Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial.

AIM AND OBJECTIVE: To compare the arresting caries effectiveness of two different silver nanoparticle (AgNP) concentrations of nano-silver fluoride (NSF), namely 400 and 600 ppm. The hypothesis is that in posterior primary teeth with occlusal and approximal active dentin carious lesions, NSF 600's effectiveness will be higher than that of the NSF 400 solution over a 6-month follow-up period. MATERIALS AND METHODS: This was a double-blind randomized clinical trial (RCT) conducted in the city of Recife, Brazil. A total of 337 children aged 5-7 years who attended the University of Pernambuco Dental School's clinics were examined. A single-blinded investigator conducted the examinations and treatment of the children. After baseline examination and recording of the dmft index, children were allocated to one of two study groups (NSF 600-intervention and NSF 400-positive control). In both groups, each tooth received two drops of NSF and treatments were performed only once in 6 months. The follow-up examinations were visual and tactile, performed in 30, 90, and 180 days to determine the activity of caries. The carious lesions that were not arrested in 30 days were recorded and referred for restorative treatment. RESULTS: The NSF 600 showed higher rate of success in arresting caries (72.7%, p = 0.025) compared with NSF 400 (56.5%). CONCLUSION: The higher rate of success of NSF 600 can be explained by the higher concentration of AgNPs. CLINICAL SIGNIFICANCE: Nano-silver fluoride has emerged as an excellent alternative to silver diamine fluoride (SDF), as it adds a high antibacterial effect to better esthetic results. Treatment is simple, non-invasive, and incurs low cost. It is ideal for use in community-based programs to increase the access to dental care without staining teeth black like other silver products. HOW TO CITE THIS ARTICLE: Arnaud M, Junior PCM, Lima MGS, et al. Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(2):207-211.

Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding / Avaliação do frênulo lingual em recém-nascidos com dois protocolos e sua relação com o aleitamento materno

Abstract Objective: To characterize the lingual frenulum of full-term newborns using two different protocols and to assess the association of the lingual frenulum with breastfeeding. Methods: This non-probabilistic sample consisted of 449 mother/baby binomials. For the anatomo-functional evaluation of the frenulum, the Neonatal Tongue Screening Test and the Bristol Tongue Assessment Tool were used for the evaluation of the lingual frenulum. Breastfeeding was evaluated using the protocol proposed by UNICEF. Scores were created (good, fair, poor) to evaluate every aspect of the breastfeeding to be observed. The results were analyzed through descriptive and inferential statistics and association tests (Pearson's chi-squared and Fisher's exact test). Results: The study showed that 14 babies had a lingual frenulum alteration, of whom three had difficulties during suction, requiring frenotomy in the first week of life, whereas 11 had no difficulties during breastfeeding. Regarding the breastfeeding evaluation, 410 mother/baby binomials had good, 36 regular, and three had bad scores. There was a statistically significant association between the tongue-tie test protocol and breastfeeding (p = 0.028) and between the Bristol Tongue Assessment Tool protocol and breastfeeding (p = 0.028). Conclusion: Alterations in the lingual frenulum are associated with interferences in the quality of breastfeeding and thus, evaluation of the lingual frenulum in newborns is important.

Resumo Objetivo: Caracterizar o frênulo lingual de recém-nascidos a termo, utilizando dois protocolos diferentes e verificar a relação do frênulo lingual com o aleitamento materno. Método: A amostra não probabilística foi constituída por 449 binômios mãe/bebê. Para a avaliação anatomofuncional do frênulo, utilizou-se o protocolo de avaliação do frênulo lingual para bebês "Teste da Linguinha" e o Bristol Tongue Assessment Tool. A mamada foi avaliada com o protocolo proposto pelo UNICEF. Foram criados escores (bom, regular, ruim) para avaliar cada aspecto da mamada a ser observada. Os resultados foram analisados através de estatísticas descritivas e inferenciais e testes de associação (Qui-quadrado de Pearson e Exato de Fisher). Resultados: O estudo mostrou que 14 bebês apresentaram alteração de frênulo lingual, nos quais três com dificuldade durante a sucção, necessitando de frenotomia na primeira semana de vida e 11 sem dificuldades durante a amamentação. Quanto à avaliação da mamada, 410 binômios mãe/bebê apresentaram o escore bom, 36 regular e 3 ruim. Houve associação estatisticamente significativa entre o protocolo "Teste da Linguinha" e amamentação (p = 0,028) e entre o protocolo Bristol Tongue Assessment Tool e amamentação (p = 0,028). Conclusão: Alterações no frênulo lingual estão associadas a interferências na qualidade da amamentação, sendo importante a avaliação do frênulo lingual em recém-nascidos.

