after selective caries removal with or without pulp lining in primary teeth. Material and Methods: Twenty-four primary molars with deep occlusal caries lesions and without pulpal alterations were selected from children, both genders, aged between 5 and 9 years old. After selective caries removal, the teeth were divided into three groups: without cavity liner (Group I), calcium hydroxide cement - CH (Group II), and Mineral trioxide aggregate - MTA (Group III). The final restoration was performed with resin-modified glass ionomer cement. Clinical and radiographic assessments were conducted at 6-month follow-up. The Kappa test determined intraexaminer reliability. Fisher's exact test evaluated intergroup comparisons (p<0.05). Results: All teeth showed clinical and radiographic success at the 6-month follow-up without statistically significant differences (p>0.05). Conclusion: Selective caries removal without cavity lining was acceptable for deep caries lesions in primary teeth.

Undergraduate dental students and dentists' acceptability and knowledge about selective caries tissue removal / Aceitabilidade e conhecimento sobre remoção seletiva de tecido cariado de graduandos em odontologia e cirurgiões-dentistas

Objetivo: Avaliar a aceitabilidade e o conhecimento de estudantes de graduação em Odontologia e cirurgiões-dentistas sobre a remoção seletiva de tecido cariado (RSTC). Materiais e Métodos: Participaram do estudo graduandos do terceiro e quarto ano de Odontologia (Grupo 1) e egressos de um Centro Hospitalar de Odontologia (Grupo 2). Os participantes responderam de forma anônima e confidencial um questionário validado contendo onze questões sobre diagnóstico e manejo de lesões cariosas profundas. Teste qui-quadrado de Pearson e regressão logística multivariada foram aplicados (p<0.05). Resultados: A amostra total foi composta por 146 participantes. Destes, 81.5% eram do sexo feminino; 52.05% eram graduados e a faixa etária mais prevalente foi de 18 a 29 anos (85.62%). Sessenta e nove participantes escolheram o tratamento expectante (p=0.027). A análise de regressão logística mostrou diferenças estatisticamente significativas. Os participantes que consideraram a parede pulpar úmida têm aproximadamente oito vezes mais chances de escolha pelo tratamento invasivo (p=0.028). Aqueles que escolheram o tratamento endodôntico como opção de sobrevida em dois anos têm três vezes mais chances de optar pelo tratamento invasivo (p=0.032). Aqueles que afirmaram que a dentina cariada próxima à polpa não deveria ser removida tiveram quase três vezes mais chances de optar por tratamentos minimamente invasivos (p=0.031). Discussão: Estudos com questionários podem ser ferramentas úteis para detectar se estudantes e cirurgiões-dentistas estão seguindo as evidências mais atuais para o tratamento de lesões cariosas profundas. Conclusão: Os participantes tinham certo nível de conhecimento sobre RSTC, mas a aceitabilidade da técnica carecia de consenso.

Aim: The aim of this study was to evaluate the acceptability and knowledge of undergraduate dental students and dentists on selective caries tissue removal (SCTR). Materials and Methods: Third- and fourth-year Dentistry undergraduates (Group 1) and graduates working in a Hospital Dentistry Center (Group 2) were included in the study. Participants anonymously and confidentially answered a validated questionnaire containing eleven questions on the diagnosis and management of deep caries lesions. Pearson's Chi-square test and multivariate logistic regression compared the answers (p<0.05). Results: Total sample comprised 146 participants. Of these, 81.5% were female; 52.05% were graduates and the most prevalent age group was 18-29 years old (85.62%). Sixty-nine participants chose stepwise caries removal (p=0.027). The logistic regression analysis showed statistically significant differences. The participants who considered pulp wall moist have approximately eight times more likelihood to choose an invasive treatment (p=0.028). Those who chose endodontic treatment as an option for two-year survival have three times more likelihood to choose an invasive treatment (p=0.032). Those who affirmed that the carious dentin close to the pulp should not be removed had almost three times more likelihood to choose minimally invasive treatments (p=0.031). Discussion: Studies with questionnaires can be useful tools to detect whether the students and dentists are following the most current evidences to treat deep carious lesions. Conclusion: The participants had certain level of knowledge on SCTR, but the technique acceptability lacked consensus.

