Association of salivary parameters and erosive tooth wear in preschool children.

The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

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.

Banda ortodôntica como alternativa de tratamento conservador provisório para primeiros molares permanentes com hipomineralização molar incisivo (HMI): relato de caso / Orthodontic banding as an alternative provisional conservative treatment for permanent first molars with incisor molar hypomineralization (IMH): case report

Introdução: a Hipomineralização Molar Incisivo (HMI) é um defeito qualitativo de desenvolvimento de esmalte que pode ocasionar fraturas pós-eruptivas (FPE), lesões de cárie e sensibilidade. Objetivo: relatar o tratamento de HMI severa através da cimentação de bandas ortodônticas para preservação da estrutura dentária em primeiros molares permanentes inferiores com FPE. Relato do caso: criança do sexo feminino, 10 anos de idade, apresentou-se com queixa de hipersensibilidade e fratura dentária associada à restauração prévia. Clinicamente, observou-se presença de HMI severa, com FPE associada à lesão de cárie em dentina nas superfícies oclusal e vestibular do dente 36 e restauração insatisfatória com cimento de ionômero de vidro (CIV) na superfície vestibular do dente 46 que apresentava opacidades demarcadas branco-creme. Radiograficamente, observou-se ausência de comprometimento pulpar. Após manejo por meio de abordagens não-invasivas (controle de biofilme e dieta e aplicação de verniz fluoretado), o tratamento proposto foi a cimentação de banda ortodôntica com CIV modificado por resina (Riva Light Cure®, SDI) nos dentes 36 e 46 para maior longevidade das restaurações. O tratamento restaurador atraumático (TRA) foi realizado no dente 36 previamente à cimentação da banda ortodôntica. Resultados: após o tratamento, a criança não relatou dor ou desconforto e as restaurações mantiveram-se intactas. A mãe da criança foi orientada quanto à importância de acompanhamento periódico a cada 4 meses. Conclusão: a cimentação das bandas ortodônticas com CIV possibilitou o manejo conservador de molares permanentes com HMI severa, com manutenção de sua funcionalidade oclusal, saúde pulpar e gengival, proporcionando melhor qualidade de vida à paciente.

Introduction: molar Incisor Hypomineralization (MIH) is a qualitative developmental enamel defect that can cause posteruptive enamel breakdown (PEB), caries lesions, and sensitivity. Objective: to report the treatment of a child with severe MIH through the cementation of orthodontic bands in lower first permanent molars with PEB to preserve tooth structure. Case report: female child, 10 years old, presenting hypersensitivity complaints and tooth fracture associated with previous restoration. Severe MIH was observed, with PEB associated with dentin caries on the occlusal and buccal surfaces of tooth #36 and unsatisfactory glass ionomer cement (GIC) restoration on the buccal surface of tooth #46 which had creamy-white marked opacities. There was no pulp involvement radiographically. After management through non-invasive approaches (biofilm and diet control and application of fluoride varnish), the proposed treatment was the cementation of an orthodontic band with resin-modified GIC (Riva Light Cure®, SDI) on teeth #36 and #46 to long-term lifespan restorations. Atraumatic restorative treatment (ART) was performed on tooth #36 prior to the cementation of the orthodontic band. Results: after treatment, the child did not report pain or discomfort and the restorations remained intact. The child's mother was instructed about the importance of periodic follow-up visits every 4 months. Conclusion: the cementation of orthodontic bands with GIC allowed the conservative management of permanent molars with severe MIH, maintaining their functional occlusion, pulpal and gingival health, providing a better quality of life to the patient.

