Percepção dos pais sobre os sinais e sintomas decorrentes da erupção dentária em bebês / Parents' perception about tooth eruption signs and symptoms in babies

A erupção dentária é definida como a movimentação dos dentes em desenvolvimento para emergir através dos tecidos moles da maxila e da mandíbula. O primeiro dente decíduo geralmente irrompe na cavidade bucal em um intervalo entre quatro e dez meses de idade e manifestações locais e sistêmicas associadas à erupção são observadas e relatadas por pais de bebês que passam pelo processo. Deste modo, este trabalho busca revisar e analisar a literatura em relação à percepção dos pais sobre os sinais e sintomas observados durante o processo de erupção dentária em bebês. Foi realizada uma revisão integrativa da literatura, buscando por artigos indexados nas bases eletrônicas de dados PubMed e Portal BVS. Ao final, foram selecionados 16 artigos científicos, sendo em sua maioria estudos com delineamento transversal (n: 11). Apenas dois estudos foram realizados no Brasil, sendo a Índia (n: 4) o país com maior número de artigos incluídos. Os sinais e sintomas mais relatados pelos pais foram febre (n: 16), perda de apetite (n: 13) e aumento da salivação (n: 12). Os estudos analisados apresentaram limitações, como a falta de padronização dos questionários direcionados aos pais. Compreende-se, desta forma, que mais estudos com populações variadas, amostras maiores e questionários padronizados são necessários.

Dental eruption is defined as the movement of developing teeth to emerge through the soft tissues of the maxilla and mandible. The first deciduous tooth usually erupts into the oral cavity between the fourth and tenth month of age. During this time, local and systemic manifestations are observed and reported by parents of babies who undergo the process. Thus, this stud seeks to review and analyze the literature regarding the perception of parents about the signs and symptoms observed during the process of tooth eruption in babies. An integrative literature review was performed, searching for articles indexed in PubMed and Portal BVS electronic databases. Sixteen papers were selected, mostly of which were cross-sectional studies (n: 11). Only two studies were carried out in Brazil, with India (n: 4) being the country with the highest number of articles included. The most reported signs and symptoms were fever (n: 16), loss of appetite (n: 13) and increased salivation (n: 12). The analyzed studies had limitations, such as the lack of standardization of the questionnaires addressed to parents. We conclude more studies with varied populations, larger samples and standardized questionnaires are needed.

Spatial and temporal gene expression patterns during early human odontogenesis process.

Studies on odontogenesis are of great importance to treat dental abnormalities and tooth loss. However, the odontogenesis process was poorly studied in humans, especially at the early developmental stages. Here, we combined RNA sequencing (RNA-seq) with Laser-capture microdissection (LCM) to establish a spatiotemporal transcriptomic investigation for human deciduous tooth germs at the crucial developmental stage to offer new perspectives to understand tooth development and instruct tooth regeneration. Several hallmark events, including angiogenesis, ossification, axonogenesis, and extracellular matrix (ECM) organization, were identified during odontogenesis in human dental epithelium and mesenchyme from the cap stage to the early bell stage. ECM played an essential role in the shift of tooth-inductive capability. Species comparisons demonstrated these hallmark events both in humans and mice. This study reveals the hallmark events during odontogenesis, enriching the transcriptomic research on human tooth development at the early stage.

Clinical and radiographic success rate of the root canal filling materials used in primary teeth: A systematic review.

One of the most important factors that determine the success of pulpectomy in primary teeth is the root canal filling material used. This systematic review is an update on the success rates of various materials used for obturation in primary teeth. An electronic search was carried out in the PubMed, Scopus, Web of Science, and Cochrane Library databases with the preset inclusion and exclusion criteria. Only randomized or quasi-randomized clinical and controlled trials with a minimum follow-up of 12 months were included for analysis. Nine articles were considered potentially eligible for inclusion in this review. All the included trials had zinc oxide-eugenol (ZOE) cement as a control group. The time span of the included trials extended from 12 to 30 months. Only 2 trials were at low risk of bias. Evidence to support the success rates of obturating materials used in primary teeth is scarce, which necessitates further highquality randomized controlled clinical trials with regard to this issue.