Dentists' Self-evaluated Ability in Diagnosing and Updating About Pulpotomy.

OBJECTIVE: This study aimed to self-evaluate the knowledge of different dental professionals' profiles in Brazil on diagnosing and indicating pulpotomy in primary teeth and how these groups updated on this theme. METHODS: Three groups (G1: professors, G2: specialists, and G3: professionals) answered an online questionnaire containing 20 questions and returned 416 questionnaires. Data were subjected to Chi-square associative tests and t tests, with P < .05. RESULTS: G1 and G2 reported to indicate pulpotomy, highlighting the tendency of these groups towards seeking updates on this subject. All 3 groups used academic materials for updating. However, G2 had a high demand for updates through congresses, whilst G3 had a high demand for updates through social media (Google and Google Scholar). The most cited indication by G1 and G2 was "accidental pulp exposure" and by G3 was "teeth with extensive carious lesions that have involved the pulp with radiographic confirmation." All 3 groups opted for pulpotomy to keep the tooth in the arch. Thus, G1 and G2 are the groups who are more updated on the subject, using mainly academic materials, which can be associated with the fact that such groups indicated pulpotomy in primary teeth. The lower interest in searching about pulpotomy in G3 can be understood as a nonclinical application of the topic for this group. CONCLUSIONS: Professionals who work directly with paediatric dentistry (professors or specialists) felt more capable of diagnosing and treating cases of pulpotomy. In addition, most of the professionals used scientifically based sources for getting information and actualisation on the subject of pulp therapies.

Could the photobiomodulation therapy induce angiogenic growth factors expression from dental pulp cells?

This study aimed to evaluate the effect of different photobiomodulation (PBM) radiant exposures on the viability, proliferation, and gene expression of pulp fibroblasts from human primary teeth (HPF) involved in the pulp tissue repair. HPF were irradiated with Laser InGaAlP (Twin Flex Evolution, MMOptics®) at 660-nm wavelength (red); single time, continuous mode, 0.04-cm2 laser tip area, and 0.225-cm laser tip diameter, keeping the distance of 1 mm between the laser beam and the cell culture. The doses used were between 1.2 and 6.2 J/cm2 and were evaluated at the 6 h, 12 h, and 24 h after PBM. MTT and crystal violet assays evaluated the cell viability and proliferation. RT-PCR verified VEGF and FGF-2 mRNA expression. A blinded examiner analyzed the data through two-way ANOVA followed by Tukey test (p < 0.05). The groups with higher powers (10 mW, 15 mW, 20 mW, and 25 mW), shortest application periods (10 s), and radiant exposures between 2.5 and 6.2 J/cm2 exhibited statistically higher viability than that of the groups with small power (5 mW), longer application period (50 s), and radiant exposure of 6.2 J/cm2 (p < 0.05). VEGF and FGF-2 mRNA expression were observed at the three evaluated periods (6 h, 12 h, and 24 h) and the highest expression was in the shortest period (p < 0.05). All radiant exposures maintained HPF viable. The period of 6 h after irradiation showed statistically greater gene expression for both growth factors than other periods. VEGF mRNA had no differences among the dosimetries studied. The best radiant exposures for FGF-2 gene expression were 2.5 J/cm2 and 3.7 J/cm2.

Pulp liner materials in selective caries removal: study protocol for a randomised controlled trial.