Association of salivary parameters and erosive tooth wear in preschool children

Abstract The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

Impact of the COVID-19 pandemic on the gingival health of children and adolescents with cerebral palsy / Impacto da pandemia do COVID-19 na saúde gengival de crianças e adolescentes com paralisia cerebral

Objective: to evaluate the impact of the COVID-19 pandemic on children and adolescents with cerebral palsy, comparing the gingival condition and the type of dental treatment before and after the interruption of dental care. Material and Methods: the retrospective longitudinal study consisted of 273 participants undergoing Dental Clinic of the AACD (Disabled Child Assistance Association), divided into three groups according to age: Group 1 (G1: 0 to 5 years and 11 months; n=137), Group 2 (G2: 6 to 11 years and 11 months; n=85) and Group 3 (G3: 12 to 17 years and 11 months; n=51). Sociodemographic, data, clinical pattern of cerebral palsy and use of medication were collected, evaluating the gingival condition by the gingival index and the type of dental treatment before the pandemic and during, nine months after the interruption of dental care. Chi-square, Fisher Exact and Kruskal-Wallis (α=5%) tests were used. Results: the groups were homogeneous in terms of sex (p=0.4581), race (p=0.1725), clinical pattern (p=0.3482) and use of antiepileptic drugs (p=0.3509). Regarding the gingival condition, in the period during the pandemic, there was a reduction in the number of participants with Gingival Index scores 0 and 1 and an increase in participants with scores 2 and 3 (p<0.05). As for the procedures performed, the three groups showed a reduction in preventive procedures (p<0.05) and an increase in surgical, periodontal and restorative procedures (p<0.05). Conclusion: it is concluded that the interruption of dental care for nine months during the COVID-19 pandemic in children and adolescents with cerebral palsy had a negative impact on oral health (AU)

Objetivo: avaliar o impacto da pandemia da COVID-19 em crianças e adolescentes com Paralisia Cerebral, comparando a condição gengival e o tipo de tratamento odontológico antes e após a interrupção dos atendimentos odontológicos. Material e Métodos: o estudo longitudinal retrospectivo foi composto por 273 participantes atendidos na Clínica odontológica da AACD (Associação de Assistência à Criança Deficiente), reunidos em três grupos segundo a faixa etária: Grupo 1 (G1: 0 a 5 anos e 11 meses; n=137), Grupo 2 (G2: 6 a 11 anos e 11 meses; n=85) e Grupo 3 (G3: 12 a 17 anos e 11 meses; n=51). Foram coletados dados sociodemográficos, padrão clínico da Paralisia Cerebral e o uso de medicação, avaliando a condição gengival pelo índice gengival e o tipo de tratamento odontológico antes e durante a pandemia, nove meses após a interrupção dos atendimentos. Foram empregados os testes Qui-quadrado, Exato de Fisher e Kruskal-Wallis (α=5%). Resultados: os grupos eram homogêneos quanto ao sexo (p=0,4581), raça (p=0,1725), padrão clínico (p=0,3482) e uso de drogas antiepiléticas (p=0,3509). Com relação à condição gengival, no período Durante Pandemia, observou-se redução no número de participantes com escores Índice Gengival 0 e 1 e aumento de participantes com escores 2 e 3 (p<0,05). Quanto aos procedimentos realizados, os três grupos apresentaram redução de procedimentos preventivos (p<0,05) e aumento dos procedimentos cirúrgicos, periodontal e restaurador (p<0,05). Conclusão: conclui-se que a interrupção do acompanhamento odontológico por nove meses na pandemia da COVID-19 em crianças e adolescentes com PC acarretou impacto negativo na saúde bucal (AU)

Low-Level Laser Therapy for Management of Hypersensitivity in Molar-Incisor Hypomineralization and Oral Health-Related Quality of Life: Case Report.

The aim was to report the use low-level laser therapy (LLLT) in the management of hypersensitivity in an adolescent with molar incisor hypomineralization (MIH) and the impact of LLLT on his oral health-related quality of life (OHRQoL). Clinical examination revealed severe MIH with hypersensitivity, in all first permanent molars and incisors. The treatment proposed was desensitization with fluoride and esthetic rehabilitation of the affected teeth. Then, LLLT was applied perpendicularly in a continuous mode (wavelength of 808 nm, power of 100 mW, dose of 1 J, and fluence of 35 J/cm2). The visual analogue scale was applied each session of LLLT. The child perceptions questionnaire (CPQ11-14) was administered at the beginning and the end of the treatment. It was concluded that LLLT can be indicated in the management of hypersensitivity in an adolescent with severe MIH to control pain and to improve his OHRQoL.