Frequency and variability of nonmetric dental crown traits of primary and permanent molars in a group of orthodontic patients.

BACKGROUND: The present study aimed to assess the frequency and variation of 13 nonmetric dental crown traits (NDCT) in permanent and primary molars in German orthodontic patients. METHODS: Dental records from orthodontic patients were screened and evaluated. First and second permanent and primary upper and lower molars (from left and right sides) were assessed. Teeth with cavitated dental caries, occlusal wear, restorations and obvious dental deformities were not evaluated. The NDCT for permanent molars were identified and scored according to the odontoscopic system developed by Arizona State University Dental Anthropology System (ASUDAS). The NDCT for primary molars were identified and scored according to ASUDAS, Hanihara's method and Sciulli's method. The χ2 test was used to investigate side preference and sexual dimorphism at a significance level of p ≤ 0.050. RESULTS: A total of 163 orthodontic patients (82 males and 81 females) aged 8-14 years were included. A sexual dimorphism was observed for the hypocone in first upper permanent molar (p = 0.041). The protostylid was observed in lower permanent molars (range 2.1-10%). Males presented more hypoconulid than females (p = 0.019). Only females presented the distal trigonid crest in lower first permanent molars (p = 0.002). The most common groove pattern in primary molars was Y; male presented more Y grade than females in the lower second primary molar (p = 0.039). Asymmetry was observed in some traits, ranging from 0 to 100%. CONCLUSION: The present study showed the frequency of NDCT of molars in German orthodontic patients and demonstrated that some traits present sexual dimorphism.

Mesenchymal Stem Cells from the Deciduous Tooth Pulp Lose their Ability to Suppress the Differentiation of Dendritic Cells during Long-Term Culturing.

A culture of cells expressing markers of mesenchymal stem cells (MSC) (CD73, CD90, CD44, CD29, and CD49b), but not hematopoietic cell markers, and capable of multilineage differentiation was isolated from the deciduous tooth pulp. Co-culturing with immature dendritic cells in the presence of LPS did not reveal an ability of the MSC to suppress the maturation of dendritic cells. On the contrary, co-culturing of MSC with monocytes in the presence of granulocyte-macrophage CSF and IL-4 led to complete suppression of monocyte differentiation into dendritic cells. However, long-term culturing of MSC from dental pulp showed that by the passage 11, they almost completely lose their suppressor ability. These results indicate that the immunological properties of MSC can change during culturing without changing their phenotypic markers. This should be taken into account when creating biomedical cell products.

Deciduous pulp tissue implantation into the root canal of mandibular incisor resulted in pulp revascularization: a case report with a 5-year follow-up.

To explore a new method to implant deciduous tooth pulp into the canal of young permanent teeth with necrotic pulps and apical periodontitis for the regenerative endodontic treatment of tooth no: 41 in a 7-year-old male. Briefly, 1.5% Sodium Hypochlorite (NaOCl) irrigation and calcium hydroxide-iodoform paste were used as root canal disinfectant at the first visit. After 2 weeks, the intracanal medication was removed, and the root canal was slowly rinsed with 17% Ethylene Diamine Tetraacetic Acid (EDTA), followed by flushing with 20 mL saline and then drying with paper points. Tooth no: 72 was extracted, and its pulp was extracted and subsequently implanted into the disinfected root canal along with induced apical bleeding. Calcium hydroxide iodoform paste was gently placed over the bleeding clot, and after forming a mineral trioxide aggregate (MTA) coronal barrier, the accessed cavities were restored using Z350 resin composite. The root developments were evaluated via radiographic imaging at 6 months, 1 year and 5 years after treatment. Imaging and clinical analysis showed closure of the apical foramen, thickening of the root canal wall, and satisfactory root length growth. Autologous transplantation might be useful to regenerate dental pulp in necrotic young permanent teeth.