INTRODUCTION: The literature shows that selective carious tissue removal (SCTR) decreases the number and diversity of bacteria, stops the caries process and reduces the risk of pulp exposure. However, no consensus exists on which pulp liner would be suitable for teeth undergoing SCTR. So, this study will verify the in vivo response of dentine-pulp complex after SCTR in primary teeth with or without pulp liner material. METHODS AND ANALYSIS: A randomised clinical trial, double-blinded, parallel-group and allocation concealment will be conducted with the enrolment of 384 patients from 5 to 9 years, with one maxillary/mandibular first/second primary molars with deep occlusal/occlusoproximal cavities. The remaining dentine will be lined with calcium hydroxide cement-group 1; mineral trioxide aggregate-group 2 and without liner-group 3. The primary outcome will be success of the of dentine-pulp complex evaluated clinically and radiographically at 6, 12 and 24 months, while the secondary outcomes will be the measurement of the dentine barrier on periapical radiographs. During all study, two trained and calibrated examiners will evaluate the treated teeth clinically and radiographically. Interexaminer and intraexaminer reliability will be verified by casual and systematic error. The Kolmogorov-Smirnov test will be adopted to test the normality of continuous variables. Comparisons among groups will be performed by using the χ2 test and anaylsis of variance, followed by Tukey test (p<0.05). The logistic regression will be applied, and the degrees of this association will be measured using the OR and 95% CI. ETHICS AND DISSEMINATION: The present protocol was submitted and approved by the Ethical Committee of the University of São Paulo, Bauru, São Paulo, Brazil (CAAE: 79123517.0.0000.5417). Consent for publication will be obtained from all parents or legal guardians. Results of this study will be reported in full through peer-reviewed journals. TRIAL REGISTRATION NUMBER: RBR-9fsxnn.

Pulp repair response after the use of a dentin-pulp biostimulation membrane (BBio) in primary teeth: study protocol for a randomized clinical trial.

BACKGROUND: Vital pulp therapy aims at maintaining the pulp tissue injured but vital. Thus, the use of capping materials that induce tissue regeneration is a great current trend. This study aims to evaluate clinically and radiographically the pulp repair after the use of dentin-pulp biostimulation membrane in primary teeth. METHODS: Four hundred and sixty-eight teeth from children aged between 5 and 9 years old, both genders, with deep caries lesion with pulp involvement, but no furcal impairment and any sign of necrosis will be selected. The vital pulp therapy will be performed with mineral trioxide aggregate (control group) and dentin-pulp biostimulation chitosan membrane (BBio group). The clinical and radiographic outcomes will be assessed at 12 and 24 months after treatment. The thickness of the dentin barrier will be verified through Image J2 software. The Wilcoxon signed rank test and Mann-Whitney test will respectively compare the intra- and intergroup clinical and radiographic outcomes. Paired t test and independent t test will respectively compare the intra- and intergroup radiographic measurements. The logistic regression will be applied, and the degrees of this association will be measured using odds ratio (OR) and 95% confidence interval (95% CI). DISCUSSION: Therefore, this study protocol aims at new perspectives of vital pulp therapy of primary teeth by employing new easy-handling, low-cost material to keep viable the pulp tissue capable of regenerating and maintain the physiological process of deciduous tooth exfoliation. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials RBR-6vr58b . Registered on 17 February 2019.

Photobiomodulation effect on angiogenic proteins produced and released by dental pulp cells.

OBJECTIVE: To verify the photobiomodulation effect on angiogenic proteins produced and released by dental human pulpal fibroblasts (HPFs). MATERIAL AND METHODS: HPFs were irradiated with 660-nm low-level laser at fluences of 2.5 J/cm2 and 3.7 J/cm2. The control group was not irradiated. MTT, crystal violet, and ELISA assays respectively verified viability, proliferation, and angiogenic protein (supernatant/lysate) at 6 h, 12 h, and 24 h after photobiomodulation. Capillary-like structure formation assay verified functional role. Two-way ANOVA/Tukey's test and ANOVA/Bonferroni's multiple comparisons test respectively verified cell viability/proliferation and intragroup and intergroup comparisons of protein synthesis (p < 0.05). RESULTS: Irradiated and non-irradiated HPFs showed statistically similar cell viability and proliferation pattern. Intragroup comparisons showed similar patterns of protein synthesis for all groups: VEGF-A, VEGF-C, and vascular endothelial growth factor receptor 1 (VEGFR1) increased significantly in the supernatant, while FGF-2 and VEGF-A increased significantly in the lysate. The lower fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (6 h and 12 h) and VEGF-D (24 h) in the lysate, while the higher fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (12 h) in the lysate. Regardless of the time, both fluences statistically downregulated placental growth factor (PLGF) and PDGF secretion. Both fluences statistically decreased VEGF-A secretion (24 h) and PLGF production (6 h). CONCLUSION: Photobiomodulation produced stimulatory effects on angiogenic protein secretion by pulp fibroblasts. In terms of photobiomodulation, over time, both fluences significantly increased the secretion of VEGF-A, VEGF-C, and VEGFR1 and significantly upregulated BMP-9 (6 h) in the supernatant; for capillary-like structure formation, the fluence of 2.5 J/cm2 was better than the fluence of 3.7 J/cm2. CLINICAL RELEVANCE: This study results addressed effective photobiomodulation parameters tailored for pulp angiogenesis.

