One-year follow-up of Atraumatic Restorative Treatment(ART) for dental caries in children undergoing oncohematological treatment: a pragmatic trial.

BACKGROUND: The oral condition in children undergoing oncohematological treatment can have a negative impact on the course of disease. Little is known about survival of tooth restorations in these patients. The aim of this study was to evaluate the longevity of restorations and sealants performed by Atraumatic Restoration Treatment (ART) in patients undergoing oncohematological treatment. METHODS: ART single surface restorations and sealants were performed in the experimental group (E), which comprised children (2-13 years old) undergoing oncohematological treatment, and in the control group (C), in which patients did not undergo such treatment. The same examiner evaluated the ART at 1, 3, 6 and 12 months after preparation, using the same criteria for restorations and sealants. ART was successful if the sealant or restoration did not need a repair in the follow-up assessment. Descriptive, bivariate and Cox's proportional hazard analyses were performed at a significance level of 5 %. RESULTS: The two groups, one including 24 children (E) and the other 14 children (C), received 101 and 52 ART procedures, respectively. The success rates were 95.0 % (E) and 100 % (C) at 1 month (P = 0.233); 81.2 % (E) and 92.3 % (C) at 3 months (P = 0.009); 72.2 % (E) and 80.8 % (C) at 6 months (P = 0.050) and 48.5 % (E) and 73.1 % (C) at 12 months (P = 0.001). The final Cox's regression model for occurrence of ART failure needing repair did not show differences between groups (E: OR = 1.6, 95 % CI 0.8-2.9); primary teeth had a shorter survival than permanent teeth (OR = 2.1, 95 % CI 1.2-3.7). CONCLUSIONS: Oncohematological treatment did not interfere with the longevity of ART restorations and sealants, which suggests the potential use of this technique in children undergoing chemotherapy. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC) RBR-2c3c52. Registered 5 June 2014. http://www.ensaiosclinicos.gov.br/rg/RBR-2c3c52/.

Evaluation of chlorhexidine on the quality of the hybrid layer in noncarious primary teeth: an in vitro study.

It has recently been observed that chlorhexidine has the capacity to inhibit matrix metalloproteinase. Therefore, the object of this study was to assess the effect of chlorhexidine on the quality of the hybrid layer of noncarious primary teeth. In group 1, the teeth were subjected to acid-etching, chlorhexidine application, Single Bond adhesive insertion, and restoration with resin composite Z250. Group 2 received the same procedures, without the application of the antimicrobial agent. Twenty-five regions were examined by scanning electronic microscopy by blind examiners. The data obtained were statistically analyzed by the chi-square and student t tests at a 5% level of significance. The groups presented few interfacial gaps without statistically significant differences. Group 1 presented a larger number of areas with a visible hybrid layer (68%) vs group 2 (52%). The layer's thickness was 3.33 microm and 3.28 microm for groups 1 and 2, respectively (P=.94). The results showed that the clinical restorative protocol with the use of chlorhexidine application does not interfere significantly in the morphological characteristics of the hybrid layer.

Tissue repair after orbital reconstruction using polypropylene mesh implants: A histological study in dogs / Reparo tecidual após reconstrução de órbita com implante de malha de polipropileno: um estudo histológico em cães

Purpose: This experimental study aimed to assess the histological outcomes of orbit reconstruction with a polypropylene mesh implant in an animal model using dogs. Methods: The right and left orbits of 12 dogs were fractured in order to simulate orbital fractures similar to those occurring in humans as a result of trauma. The orbits were reconstructed with a polypropylene mesh positioned approximately 10 mm beyond the bone defect borders. The 24 orbits were divided into four groups of six: one group was given one polypropylene mesh layer; another group received two layers; a third group was given three polypropylene mesh layers; and the fourth group did not receive any implant (control group). The dogs were divided into clusters of four animals and were euthanized 15, 30, or 60 days after the surgery. The orbit medial wall was removed, and samples were subjected to histological polypropylene mesh analysis by optical microscopy. Data were analyzed using a non-parametric test with a 5% level of significance. Results: It was found that the polypropylene mesh caused a mild to moderate tissular reaction. Conclusion: The implant was well tolerated even with two or three overlapping layers.