Digital measurement of deciduous tooth dimensions in China: A cross-sectional survey.

OBJECTIVE: Crown dimensions data of deciduous teeth hold anthropological, forensic, and archaeological value. However, such information remains scarce for the Chinese population. This multi-center study aimed to collect a large sample of deciduous crown data from Chinese children using three-dimensional measurement methods and to analyze their dimensions. DESIGN: A total of 1592 children's deciduous dentition samples were included, and the sample size was distributed according to Northeast, North, East, Northwest, Southwest and South China. Digital dental models were reconstructed from plaster dental models. Independent sample t test, paired t test, principal component analysis (PCA), and factor analysis (FA) were used to analyze the tooth crown dimensions. RESULT: 18,318 deciduous teeth from 1592 children were included. Males exhibited slightly larger values than females. The range of sexual dimorphism percentages for each measurement was as follows: mesiodistal diameter (0.40-2.08), buccolingual diameter (0.13-2.24), and maxillogingival diameter (0.48-3.37). The FA results showed that the main trend of crown dimensions changes was the simultaneous increase or decrease in mesiodistal diameter, buccolingual diameter and maxillogingival diameter in three directions. CONCLUSION: This is the first large-scale survey of deciduous tooth crown dimensions in China, which supplements the data of deciduous tooth measurement and provides a reference for clinical application.

Factors influencing root resorption in retained mandibular second deciduous molars with congenital absence of second premolars: a cross-sectional study.

BACKGROUND: There are currently no studies that quantitatively compare the relationship of root resorption to the patient's systemic history or craniofacial and intraoral morphology, especially in relation to possible host factors. Thus, this study aimed to clarify the factors associated with root resorption in retained mandibular second deciduous molars with the congenital absence of second premolars and predict the prognosis of retained mandibular second deciduous molars. METHODS: A cohort of 5547 patients who visited the orthodontic clinic at Tokyo Medical and Dental University Dental Hospital between 2013 and 2022 was screened. Lateral cephalometric radiographs, panoramic radiographs, upper and lower dental models, and orthodontic treatment questionnaires were used as reference materials to apply the inclusion and exclusion criteria. Ultimately, 111 patients were included in the analyses. The patients were divided into two groups based on the root resorption levels of the retained mandibular second deciduous molars. Those with less root resorption were classified under the good condition (GC) group, whereas those with more root resorption were classified under the poor condition (PC) group. Demographic, clinical, and cephalometric parameters were compared between the groups. A multivariate logistic regression model was used to predict the probability of root resorption. RESULTS: The prevalence of congenitally missing mandibular second premolars with persistent mandibular second deciduous molars was 2.0%. In a total of 111 patients, eighty-three teeth (53.2%) were classified into the GC group, whereas 73 teeth (46.8%) were classified into the PC group. The Frankfort-mandibular plane angle (FMA) [odds ratio (OR): 0.87], Frankfort-mandibular incisor angle (FMIA) (OR: 0.93), overbite (OR: 1.38), adjacent interdental space (OR: 1.46), distance from occlusal plane (OR: 0.80), and caries treatment (OR: 7.05) were significantly associated with the root resorption of the retained mandibular second deciduous molars. CONCLUSIONS: Our findings suggest that skeletal morphology, oral morphological patterns, and history contribute to root resorption in retained mandibular second deciduous teeth with congenital absence of subsequent permanent teeth.

Infraocclusion in the Primary and Permanent Dentition-A Narrative Review.