Angiogenic protein synthesis after photobiomodulation therapy on SHED: a preliminary study.

This study evaluated the viability, proliferation, and protein expression after photobiomodulation (PBM) of stem cell from human exfoliated deciduous teeth (SHED). The groups were the following: G1 (2.5 J/cm2), G2 (3.7 J/cm2), and control (not irradiated). According to the groups, cells were irradiated with InGaAlP diode laser at 660 nm wavelength, continuous mode, and single time application. After 6 h, 12 h, and 24 h from irradiation, the cell viability and proliferation, and the protein expression were analyzed by MTT, crystal violet, and ELISA multiplex assay, respectively. Twenty-four hours after PBM, SHED showed better proliferation. Over time in the supernatant, all groups had an increase at the levels of VEGF-C, VEGF-A, and PLGF. In the lysate, the control and G2 exhibited a decrease of the VEGF-A, PECAM-1, and PLGF expression, while control and G3 decreased VEGF-C, VEGF-A, and PDGF expression. The dosimetries of 2.5 J/cm2 and 3.7 J/cm2 maintained viability, improved proliferation, and synthesis of the angiogenic proteins in the supernatant in the studied periods on SHED.

Does photobiomodulation change the synthesis and secretion of angiogenic proteins by different pulp cell lineages?

This study aimed to compare the synthesis and secretion of VEGF-A, VEGF-C, VEGF-D, VEGFR1, VEGFR2, and FGF-2 between pulp fibroblasts from human primary teeth (HPF) and stem cell from human deciduous teeth (SHED) before and after photobiomodulation. HPF were obtained from explant technique and characterized by immunohistochemistry, while SHED were obtained from digestion technique and characterized by flow cytometry. HPF (control group) and SHED were plated, let to adhere, and put on serum starvation to synchronize the cell cycles prior to photobiomodulation. Then, both cell lineages were irradiated with 660-nm laser according to the following groups: 2.5 and 3.7 J/cm2. MTT and crystal violet assays respectively verified viability and proliferation. ELISA Multiplex Assay assessed the following proteins: VEGF-A, VEGF-C, VEGF-D, VEGFR1, VEGFR2, FGF-2, at 6, 12, and 24 h after photobiomodulation, in supernatant and lysate. Two-way ANOVA/Tukey test evaluated cell viability and proliferation, while angiogenic production and secretion values were analyzed by one-way ANOVA (P < .05). Statistically similar HPF and SHED viability and proliferation patterns occurred before and after photobiomodulation (P > .05). HPF exhibited statistically greater values of all angiogenic proteins than did SHED, at all study periods, except for FGF-2 (supernatant; 12 h); VEGFR1 (lysate; non-irradiated; 12 h); and VEGFR1 (lysate; non-irradiated; 24 h). Photobiomodulation changed the synthesis and secretion of angiogenic proteins by HPF. HPF produced and secreted greater values of all tested angiogenic proteins than did SHED before and after irradiation with both energy densities of 2.5 and 3.7 J/cm2.

Tratamento odontológico na atenção básica à saúde de crianças durante a pandemia da COVID-19: o que fazer? / Dental care in primary health care of children during COVID-19 pandemic: what to do?