Shprintzen-goldberg craniosynostosis: craniofacial and oral characteristics, diagnosis, and clinical management of a very rare syndrome / Craniossinostose de shprintzen-goldberg: características craniofaciais e orais, diagnóstico e manejo clínico de uma síndrome muito rara

ABSTRACT Shprintzen-Goldberg craniosynostosis syndrome, characterized by craniosynostosis and marfanoid habitus, is a very rare entity described in 75 individuals worldwide. This study aimed to present a case report of a 6-year-old female Brazilian child with Shprintzen-Goldberg's craniosynostosis syndrome. We described the craniofacial and oral characteristics and its clinical management, comparing to the existing literature. The patient presented with intellectual disability, craniosynostosis, ocular proptosis, low-set anomalous ears, and other skeletal and connective tissue defects. Oral features included malocclusion, micrognathia, pseudo-cleft palate, dental caries, and inefficient biofilm control. The treatment started with guidance on cariogenic foods, oral hygiene, and an indication to discontinue bottle feeding. Subsequently, the carious lesions were restored with composite resins, and the patient was referred for orthopedic surgery, orthodontic treatment, speech therapy, and nutritional counseling. The patient was followed for 5 years. This case report emphasizes the importance of knowing the craniofacial and oral characteristics for the diagnosis and clinical management of a female child with a rare Shprintzen-Goldberg's craniosynostosis syndrome. The case also highlights the need for oral health care in individuals with intellectual disabilities.

RESUMO A síndrome Shprintzen-Goldberg é uma entidade muito rara descrita em 75 pessoas, caracterizada por craniossinostose e habitus marfanóide. O objetivo deste estudo é apresentar o relato de um caso clínico de uma criança brasileira de 6 anos com síndrome da craniossinostose de Shprintzen-Goldberg, apresentando as características craniofaciais e orais e seu manejo clínico, comparando com a literatura. O paciente apresentava deficiência intelectual, craniossinostose, proptose ocular, orelhas anômalas de implantação baixa e outros defeitos esqueléticos e do tecido conjuntivo. As características orais incluíram má oclusão, micrognatia, pseudo fenda palatina, atividade de cárie e controle ineficiente do biofilme. O tratamento foi iniciado com orientações sobre alimentos cariogênicos, higiene oral e indicação de suspensão do uso de mamadeira. Em seguida, as lesões cariosas foram restauradas com resina composta e o paciente encaminhado para cirurgia ortopédica, tratamento ortodôntico, fonoaudiologia e nutricionista. O paciente foi acompanhado periodicamente por 5 anos. Este relato de caso enfatiza a importância do conhecimento das características craniofaciais e orais para o diagnóstico e manejo clínico de uma criança do sexo feminino com síndrome de craniossinostose de Shprintzen-Goldberg rara, destacando a necessidade de cuidados com a saúde bucal em indivíduos com deficiência intelectual.

Effect of Xylitol Varnishes on the Inhibition of Demineralization in Vitro

Abstract Objective: To evaluate the efficacy of xylitol varnishes in the inhibition of enamel demineralization in vitro. Material and Methods: Bovine enamel blocks (n=120) were randomly allocated to four groups (n = 30), and the surface hardness (SH) was measured at baseline. The blocks were treated with the following varnishes: 20% xylitol, 20% xylitol plus F (5% NaF), Duraphat™ (5% NaF, positive control), and placebo (no-F/xylitol, negative control). The varnishes were applied and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH cycles (demineralization and remineralization for 2 and 22h/day, respectively, for 8 days). Surface and cross-sectional hardnesses were measured to calculate the percentage of SH loss (%SHL) and the integrated loss of the subsurface hardness (ΔKHN). Data were statistically analyzed using Kruskal-Wallis and Tukey's tests (p<0.05). Results: %SHL was significantly decreased by 20% xylitol plus F, Duraphat™, and 20% xylitol varnishes compared to placebo. The use of 20% xylitol plus F varnish led to a significantly lower percentage of SH loss compared to the use of 20% xylitol varnish without F. However, the experimental and commercial varnishes led to significantly lower subsurface demineralization compared to placebo and did not differ from each other. Conclusion: Xylitol varnishes, especially when combined with F, effectively prevent enamel demineralization (AU).

Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study

Abstract Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question "In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?" was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR= 1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR= 1.81; 95% CI: 1.51-2.15), dental trauma (PR= 1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR= 1.36; 95% CI:1.18-1.57), dental crowding (PR= 1.60; 95% CI:1.40-1.83), midline diastema (PR= 1.30; 95% CI:1.11-1.44), tooth loss (PR= 1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR= 1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR= 1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents (AU).

Perfil dos endodontistas de uma metrópole brasileira quanto ao atendimento odontológico a pacientes com necessidades especiais / Profile of endodontists in a Brazilian metropolis regarding dental care for patients with special needs

O objetivo do estudo foi caracterizar o perfil dos endodontistas do estado de São Paulo, Brasil em relação ao tratamento odontológico depacientes com necessidades especiais (PNE). Um questionário onlinesobre capacitação do profissional e dados sobre o atendimento odontológico de PNEfoi enviado para 3.500 endodontistas registrados no Conselho Regional de Odontologia de São Paulo. Dentre os 138 profissionais que retornaram, 57,2% eram do sexo feminino; 34,8% estavam na faixa etária entre 31e 40 anos; 42,8% tinham entre 11 e20 anos de formados; e 38,4% possuíam 11 a 20 anos de especialidade. Apenas 22,5% eram capacitados para o atendimento de PNE, sendo que desses, 58,1% tiveram apenas aula teórica. Dos que não receberam capacitação na pós-graduação, 80,4% gostariam de ter recebido. Com relação ao interesse em cursos de atendimento a PNE após a especialização, observou-se que apenas 15,9% realizaram algum tipo de curso, a maioria apenas teórico. Em relação às dificuldades durante o atendimento de PNEa "falta de colaboração do paciente durante o atendimento" foi citada por 74,6%, a "insegurança devido àfalta de preparo profissional" por 55,0%. A análise da associação das variáveis pelo teste Qui-quadrado apontou que quanto maior o tempo de formação, menor essa dificuldade (p=0,0415). Os especialistas encontram mais dificuldades comparados aos que tem formação associada (mestrado e doutorado) (p=0,0369). Não houve associação significativa entre as dificuldades e o tipo de instituição de formação(pública ou privada) (p>0,05). O panorama atual da formação do endodontista não contempla o atendimento as pessoas com necessidades especiais (AU).

The aim of this study was to characterize the profile of endodontic professionals from the state of São Paulo, Brazil in relation to dental treatment for patients with special needs (PSN). An online questionnaire on professional training and data on PSN dental care was sent to 3,500 endodontic professionals registered with the São Paulo Regional Dental Council in 2017. Of the 138 returning professionals, 57.2% were female; 34.8% aged 31-40 years; 42.8% had 11-20 years since graduation; 38.4% had 11-20 years of endodontic specialization. Only 22.5% were trained to provide dental care to PSNs and of these, 58.1% had only theoretical classes. Of those who did not receive post-graduation training, 80.4% would like to have received it. Regarding the interest in PSN care courses after specialization, it was observed that only 15.9% performed some type of course, most of them theoretical only. Regarding difficulties during PSN care, "lack of patient collaboration during care" was mentioned by 74.6%, and "insecurity due to lack of professional preparation" by 55.0%. The analysis of the association of variables by the Chi-square test showed that the longer the training time, the lower the difficulty during PSN care (p=0.0415). Specialists find more difficulties compared to those with associated training (masters and doctorate) (p=0.0369). There was no significant association between difficulties in PSN care and typeof HEI (public or private) (p> 0.05). The current panorama of endodontic professional training does not seem to include care for patients with special needs (AU).

Caries prevalence using ICDAS visual criteria and risk assessment in children and adolescents with cerebral palsy: A comparative study.