The gradual movement of a tooth away from the occlusal plane is called infraocclusion or reinclusion. Reincluded teeth are most often deciduous molars, and permanent teeth are less frequently affected. Depending on the level of the infraocclusion, the severity of the disorder is classified as mild, moderate, or severe. The etiology of the phenomenon is not fully known. Tooth submerging can lead to serious complications, such as abnormal position of adjacent teeth, displacement of the bud of the permanent successor, shortening of the dental arch, or developmental disturbances of alveolar process. Early diagnosis of the tooth infraocclusion and regular monitoring of its progression help to avoid serious permanent sequelae. The treatment of reinclusion often involves only observation. However, in some cases, the therapeutic procedure requires interdisciplinary treatment by specialists from various fields of dentistry. This study presents current methods of diagnosis and treatment of patients with submerged teeth.

Advancing the assessment of pacifier effects with a novel computational method.

BACKGROUND: Numerous studies have demonstrated a high likelihood of malocclusions resulting from non-nutritive sucking. Consequently, quantifying the impact of pacifiers can potentially aid in preventing the development or exacerbation of malocclusions and guide the design of improved performance pacifiers. METHODS: This work proposes and assesses a computational methodology that can effectively gather crucial information and provide more precise data regarding the consequences of non-nutritive pacifier sucking. The computational framework utilized is based on solids4Foam [1, 2], a collection of numerical solvers developed within the OpenFOAM® computational library [3]. The computational model focuses on the palate of a six-month-old baby and incorporates various components such as palate tissues, pacifier and tongue, and considers the negative intraoral pressure generated and the tongue displacement. Different models were tested, each offering varying levels of detail in representing the palate structure. These models range from a simplified approach, with one tissue, to a more intricate representation, involving up to five different tissues, offering a more comprehensive palate model compared to existing literature. RESULTS: The analysis of results involved examining the distribution of stress on the palate surface, as well as the displacement and forces exerted on the dental crowns. By comparing the obtained results, it was possible to evaluate the precision of the approaches previously described in the literature. The findings revealed that the predictions were less accurate when using the simplified model with a single tissue for the palate, which is the most common approach proposed in the literature. In contrast, the results demonstrated that the palate model with the most intricate structure, incorporating five different tissues, yielded distinct outcomes compared to all other combinations. CONCLUSIONS: The computational methodology proposed, employing the most detailed palate model, has demonstrated its effectiveness and necessity in obtaining accurate data on the impact of non-nutritive sucking habits, which are recognized as a primary contributor to the development of dental malocclusions. In the future, this approach could be extended to conduct similar studies encompassing diverse pacifier designs, sizes, and age groups. This would foster the design of innovative pacifiers that mitigate the adverse effects of non-nutritive sucking on orofacial structures.

Count Me in, Count Me out: Regulation of the Tooth Number via Three Directional Developmental Patterns.

Tooth number anomalies, including hyperdontia and hypodontia, are common congenital dental problems in the dental clinic. The precise number of teeth in a dentition is essential for proper speech, mastication, and aesthetics. Teeth are ectodermal organs that develop from the interaction of a thickened epithelium (dental placode) with the neural-crest-derived ectomesenchyme. There is extensive histological, molecular, and genetic evidence regarding how the tooth number is regulated in this serial process, but there is currently no universal classification for tooth number abnormalities. In this review, we propose a novel regulatory network for the tooth number based on the inherent dentition formation process. This network includes three intuitive directions: the development of a single tooth, the formation of a single dentition with elongation of the continual lamina, and tooth replacement with the development of the successional lamina. This article summarizes recent reports on early tooth development and provides an analytical framework to classify future relevant experiments.

Material of choice for non-invasive treatment of dentin caries: An in vitro study using natural carious lesions.