Este artigo objetivou discutir estratégias de atendimento odontológico para crianças na atenção básica à saúde considerando a transmissibilidade do SARS-COV-2. O telemonitoramento seria o meio mais exequível de prestar a promoção da orientação/reforço da higiene oral/aconselhamento dietético. Os procedimentos de mínima intervenção em dentes decíduos/permanentes possibilitariam o manejo de lesões de cárie iniciais, moderadas e severas, sem geração de aerossol. Quando procedimentos com geração de aerossol são necessários, esses devem ser agendados para o final do período, esperando- -se pelo menos 30 minutos para iniciar a desinfecção do ambiente. A abordagem odontológica às crianças com necessidades especiais deve ser direcionada primeiramente para promoção e prevenção da saúde bucal, seguida da preferência pelas técnicas não farmacológicas para o gerenciamento do comportamento, como FALAR-MOSTRAR-FAZER, para aqueles pacientes com cognitivo que permita a interação e entendimento razoáveis. Recursos como estabilização protetora devem ser utilizados para os casos de comportamentos mais difíceis e, por fim, a intervenção sob anestesia geral com indicação bem restrita.

This study aimed to discuss dental care approaches for the primary health care of children considering the SARS-COV-2 transmissibility. Teledentistry would be the most reasonable way of promoting oral health guidance and dietary counseling. Minimum intervention procedures in primary/permanent teeth would enable the management of initial, moderate, and severe caries lesions without generating aerosol. When aerosol-generating procedures are necessary, these should be scheduled at the end of the working day, waiting for at least 30 minutes after the procedure for disinfection. The dental care of children with special needs should firstly address oral health promotion and prevention, followed by non-pharmacological behavioral techniques (TELL-SHOW-DO) in children with reasonable cognitive understanding. For difficult behaviors, we suggest the use of resources as protective stabilization and general anesthesia in a very restrictive manner.

Diagnóstico diferencial e conduta clínica de um cisto folicular inflamatório mandibular / Differential diagnosis and management of inflammatory follicular cyst in mandibular anterior area

Este artigo descreve a dificuldade em diagnosticar um cisto folicular inflamatório na área anterior da mandíbula em um menino com dentinogênese imperfeita tipo I (DI-1). Um menino de 6 anos de idade, com DI-1, procurou tratamento devido ao comprometimento estético. O exame radiográfico revelou uma lesão periapical envolvendo os dentes decíduos incisivo central e lateral direitos. Esses dentes foram extraídos sem intercorrências. Após três meses, a criança se queixou de dor em um edema de cor azulada na mesma área. O diagnóstico diferencial foi de cisto folicular e a lesão foi acompanhada. Como os sinais e sintomas persistiram, o tratamento de escolha foi a descompressão da lesão, seguido por irrigação abundante e curetagem das paredes da lesão. O acompanhamento clínico e radiográfico, mostrou, após 6 meses, remissão da lesão, reparo ósseo, e erupção ativa dos incisivos permanentes. As características incomuns deste caso, fizeram com que o diagnóstico de cisto folicular inflamatório fosse dificultado.

This article reports the difficulties in diagnosing an inflammatory follicular cyst in the mandibular anterior area of a boy with type 1 dentinogenesis imperfecta (DI-1). A 6-year-old boy, with DI-1, sought treatment due to esthetic complaints. The radiographic examination revealed a periapical lesion involving the right primary central and lateral incisors. These teeth were extracted with no complications. After three months, the boy complained of pain in a blue-black edema in the same area. The differential diagnosis was of follicular cyst and the lesion was followed-up. As the signs and symptoms persisted, the treatment of choice was to decompress the lesion, followed by copious irrigation, and lesion's wall curettage. After six months, the clinical and radiographic follow-up showed lesion remission, bone repair, and active eruption of permanent incisors. The uncommon characteristics of the case make the diagnosis of inflammatory follicular cyst difficult.

A randomized clinical trial of cavity liners after selective caries removal: one-year follow-up.