AIMS: To compare the dental caries prevalence using the International Caries Detection and Assessment System (ICDAS) and the caries risk by Caries Management by Risk Assessment (CAMBRA) in individuals with cerebral palsy (CP) and normoactives (NAs). METHODS AND RESULTS: Sixty children and adolescents aged 6-12 years (30 CP/30 NA) were clinically evaluated by one calibrated examiner using two-digit ICDAS criteria and converted into components of dmf/DMF indices: d2mf2/D2MF2 (enamel and dentin lesions) and d3mf3/D3MF3 (dentin lesions). An adapted CAMBRA was used for risk classification. The mean d2mf2s/d2mf2t and D2MF2S/D2MF2T for CP were 17.0 ± 16.8/7.5 ± 4.3 and 10.7 ± 17.6/5.3 ± 5.8, respectively, and for NA were 17.2 ± 16.9 /6.9 ± 4.8 and 11.1 ± 11.7/5.5 ± 4.7, respectively. The mean d3mf3s/d3mf3t and D3MF3S/D3MF3T for CP were 10.1 ± 16.7/3.0 ± 4.1 and 4.9 ± 15.6/0.2 ± 0.4, respectively, while for NA the mean values were 9.8 ± 13.0/3.5 ± 3.8 and 2.1 ± 5.7/0.9 ± 2.0, respectively. There were no statistically differences for caries prevalence and risk in both groups (p > 0.05). CONCLUSIONS: Dental caries was highly prevalent in CP and NA children and adolescents. Enamel and dentin lesions and high caries risk were the most common condition.

Dimensional Changes in Dental Arches after Complete Dentures Rehabilitation of a Patient with Hypohidrotic Ectodermal Dysplasia: A Case Report with 18-Year Follow-Up.

BACKGROUND: This case report presents the dimensional changes in dental arches in a patient with hypohidrotic ectodermal dysplasia (HED) after complete denture rehabilitation, with an 18-year follow-up period. CASE REPORT: The patient had complete anodontia and was successfully rehabilitated with conventional complete dentures at 3, 4, 5, 7, 9, 12, 16, and 21 years of age. Each successive denture was larger and contained more and larger teeth so as to accommodate for the increase in the size of the developing jaw. A series of diagnostic casts were used to measure the dimensional changes in the arch length and width of the alveolar ridge. Cast analysis revealed that there was an increase in arch length and width in both the maxilla and mandible over time. Cephalometric analysis of craniofacial development was performed at 21 years of age, and suggested protrusion of the maxilla and mandible. CONCLUSIONS: The absence of teeth due to HED did not affect the dimensional changes in dental arches after complete denture rehabilitation from childhood to adulthood. The prosthetic treatment improved the patient's social integration and enabled the development of normal dietary habits, speech, and facial esthetics, which in turn led to improved quality of life.

Initial Mechanical Stabilization of Conventional Glass Ionomer Cements with Different Active Principles

ABSTRACT Objective: To determine the initial mechanical stabilization of conventional glass ionomer cements (GICs) indicated for the atraumatic restorative treatment (ART) in different storage periods. Material and Methods: Specimens were divided according to the GIC (n=12): IZ - Ion-Z, KM - Ketac Molar Easymix, RS - Riva Self Cure, and GL - Gold Label 9. They were prepared and stored in distilled water. Superficial microhardness (SMH) was evaluated (KHN) in three phases: (A) after 1, (B) 3, and (C) 7 days of storage. Data were submitted to 2-way ANOVA and Tukey tests (α = 5%). Results: The average KHN values for phases A, B, and C were, respectively, 33.05 ± 9.74; 33.21 ± 10.31 and 52.07 ± 11.75 (IZ); 50.35 ± 11.39; 66.05 ± 10.48 and 67.77 ± 13.80 (KM); 89.63 ± 15.59; 71.31 ± 23.86 and 57.70 ± 16.89 (RS); 42.18 ± 9.03; 68.54 ± 6.83 and 57.95 ± 8.24 (GL). Significant differences were observed: GIC, time, and interaction of both (p<0.05). KHN values differed between the groups, except in the GIC parameter for KM and GL. The time parameter values of phase A were lower than those of B and C, except for IZ and RS. Conclusion: The initial mechanical stabilization differed between the types of GIC tested and the storage time, and after the final period, all had similar SMH.

Effectiveness of Home Bleaching Treatment after Resin Infiltrant Application.