INTRODUCTION: In community settings with limited dental personnel and equipment, and in an era when the aerosol transmission of infectious agents is on the rise, a non-invasive approach to caries management is critical. To provide information on non-invasive material selection, the aim of this study was to compare the remineralization effect of commonly used fluoride-containing materials, adjunctive to the everyday use of fluoride toothpaste (F-toothpaste), on primary tooth natural dentin caries. METHODS: Fifty-five specimens were randomly divided into five groups: 38% silver diamine fluoride (SDF), 5% fluoride varnish (F-varnish), glass-ionomer cement (GIC), deionized water (DW) with F-toothpaste slurry, and DW as a control group (n = 11). The lesion depth and mineral density were measured before and after bacterial pH-cycling using micro-computed tomography. The percentage of mineral density change (%MDchange) was quantified. The dependent t-test, Wilcoxon-Signed-Rank Test, and one way ANOVA with Bonferroni correction were used to analyse the data. RESULTS: SDF application reduced lesion depth from 844.6 to 759.1 µm (p < 0.045) while increasing mineral density from 551.4 to 763.0 mgHA/cm3 (p < 0.003). Only mineral density rose from 600.2 to 678.4 mgHA/cm3 (p < 0.013) when GIC was used. The other groups showed no difference. The highest %MDchange was also found after SDF treatment (49.7%, p < 0.05), whereas GIC (17.2%, p < 0.05) presented a higher percentage than the F-varnish (2.0%), F-toothpaste (-1.1%) and no-treatment groups (-1.4%). CONCLUSION: In this in vitro study, where the pH of cycling was almost neutral, using SDF as an adjunct to F-toothpaste resulted in the highest remineralization compared with other remineralizing materials.

Performance of near-infrared light transillumination in the detection of occlusal caries lesions in deciduous teeth.

BACKGROUND: This study compared the performance of near-infrared light transillumination (NILT; DIAGNOcam [DC]) in detecting occlusal caries lesions in deciduous molars with the performance of the International Caries Detection and Assessment System (ICDAS), digital radiographic method (RX) and laser fluorescence (DIAGNOdent pen [LFpen]). METHODS: Fifty-seven extracted deciduous molars with no frank cavitation caries lesions were selected. One site per tooth was evaluated twice each by two examiners using all methods. Then, a histological examination was performed using a stereomicroscope. The performance of the methods was assessed with respect to two thresholds: D1 (all visible caries lesions affecting enamel) and D3 (caries lesions extended into dentin). RESULTS: A weighted kappa and intraclass correlation coefficients were calculated for intra- and inter-observer reproducibilities, varying from 0.31 (RX) to 0.89 (LFpen). The intra-observer reproducibility at D1 and D3 thresholds varied from 0.51 (ICDAS) to 0.85 (DC) and from 0.30 (ICDAS) to 1.00 (RX), respectively. The inter-observer reproducibility varied from 0.28 (RX) to 0.47 (DC) and from 0.22 (LFpen) to 0.75 (DC), respectively. At the D1 threshold, higher sensitivity and accuracy were found for LFpen (0.76/0.71) and ICDAS (0.65/0.66); and higher specificities were found for RX (0.94), DC (0.79), and ICDAS (0.71). At the D3 threshold, all methods exhibited lower sensitivities (0.13-0.35) and higher specificity, accuracy, and area under the ROC curve values (0.70-1.00). All methods showed a correlation with histological results, especially for ICDAS and DC. CONCLUSIONS: NILT technology (DC) and LFpen exhibited similar performance for the detection of occlusal caries lesions in deciduous molars when compared with ICDAS criteria.

Periodontitis en niños sanos de 3 años: dos casos con seguimiento a 5 años / Periodontitis in healthy 3-year-old children: two cases with 5-year follow-up

Objetivo: La periodontitis en dentición primaria es ex- cepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y ra- diográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos: En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de inci- sivos inferiores. El examen clínico y radiográfico mostró pér- dida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la intercon- sulta médica y se descartó que los niños padecieran enferme- dades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, ins- trumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se rea- lizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la con- sulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis (AU)

Aim: Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic charac- teristics of two cases of systemically healthy 3-year-old chil- dren with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases: In both cases, at 3 years of age, the chil- dren were referred to a periodontic specialist by their pediat- ric dentist, due to the very early loss of lower incisors. Clin- ical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a mani- festation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and perio- dontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis (AU)

The Contribution of Various In Vitro Methodologies to Comprehending the Filling Ability of Root Canal Pastes in Primary Teeth.