Objetivo: Trata-se de estudo experimental em que se reconstruíram os continentes orbitais de 12 cães com implante de tela de polipropileno. Metodologia: Os continentes orbitais foram fraturados simulando as fraturas orbitais que ocorrem em humanos devido ao trauma e reconstruídas com tela de polipropileno cortadas com extensão de cerca de 10mm além da margem do defeito ósseo. Utilizaram-se uma, duas ou três camadas de tela de polipropileno nas órbitas teste e algumas órbitas, somente fraturadas, serviram como controle. Os cães foram sacrificados nos tempos de 15, 30 e 60 dias de pós-operatório; os tecidos das órbitas teste e controle foram removidos e preparados para análise histológica em microscopia óptica. Os resultados obtidos pela análise histológica foram submetidos a análise estatística não paramétrica com 5% de significância. Resultados: A tela de polipropileno causou reação tecidual de leve a moderada nos tecidos. Conclusão: O implante foi bem tolerado, mesmo quando a tela foi superposta em duas ou três camadas.

Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition.

BACKGROUND: Plaque control and caries arrest still remain a challenge for dentists. OBJECTIVE: This study was conducted to assess the effect of the combined use of chlorhexidine varnish and fluoride varnish on the visible plaque index (VPI) and white spot lesion (WS) remineralization in primary dentition. METHODS: A total of 80 caries-active preschool children (3-5 years) were randomly divided into four groups. Group 1 received a chlorhexidine varnish application every week during 4 weeks. Group 2 received a fluoride varnish application every week during 4 weeks. Group 3 received alternated applications of chlorhexidine and fluoride varnish during 4 weeks. Group 4 served as control (without any type of cariostatic agent). RESULTS: There was no statistically significant difference in the VPI and WS remineralization among the groups after 1 month. However, 3 months follow-up demonstrated that group 3 (chlorhexidine + fluoride) showed significantly better results for both VPI and WS remineralization. CONCLUSION: The combined application of chlorhexidine and fluoride varnishes is more effective on plaque and remineralization of incipient caries after 3 months than the same agents applied separately.

[Knowledge of oral health and practices among mothers attending a mother-child dental care program]. / Conhecimentos e práticas em saúde bucal de mães que freqüentaram um programa odontológico de atenção materno-infantil.

This study assesses the assimilation of knowledge and preventive practices in oral health among the mothers of children assisted by a mother-child dental care program. The Preventive Program for Pregnant Mothers and Babies (PPPMB) is an extension project run by the Piauí Federal University (UFPI), whose goal is to make pregnant women and mothers of children from zero to 36 months old more concerned about habits fostering oral health. After a random selection of clinical record cards for children who had participated in this Program, letters were sent to their mothers. Feedback was received from 281 mothers, who responded through interviews that included questions on matters addressed by the Program. The findings indicate that mothers attending this Program were properly informed, adopting hygienic practices in their families that underpin the control and prevention of oral diseases.

Prevalence of dental caries in children born prematurely or at full term.

The objective of this study was to evaluate the prevalence of dental caries in 192 children, 96 born prematurely and 96 at full term, in a regional hospital in Brazil. Mean age at clinical examination was 40.72 months in the full-term group (G1) and 30.44 months in the premature group (G2). The children were divided in two age subgroups: 0 to 3 and 4 to 6 years. Statistical results (Student's t and Kruskal-Wallis tests) showed that dmft was 0.43 for G1 and 0.01 for G2 in the 0-3 age subgroup, and 1.7 for G1 and 1.1 for G2 in the 4-6 age subgroup. Differences were significant between G1 and G2 only in the 0-3 age subgroup (p = 0.047). Caries evaluation showed that, of the 96 children in G1, 75 were caries free, while in G2, 84 did not have the disease. These differences were not significant (p = 0.088). The lower mean dmft found in the 0-3 age subgroup in G2 may be attributed to routines established by the hospital's neonatology staff, such as frequent dental visits and preventive instructions about oral habits, oral hygiene and diet. After this age, with the completion of the primary dentition, values increased and became similar between the G1 and G2 groups. Results also suggested a highly skewed distribution since most caries were found in only a small number of children.

Dental caries in children that participated in a dental program providing mother and child care.