PURPOSE: Resin infiltration may be a barrier for bleaching gels. The aim of this study was to compare dental bleaching effectiveness using low-concentration gels on heavily or mildly stained teeth that were or were not treated with resin infiltration agents. MATERIALS AND METHODS: Forty bovine enamel surfaces were submitted to demineralisation, after which two staining protocols were performed. Twenty specimens were immersed in a staining broth for 24 h (Lab 1) or 7 days (Lab 2). Ten specimens of each group received resin infiltrant application following the manufacturer's recommendation. All specimens were bleached using 15% carbamide peroxide gel for 14 days (8 h daily). Colour measurement was performed using a reflectance spectrophotometer at three time points: baseline, after staining, and after bleaching. Data (CIEDE00) were analysed using Student's t-test (p < 0.05). RESULTS: No statistically significant differences were observed in Lab 1 (p = 0.560). For Lab 2, statistically significant differences were detected (p = 0.031). Once bleaching was achieved to some degree (Lab 2), the resin infiltrant may have behaved as a semipermeable barrier to the carbamide peroxide gels. CONCLUSION: Bleaching treatment was effective on mildly pigmented tooth surfaces. On the other hand, in comparison to the control group, the heavily pigmented surfaces bleached less in the presence of the resin infiltrant, possibly due to the lack of free radicals penetrating into the substrate.

Optical magnification has no benefits on the detection of occlusal caries lesions in permanent molars using different visual scoring systems: An in vitro study.

BACKGROUND: Some studies have addressed the influence of optical magnification on the detection of caries lesions using a visual scoring system. However, there is a lack of research related to the use of the CAST and ADA-CCS visual scoring systems. In addition, the reliability and accuracy of ADA-CCS index in permanent teeth were not studied yet. So, the aim of this study was to evaluate, in vitro, the influence of different levels of optical magnification on the detection of occlusal caries lesions in permanent molars using three visual scoring systems. MATERIAL AND METHODS: One occlusal site per tooth was analyzed in 120 extracted permanent molars. Two trained examiners inspected the teeth using ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment), and ADA-CCS (American Dental Association-Caries Classification System) visual criteria, twice with each scoring system, with a one-week interval between examinations. The study was conducted in three phases: (A) without optical magnification, (B) using a binocular lens (3.5× magnification), and (C) using an operating microscope (16× magnification). Then, the teeth were sectioned longitudinally through the center of the selected site and the section with the more severe lesion was histological evaluated considering the D1 (lesions in enamel and dentin) and D3 (dentin lesions) thresholds. RESULTS: Kappa values for intra- and inter-examiner reproducibility were good to excellent for all systems. At the D1 threshold, sensitivity, accuracy, and area under the ROC curve were high for ICDAS and CAST in all phases. However, this was not the case for the ADA-CCS in phase C (<0.05). At the D3 diagnostic threshold, there was no significant difference between the visual scoring systems during the study phases (>0.05). CONCLUSIONS: The magnification does not improve the accuracy of the visual scoring systems in the detection of occlusal caries lesions in permanent molars. Key words:Dental caries, caries detection, permanent teeth, visual examination, magnification.

Monitoring enamel caries on resin-treated occlusal surfaces using quantitative light-induced fluorescence: an in vitro study.

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.

Protocol for Low-level laser therapy in traumatic ulcer after troncular anesthesia: Case report in pediatric dentistry.

The aim of this study was to report a protocol of use for low-level laser therapy (LLLT) in traumatic ulcer in the lower lip after inferior alveolar nerve block anesthesia (IANBA). A 3-year-old patient, male, undergoing treatment of carious lesions was submitted to an indirect pulp capping in tooth 74 under IANBA. The procedure was completed without intercurrences, but on next day, the child presented extensive traumatic ulcer in the left lower lip, with complaint of pain. Two sequential applications with LLLT were applied in punctual mode under pressure around the lesion. After 1 week, the mother reported significant improvement. After 30 days, the lesion was fully healed. In conclusion, LLLT promoted rapid analgesia and healing, being a good treatment alternative for traumatic ulcer after troncular anesthesia. Key words:Local anesthesia, soft tissue injuries, laser therapy, children.