Prevalence of sleep-disordered breathing and associations with malocclusion in children.

STUDY OBJECTIVES: This study aimed to determine the prevalence of sleep-disordered breathing (SDB) and its association with malocclusion among children in Recife, Brazil. METHODS: This study included 390 children aged 7 to 8 years. The data comprised the measurement of body mass, orthodontic examination, and parental information required by the Sleep Disturbance Scale for Children. The statistics tools used were Pearson's chi-square test and the Lemeshow test. RESULTS: Positively screened for SDB was found in 33.3% of the children, and the association with overjet was P = .007 (odds ratio [OR], 95%, confidence interval [CI]: 1.93). The association with anterior open bite was P = .008 (OR, 95% CI: 2.03), and the association with posterior crossbite was P = .001 (OR, 95% CI: 2.89). This report was unable to indicate an association between body mass index and SDB. The multivariate logistic regression model revealed that the anterior open bite (P = .002; OR, 95% CI: 2.34) and posterior crossbite (P = .014; OR, 95% CI: 2.79) had an association with positively screened for SDB. CONCLUSIONS: The results of this study indicated that the prevalence of SDB was high and highly associated with malocclusion. Since posterior crossbite and anterior open bite were associated with positively screened for SDB, early diagnosis and intervention may prevent and minimize adverse effects of SDB on individuals lives.

Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding.

OBJECTIVE: To characterize the lingual frenulum of full-term newborns using two different protocols and to assess the association of the lingual frenulum with breastfeeding. METHODS: This non-probabilistic sample consisted of 449 mother/baby binomials. For the anatomo-functional evaluation of the frenulum, the Neonatal Tongue Screening Test and the Bristol Tongue Assessment Tool were used for the evaluation of the lingual frenulum. Breastfeeding was evaluated using the protocol proposed by UNICEF. Scores were created (good, fair, poor) to evaluate every aspect of the breastfeeding to be observed. The results were analyzed through descriptive and inferential statistics and association tests (Pearson's chi-squared and Fisher's exact test). RESULTS: The study showed that 14 babies had a lingual frenulum alteration, of whom three had difficulties during suction, requiring frenotomy in the first week of life, whereas 11 had no difficulties during breastfeeding. Regarding the breastfeeding evaluation, 410mother/baby binomials had good, 36 regular, and three had bad scores. There was a statistically significant association between the tongue-tie test protocol and breastfeeding (p=0.028) and between the Bristol Tongue Assessment Tool protocol and breastfeeding (p=0.028). CONCLUSION: Alterations in the lingual frenulum are associated with interferences in the quality of breastfeeding and thus, evaluation of the lingual frenulum in newborns is important.

Dental development in children born to Zikv-infected mothers: a case-based study.

BACKGROUND: In Brazil, in October 2015, an outbreak of Zika virus (ZIKV) infection and an increase in newborns with microcephaly suggested a relationship between maternal infection and microcephaly in children. OBJECTIVE: First, to assess the presence of dental bud sin 13 infants with a confirmed diagnosis of congenital ZIKV syndrome, born to mothers infected with the virus during pregnancy; second, to evaluate the dental development of these children at a 36-month follow-up. DESIGN: Case-based longitudinal study. RESULTS: Dental radiographs in the first semester showed that all children had dental buds. Along with the study, the individuals presented with various dental disturbances. At the end of the evaluation period, some children still had incomplete deciduous dentition. CONCLUSION: The abnormal chronology of dental eruption and dental development disturbances in children with microcephaly infected with ZIKV born to infected mothers indicate a possible role of the virus in odontogenesis.

Prevalence of TMD and level of chronic pain in a group of Brazilian adolescents.