INTRODUCTION: Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. OBJECTIVE: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. METHODOLOGY: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). RESULTS: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). CONCLUSION: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.

Clinical and Radiographic Success of Selective Caries Removal to Firm Dentin in Primary Teeth: 18-Month Follow-Up.

The selective caries removal is increasingly spreading in daily clinical practice because this minimally invasive technique treats deep carious lesion and decreases the risk of pulp exposure. This case report was aimed at describing the selective removal to firm dentin on the primary mandibular left first molar of a girl aged 7 years and 6 months. The Mineral Trioxide Aggregate (MTA Angelus™) was used as liner, and the tooth was definitively restored with resin-modified glass ionomer cement (Vitremer™). The clinical and radiographic following-up was performed at 6, 12, and 18 months after treatment. The treatment showed satisfactory results after 18-month following-up, suggesting that this minimally invasive approach for carious lesion removal can replace the total removal, when properly indicated. Notwithstanding, further randomized clinical trials with longer following-up periods are still necessary.

Oral health-related quality of life of children with oral clefts and their families.

Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.

Dental enamel defect diagnosis through different technology-based devices.

INTRODUCTION: Dental enamel defects (DEDs) are faulty or deficient enamel formations of primary and permanent teeth. Changes during tooth development result in hypoplasia (a quantitative defect) and/or hypomineralisation (a qualitative defect). OBJECTIVE: To compare technology-based diagnostic methods for detecting DEDs. MATERIAL AND METHODS: Two-hundred and nine dental surfaces of anterior permanent teeth were selected in patients, 6-11 years of age, with cleft lip with/without cleft palate. First, a conventional clinical examination was conducted according to the modified Developmental Defects of Enamel Index (DDE Index). Dental surfaces were evaluated using an operating microscope and a fluorescence-based device. Interexaminer reproducibility was determined using the kappa test. To compare groups, McNemar's test was used. Cramer's V test was used for comparing the distribution of index codes obtained after classification of all dental surfaces. RESULTS: Cramer's V test revealed statistically significant differences (P < .0001) in the distribution of index codes obtained using the different methods; the coefficients were 0.365 for conventional clinical examination versus fluorescence, 0.961 for conventional clinical examination versus operating microscope and 0.358 for operating microscope versus fluorescence. The sensitivity of the operating microscope and fluorescence method was statistically significant (P = .008 and P < .0001, respectively). Otherwise, the results did not show statistically significant differences in accuracy and specificity for either the operating microscope or the fluorescence methods. CONCLUSION: This study suggests that the operating microscope performed better than the fluorescence-based device and could be an auxiliary method for the detection of DEDs.

Oral health-related quality of life of children with oral clefts and their families

Abstract Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. Objective: To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. Materials and Methods: 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). Results: According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. Conclusions: The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.

Effects of PBM in different energy densities and irradiance on maintaining cell viability and proliferation of pulp fibroblasts from human primary teeth.

This study aimed to compare the effects of photobiomodulation (PBM) in different energy densities and irradiances on maintaining cell viability, and proliferation of pulp fibroblasts from human primary teeth (HPF) were cultured in DMEM and used between the fourth and eighth passages. Then, HPF were irradiated with the following different energy densities: 1.25 J/cm2 (a), 2.50 J/cm2 (b), 3.75 J/cm2 (c), 5.00 J/cm2 (d), and 6.25 J/cm2 (e); but varying either the time of irradiation (groups 1a-1e) or the output power (groups 2a-2e). Positive (groups 1f and 2f) and negative controls (groups 1g and 2g), respectively, comprised non-irradiated cells grown in regular nutritional conditions (10% fetal bovine serum [FBS]) and under nutritional deficit (1% FBS). Cell viability and proliferation were respectively assessed through MTT and crystal violet (CV) assays at 24, 48, and 72 h after irradiation. Statistical analysis was performed by two-way ANOVA, followed by Tukey test (P < 0.05). The negative controls showed significantly lower viability in relation to most of the corresponding subgroups, both for MTT and CV assays. For both assays, the intragroup comparison showed that the periods of 24 h exhibited lower viability than the periods of 48 and 72 h for most of the subgroups, except the negative controls with lower viability. The different irradiation protocols (equal energy densities applied with different irradiances) showed no statistically significant differences on cell viability and proliferation at the evaluated periods. The proposed PBM in different energy densities and irradiance did not affect the viability and proliferation of pulp fibroblasts from human primary teeth.