A void-free obturation during root canal treatment on primary teeth is currently very difficult to attain. In this study, the pulpectomy filling abilities of Bio-C Pulpecto (Angelus, Basil, Londrina, Paraná, Brazil) and of zinc oxide eugenol, or "ZOE" (DenPro, Prevest, New York, NY, USA), were compared using several in vitro techniques. Therefore, 30 primary anterior teeth were used in the present in vitro study. Analysis of variance (ANOVA), including a multiple comparison procedure (Holm-Sidak method, Dunn's Method, or Tukey test), was used. On micro-CT, Bio-C Pulpecto exhibited higher void percentages than did ZOE (10.3 ± 3.8%, and 3.5 ± 1.3%), respectively (p < 0.05). With digital microscopy, higher total void percentages were found in the BC (13.2 ± 26.7%) group compared to the ZOE (2.7 ± 2.8%) group (p < 0.05). With the CLSM, mean tubular penetration depths were higher for Bio-C Pulpecto than for ZOE in all canal thirds (p < 0.05). SEM images demonstrated no tags into dentinal tubules in either group throughout the three thirds. Moreover, higher statistically significant flowability was found for Bio-C (2.657 ± 0.06 mm) compared to ZOE (1.8 ± 0.13 mm) (p < 0.05). The findings of this study indicate that neither ZOE nor Bio-C Pulpecto appears to meet the criteria for an ideal root canal filling paste for primary teeth. This study laid the groundwork for future research by determining how micro-CT, digital microscopy, SEM, and CLSM contribute to our understanding of the filling process of primary teeth. More thorough research on the mechanism of root canal obturation on primary teeth is required to achieve a long-term successful root canal therapy in young children.

Evaluation of the reasons for failure in teeth with vital amputation treatment.

AIM: This study aims to evaluate the primary teeth undergoing amputation due to dental caries or trauma clinically and radiologically. MATERIAL AND METHODS: The amputation treatment of 90 primary teeth of 58 patients (Female: 20, Male: 38) aged 4-11 years was evaluated clinically and radiologically. Calcium Hydroxide was used for amputation in this study. Composite or amalgam was preferred as filling material in the same session of the patients. Clinical/radiological (Periapical/Panoramic X-ray) examination was performed on the teeth that were unsuccessful in treatment, on the day of the patient's complaint, and at the end of 1 year in the others. RESULTS: According to the clinical and radiological findings of the patients, 14.4% of the boys and 12.3% of the girls were unsuccessful. Amputation in male was a need in the 6-7 age group with a rate of 44.6% at most. Amputation in females was a need in the 8-9 age group with a rate of 52% at most. CONCLUSION: Success in amputation treatment depends on the tooth, the dentist, and the dental material applied.

Periodontitis en niños sanos de 3 años. Dos casos con seguimiento a 5 años / Periodontitis in healthy 3-year-old children. Two cases with 5-year follow-up

Resumen Objetivo La periodontitis en dentición primaria es excepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y radiográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de incisivos inferiores. El examen clínico y radiográfico mostró pérdida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la interconsulta médica y se descartó que los niños padecieran enfermedades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, instrumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se realizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la consulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis.

Abstract Aim Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic characteristics of two cases of systemically healthy 3-year-old children with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases In both cases, at 3 years of age, the children were referred to a periodontic specialist by their pediatric dentist, due to the very early loss of lower incisors. Clinical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a manifestation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and periodontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis.

The effect of silver diamine fluoride on the bond strength of glass ionomer to the enamel of primary teeth.