AIMS: To determine the prevalence of temporomandibular disorders and associated factors in an adolescent sample from Recife, Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted with 1342 adolescents aged 10-17 years. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used by calibrated examiners to evaluate the presence and levels of chronic pain. To evaluate the socioeconomic conditions, the subjects answered the Brazilian Economic Classification Criteria (CCEB) questionnaire. Data were analyzed by means of binary logistic regression in SPSS. RESULTS: The results showed that 33.2% of the subjects had TMD irrespective of age (p = 0.153) or economic class (p = 0.653). Statistically significant associations were found between TMD and female gender (p = 0.017), headache/migraine in the past six months (p<0.001), chronic pain (p<0.001) and chronic pain level (p<0.001). In the final model, logistic regression showed that the level of chronic pain and the headache/migraine in the past six months were related to the presence of TMD. CONCLUSIONS: The prevalence of TMD was considered high (33.2%) and adolescents with chronic pain and headache in the past six months were more likely to have TMD. CLINICAL RELEVANCE: The data contribute to the understanding of TMD among adolescents and to the development of preventive measures and polices to identify the dysfunction promptly.

Effects of a New Nano-Silver Fluoride-Containing Dentifrice on Demineralization of Enamel and Streptococcus mutans Adhesion and Acidogenicity.

An experimental dentifrice containing nano-silver fluoride (NSF) and a sodium fluoride (NaF) toothpaste were tested in vitro, against S. mutans, to evaluate the minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), antiadherence, antiacid, enamel microhardness, and OCT. The microdilution technique was used to determine the MIC and MBC. Fragments of deciduous enamel were treated with dentifrice slurries, containing bacterial suspension and PBS-treated saliva. The quantification of the microorganisms that adhered to the enamel was determined after 24 hours of incubation, and media pH readings were performed after 2 hours and 24 hours. Deciduous teeth were evaluated for microhardness and OCT during 14 days of pH cycling. Data were statistically analyzed using Student's t-test, Mann-Whitney U test, ANOVA, and Tukey tests at 5% of significance. Dentifrices containing NSF presented a lower MIC and higher statistically significant results compared to NaF dentifrices with respect to preventing bacterial adhesion and pH decreases. NSF and NaF dentifrices showed the same ability to avoid enamel demineralization corroborated by the OCT images. The NSF formulation had a better antibacterial effect compared to NaF dentifrices and similar action on the demineralization of enamel indicating their potential effectiveness to prevent caries.

Prevalência de periodontite apical crônica (PAC) em pacientes idosos atendidos nas clínicas de graduação da FOP, UFPE e FOR / Prevalence of chronic apical periodontites in elderly patients taken care at graduation clinics of FOP, UFPE and FOR

Esta pesquisa foi realizada em 32 pacientes acima de 60 anos de idade atendidos nas clínicas de Semiologia, Prótese Dentárias e Clínica Integrada da graduação das Faculdades de Odontologia da UPE, UFPE e FOR, com o objetivo de avaliar a prevalência de Periodontite Apical Crônica (P.A.C.)nestes idosos através de axames radiográficos correlacionando esses achados com fatores como: idade, gênero, escolaridade, dente mais acometido, número de dentes presentes na cavidade oral e estado geral do paciente. A presença da P.A.C. foi confirmada em apenas cinco (15,6%) idosos, portanto a prevalência da lesão foi considerada baixa, mesmo levando em consideração a pequena amostra; a presença da mesma foi registrada em 8 dentes, destes pacientes destaca-se que: quatro era do sexo feminino, com idades variando entre 61 a 69 anos, sendo que três tinham 67 anos; todos tinham hipertensão arterial; em relação à escolaridade registrou-se que um paciente era analfabeto, um tinha primeiro grau incompleto e três tinham 1º grau completo.

This study done on 32 pacients 60 years odl and over, who received care at the clinics of semiology, prosthodontics, and integrated clinic of graduation of the dentistry scholls of UPE, ufpe, and FOR, with the purpose of evaluating the prevalence of Chronic Apical Periodontitis on these people of age through radiographic examinations, correlating these findings with factors such as: age, gender, level of education, more tooth, number of teeth present in the oral cavity, and overall state of the pacient. The presence of Chronic Apical Periodontitis was confirmed on only 5 (15.6%) pacients, wich was a low prevalence of the lesion; the presence of the same was registered in 8 teeth, of these pacients it is notable that: 4 were females, with age varying from 61 to 69 years, with 3 being 67 years old; each one had arterial hypertension; in relation to level of education, it was noted that 1 pacient was illiterate.