Storage protocol of dental pulp cells from human exfoliated deciduous teeth / Protocolo de armazenamento de células pulpares de dentes decíduos humanos

Objetivo: O objetivo deste estudo foi isolar células do tecido pulpar de dentes decíduos humanos, avaliar a capacidade de proliferação, caracterizá-las e normatizar as técnicas de cultivo e expansão celular destas para a criação de um banco de células. Material e métodos: Dentes decíduos sem cárie e com indicação ortodôntica de para extração foram utilizados como doadores de tecido para a pesquisa. As células foram extraídas de tecidos pulpares, isoladas e cultivadas em condições ideais até alcançarem confluência. Resultados: Após consecutivas passagens, as células cultivadas foram caracterizadas por meio de técnicas de imunofluorescência e congeladas entre a 2ª e a 6ª passagem, criando-se um biorrepositório de células da polpa de dentes decíduos humanos. Conclusão: A criação de bancos de células pulpares de dentes decíduos humanos permite uma aplicação mais ágil nas pesquisas laboratoriais, reduzindo o tempo e o custo da obtenção de novas amostras. Evita necessidade de triagem e obtenção de novos doadores de dentes e tecidos, e permite maior rapidez nas repetições de protocolos de pesquisas. (AU)

Objective: This study aimed to isolate the cells from the dental pulp tissue of human primary teeth, study the capacity of proliferation, characterize the cells and standardize the technique of culture and expansion to create a cell banking. Material and Methods: Primary teeth with no caries and orthodontic reasons were extracted for pulp tissue obtainment. The cells were extracted from the pulp cells, isolated and cultured under ideal conditions until full expansion. Results: After consecutive passages, the cultured cells were characterized using immunofluorescence technique and frozen between the 2nd and 6th passage, thus creating a biorepository of dental pulp cells from human primary teeth. Conclusion: The creation of a cell banking from dental pulp cells from human primary teeth enables the easy application of cells in laboratorial studies, reducing the cost and time for obtaining the samples, avoid the involvement of new subjects and allow a fast reproducibility of the researches. (AU)

Impact of malocclusion on oral health-related quality of life inBrazilian children with cleft lip and palate / Impacto da má oclusão na qualidade de vida relacionada à saúde oral de crianças brasileiras com fissura de lábio e palato

This cross-sectional study aimed to evaluate the impact of malocclusion on the oral health-related quality of life (OHRQoL) in Brazilian children with non-syndromic oral cleft sat tertiary craniofacial center. Material and Methods: Sixty-nine children with non-syndromicoral clefts, aged between 8 and 10 years, were selected and divided into groups according to the cleft type: Group 1 – Children with complete unilateral cleft lip and alveolus; Group 2 – Children with unilateral cleft lip and palate; Group 3 –Children with cleft palate. Each child ans wered the Child Perceptions Questionnaire 8-10 (CPQ8-10) which is a multiple-choice questionnaire, with 29 questions on the impact of oral diseases on the OHRQoL. Then, a visual examination of dental occlusion was carried out. Kruskal-Wallis and Mann-Whitney tests were used to determine statistical significant differences among groups(p<0.05). Results: No statistically significant differences were verified for the impact of cleft type (p=0.895) and malocclusion (p=0.528) on HRQoL of Brazilian children with oral clefts. Conclusion: The malocclusion did not impact onthe OHRQoL of 8-10 year-old children with nonsyndromicclefts...