Background: Dental caries is a disease which is caused by the acidic by-products of the metabolic processes of dental plaque. Silver components are one of the clinical solutions to prevent caries. This study aimed to investigate the effect of silver diamine fluoride (SDF) application on the shear bond strength of glass ionomer to primary teeth enamel. Materials and Methods: In this in vitro study, a total of 48 anterior sound primary teeth were randomly divided into four groups (n = 12). The control group (G1) consisted of healthy primary teeth, and the three experimental groups (G2-G4) were composed of demineralized primary teeth. The second group did not undergo SDF treatment, the third group underwent SDF treatment, and the fourth group underwent SDF treatment plus polishing. Glass ionomer cylinders were bonded to all specimens and subsequently tested by a universal testing machine to measure the glass ionomer shear bond strength. The type of fracture was examined by a stereomicroscope. Data analysis was carried out using the SPSS 22 statistical software. Data were analyzed by one-way analysis of variance and posthoc Tukey tests (α =0.05). Results: The mean shear bond strength of the glass ionomer was significantly higher in the control group than in the other three groups (P < 0.05). The mean shear bond strength of glass ionomer was significantly higher in the SDF-treated group than in the non-SDF treated and SDF-treated and polished groups (P < 0.05). Conclusion: Although the glass ionomer bond strength to sound enamel was higher than other groups by a significant margin, the application of SDF increases the shear bond strength of the glass ionomer to remineralized white spot enamel in primary teeth.

Comparison of the morphology of the primary first molars and the forms of stainless steel crowns used in clinical practice.

This study aimed to assess the difference in the mesiodistal (MD) and buccolingual (BL) dimensions of primary first molars between Taiwanese boys and girls using a three-dimensional (3D) scanner (Microscribe G2 digitizer), record the coordinates in the 3D systems of Graph-R Project and reconstruct 3D images for subsequent analysis. We also determined whether the differences in these parameters between primary first molars and stainless steel crowns (SSC, 3M ESPE, No. 2-7) could be used as a reference for selecting a suitably-sized SSC and performing adjustments during restoration. The results indicated a statistically significant difference in the mesiodistal distance of lower primary first molar crowns between boys (7.75 ± 0.38 mm) and girls (7.41 ± 0.41 mm) (p < 0.05) but no differences in the mesiodistal distance of upper primary first molars between the two sexes. The mean mesiodistal distances of the upper and lower primary first molars of boys were close to SSC size 4 and 3, respectively, while those of girls were close to size 3 in both arches. Overall, the buccolingual distance between the first maxillary and mandibular molars of Taiwanese children was greater than the buccolingual distance between the 3M ESPE SSC. Reducing the buccolingual length of the abutment teeth might quickly help achieve a better fit, reduce chair time, and minimize patient discomfort. In addition, trimming the mesial and distal metal margins of SSCs might help reduce microleakage from the crown margins and improve its retention and survival rate. In conclusion, the 3D scanning and analysis method used in this study can serve as a reference for fabricating SSC to achieve better crown adaptation and improve dental procedures.

Periodontal Ehlers-Danlos syndrome in early childhood: A case report of loss of deciduous teeth.

The aim of the present study is to report a case of periodontal Ehlers-Danlos syndrome (pEDS) in early childhood. A 3-year-old child, complaining of severe tooth mobility, gingival bleeding, and early loss of deciduous teeth sought the dental clinics. The patient was diagnosed with pEDS, and no other systematic health impairments were diagnosed. It was implemented a strict supragingival biofilm control, using mechanical and chemical strategies. However, during the treatment, the patient had to receive multiple dental extractions. Scaling and root planing were performed in the remaining teeth, and the patient is included in the periodontal maintenance program to prevent recurrence of the disease. It was concluded that, although rare, severe cases of periodontitis may occur in deciduous teeth. Strict supragingival biofilm control and periodontal maintenance are strongly recommended in those patients, along with familial monitoring.