The main goal of this study was to evaluate the prevalence of caries in children that participate in a dental program attending mothers and children in Teresina, Piauí, Brazil. A selection was made of 343 children of both genders, from 3 to 6 years of age. The mothers answered questionnaires and children were examined at the Infant Dental Clinic of the Federal University of Piauí. The epidemiological index dmft was applied and active white spot lesions were included. The SPSS for Windows program, version 11.1 was used and non-parametric tests carried out (Friedman and Kruskal-Wallis). An alpha error of 5% (0.05) was considered for the null hypothesis of false rejection, with a confidence interval of 95%. The results showed that 57.5% (197) of the children were breast-fed for a period longer than 12 months. The mean dmft index and percentages of caries-free children at the age of 3 was 1.86 (58.82%); at 4 years of age 1.94 (57.60%); at 5 years of age 1.98 (56.86%) and at 6 years of age 2.42 (42.55%). The decay component (d) was prevalent at all ages. When active white spot lesions were added to the dmft index, there was an increase of 7.2% for children who had caries activity and/or previous caries experience and 2.61% for those with dmft equal to zero. The daily consumption of fermentable carbohydrates and free demand breast-feeding were factors increasing caries activity. Dental follow-up after the program and the number of daily brushings were shown to be factors providing protection against caries. Based on the results, the authors were able to conclude that the program caused a positive impact on caries disease control, as the number of dental appointments kept influenced the dmft index values in a statistically significant manner.

Effect of oral anticipatory guidance on oral health and oral hygiene practices in preschool children.

Thirty children (6 to 18 months), enrolled in a dental program since birth, make up the intervention group. Control group consisted of thirty children who were of similar age and gender but had never been to a dental office. The presence of visible dental plaque and the performance of oral hygiene differed statistically between both groups. The dental program was effective in reducing visible dental plaque, and in establishing oral health habits among parents and young children.

Feeding habits and severe early childhood caries in Brazilian preschool children.

PURPOSE: The objective of this study was to analyze the association between the feeding practice and presence or absence of SECC (Severe Early Childhood Caries) in Brazilian preschool children. METHODS: This cross-sectional study was conducted with male and female preschool children, aged 36 to 71 months, randomly selected from a low-income population. A 24-hour recall diary was used to assess data about infant feeding practices and dietary habits. The data were statistically analyzed using the chi-square test with a significance level of 5%. RESULTS: SECC was observed in 36% of the children examined. Infant feeding practices showed the association between SECC and night-time breast-feeding (P = .02) or breast-feeding (P = .0004) in children older than 12 months of age. The use of a bottle at night as a substitute for the pacifier and its use on demand during the day were also correlated with SECC (P < .0001). CONCLUSIONS: It was concluded that night-time breast-feeding in children older than 12 months of age, the use of a bottle at night as a substitute for the pacifier, and use of the bottle on demand during the day are feeding practices correlated with the etiology of SECC.

Reaction of mouse subcutaneous tissue to Carisolv--a morphologic study.

This study was designed to investigate in vivo subcutaneous tissue reactions after Carisolv contact in a mouse model. Eighteen mice were implanted with two polyethylene tubes: the implant on the right side included a sponge soaked in Carisolv; the implant on the left side served as a control. Similar tissue response was displayed in both test and control groups, suggesting that Carisolv does not result in adverse effects as compared with a control. The tendency of connective tissue encapsulating the implants in both groups may result from the presence of materials that can be well-tolerated by the organism.

Effectiveness of teaching methods for toothbrushing in preschool children.

Three different methods of instruction and motivation were used to assess the learning process and ability of preschool children in performing toothbrushing. Forty children from a private nursery of Brasília, DF, Brazil, were divided into 2 groups according to age (3-4 years old and 5-6 years old). The following methods of instruction and reinforcement were applied: I--audiovisual; II--child as a model; III--individual instruction. Professional prophylaxis was then performed and the children remained 48 hours without any kind of oral hygiene. Plaque disclosing and plaque index were carried out and recorded. The children subsequently brushed their teeth according to each method of instruction and a new plaque index was recorded. The data were analyzed statistically using the Student t-test and the comparison of two proportions. The results showed that the children of both groups reduced plaque index and that the individual instruction method was superior (p<0.05) to the others at all ages. Children older than 5 years of age were able to learn and accomplish toothbrushing better than younger children.