Este estudo transversal avaliou o impacto da má oclusão sobre a qualidade de vida relacionada à saúde oral de crianças brasileiras com fissuras labiopalatina não sindrômicas de um centro de tratamento craniofacial. Material e Métodos: Sessenta e nove crianças com fissurelabiopalatina não sindrômica, com idades entre oito e dez anos, foram selecionadas e divididas em grupos de acordo com o tipo de fissure: Grupo 1 – Crianças com fissura completa de lábio e alvéolo; Grupo 2 – Crianças com fissura completa de lábio e palato; Grupo 3 –Crianças com fissura de palato. Cada criança respondeu o Child Perceptions Questionnaire 8-10 (CPQ 8-10) que é um questionário de múltipla escolha, com 29 perguntas sobre o impacto das doenças orais sobre a qualidade devida. Em seguida, o exame visual da oclusão foi realizado. Os testes de Kruskal-Wallis and Mann-Whitney foram usados para determinar as diferenças estatisticamente significativas entre os grupos (p<0,05). Resultados: Diferenças estatisticamente significativas não foram verificadas para o impacto do tipo de fissura (p=0,895) e má oclusão (p=0,528) na qualidade de vida de crianças brasileiras com fissuras labiopalatinas. Conclusão: A má oclusão não teve impacto sobre a qualidade de vida de crianças com idade entre oito a dez anos com fissure de lábio e palato não sindrômica...

Do technology-based devices improve carious lesion detectionin children with oral cleft? / Os aparelhos baseados em tecnologia melhoram a detecção de lesões de cárie em crianças com fissura labiopalatina?

Objetivo: Comparar o exame visual-tátil com os exames baseados em tecnologia na detecção de lesões de cárie em crianças com fissuras labiopalatina. Material e Métodos: 405 faces mesial, distal, vestibular e palatina dos dentes permanentes anteriores superiores próximos a área da fissura de 95 crianças com idade entre 6-12 anos (média 10 anos± 2 anos e 9 meses) foram avaliadas por dois examinadores previamente calibrados. Os seguintes métodos de detecção de lesão de cárie foram usados: exame visual-tátil (Método 1), exame visual-tátil com o auxílio do microscópio operatório (Método 2), exame visual por meio de um aparelho de fluorescência por LED (Método 3). ICDAS foi o sistema usado para classificar todas as lesões de cárie nos três métodos. A sonda OMS foi usada durante o exame visual-táctil. O microscópio operatório foi usado em magnificação de 10x. O aparelho de fluorescência por LED (Evince ®) tinha uma câmera ligada à peça de mão e conectada ao computador. Os métodos auxiliares de detecção de cárie foram comparados ao exame visual-táctil pelo teste de Friedman (P < 0,05). Resultados: Não houve diferença estatisticamente significante na eficácia dos métodos de detecção de lesão de cárie (P = 0,786). Conclusão: O microscópio operatório e o aparelho de fluorescência por LED não mostraram diferença na a detecção de lesão de cárie para avaliar dentes próximos à área da fissura labiopalatina.

Objective: To compare the visual-tactile examination with the technology-based caries detection examinations in children. Material and Methods: Two previously calibrated examiners assessed 405 mesial, distal, labial, and palatal surfaces of the upper anterior permanent teeth next to the cleft area of 95 children aged 6 to 12 years (mean age of 10 years ± 2 years and 9 months) with oral clefts but without the presence of any associated syndrome or craniofacial anomaly. The following detection methods were used: visual-tactile examination (Method 1), visual-tactile examination through operating microscope (Method 2), visual examination through LED-based fluorescence device (Method 3). ICDAS was the system used to score all caries lesions for all methods. WHO probe was used during the examination with visual-tactile examination. Operating microscope was used at x10 magnification. LED-based fluorescence (Evince™) had a video camera coupled to the handpiece and linked to a computer. The adjunct caries detection methods were compared to visual-tactile examination by Friedman test (P < 0.05). Results: The efficacy of carious lesion detection methods were statistically similar (P = 0.786). Conclusion: Both the operating microscope and the LED-based fluorescence device did not improve caries lesion detection in the permanent anterior teeth next to the cleft area.