Association of dental caries morbidity stages with oral health-related quality of life in children and adolescents.

BACKGROUND: Dental caries morbidity stages and their impact on oral health-related quality of life (OHRQoL) have not yet been established. AIM: To compare the association of dental caries morbidity stages with OHRQoL in children and adolescents from public schools of Patos-PB, Brazil. DESIGN: A cross-sectional study was performed on 461 students at 8-10 years and 454 at 11-14 years. Caries was evaluated by Caries Assessment Spectrum and Treatment (CAST) instrument. The maximum CAST code per individual was registered. OHRQoL was assessed using the Child Perceptions Questionnaires for children (CPQ8-10 ) and adolescents (CPQ11-14 ). RESULTS: Morbidity stage was the most prevalent caries condition in children (40.8%) and adolescents (38.1%). Factors associated with higher CPQ8-10 scores in the multivariate regression analysis after adjustments were age [9 years, prevalence ratio (PR): 1.24; 95% confidence interval (CI): 1.06-1.45; and 10 years, PR: 1.32, CI: 1.13-1.55] and dental caries status [morbidity, PR: 1.23, CI: 1.03-1.48; and severe morbidity, PR: 1.30, CI: 1.04-1.61]. The factor associated with higher CPQ11-14 scores was dental caries status [morbidity, PR: 1.20, CI: 1.00-1.44]. CONCLUSIONS: The OHRQoL of children was negatively associated with morbidity and severe morbidity stages of dental caries, while for adolescents, only morbidity had a negative association with their OHRQoL.

Three-Month Effect of Silver Diamine Fluoride (SDF) in Salivary Levels of Streptococcus Mutans in Children. An Exploratory Trial.

PURPOSE: The aim of this exploratory trial was to compare the 3-month effect of two antimicrobials on the salivary levels of Streptococcus mutans (SM) in children. MATERIALS AND METHODS: Ninety school children aged 6-10 years participated. They were divided into two groups according to treatment used: 1% chlorhexidine gel (CHX) or 30% silver diamine fluoride (SDF). Saliva for SM colony forming unit (CFU)/ml counting was harvested in four periods: baseline (prior to antimicrobials); P1 (24 h after antimicrobial therapy); P30 (30 days after antimicrobial therapy); and P90 (90 days after antimicrobial therapy). CFU/ml data was submitted to repeated measures by analysis of variance (ANOVA). RESULTS: Only the time factor influenced the results (p <0.001), with a reduction of SM for all evaluated periods in comparison to the baseline. No influence of antimicrobials or interactions of factors were detected (p >0.05). P30 presented the lowest levels of SM and at P90, SM levels were similar to P1 but still lower than the baseline observations. SDF and CHX presented a similar effect on SM within each period of evaluation (p = 0.65). CONCLUSION: It was concluded that 30% SDF presents similar antimicrobial effects as 1% CHX over time. SDF might be used as an adjunctive therapy for controlling dental caries in children.

Oral Anomalies In Newborns: An Observational Cross-Sectional Study.

Purpose: To determine the prevalence of oral anomalies in newborns and the influence of maternal and neonatal factors on the development of these anomalies.
Methods: Four hundred newborns were included in the study conducted at the Hospital and Maternity Dom Orione (HMDO) in the city of Araguaína, Tocantins, Brazil. After collecting demographic data and information about the newborns from the medical records, an oral examination was performed by a single examiner.
Results: The prevalence of oral anomalies was 50 percent. Cysts of the oral cavity were the most prevalent anomalies (43 percent), with palatine cysts (26 percent) and alveolar cysts (23 percent) being the most common. Ankyloglossia was present in nine percent of newborns, and congenital eruption cysts and neonatal teeth were present in 0.5 percent and 0.2 percent, respectively. No statistically significant correlation was observed between the prevalence of palatine cysts, alveolar cysts, or ankyloglossia and maternal or neo-natal factors.
Conclusion: Oral anomalies in newborns are not uncommon, making essential the presence of a dentist, especially a pediatric dentist, in the multidisciplinary team of hospitals and maternal wards.