Traumatic dental injuries in the primary lower incisors.

BACKGROUND: Primary lower incisors are susceptible to traumatic dental injury (TDI), which may affect both primary and permanent dentitions. AIM: This study aimed to evaluate the prevalence of TDIs in the primary lower incisors and the factors associated with their occurrence and with the incidence of sequelae in the permanent successor teeth. DESIGN: Dental files (n = 2926) from patients who attended a reference center for dental trauma in the primary teeth, from 1998 to 2020, were screened. Multilevel Poisson regression analyses were conducted between exploratory variables related to the traumatized teeth and outcome variables: occurrences of severe TDI and sequelae in the permanent successor. Prevalence ratios (PRs), relative risks (RRs), and respective 95% confidence intervals (95% CIs) were calculated. RESULTS: One hundred and thirteen (3.9%) children and 208 teeth presented with TDIs in the primary lower incisors. The prevalence of severe TDI was lower in 4-year-olds (PR = 0.43; 95% CI = 0.19-0.94) than in 2-year-olds. Moreover, severe TDI was significantly associated with the occurrence of sequelae in the permanent successors (RR = 3.97; 95% CI = 1.72-9.18), when compared to not severe TDI. CONCLUSIONS: The prevalence of TDI in the primary lower incisors is low, with a higher prevalence in children younger than 3 years. Older children also present less frequently with severe TDI, and the risk of sequelae in permanent teeth is higher following severe TDI.

Uso e prognóstico de contenção em dente decíduo traumatizado: revisão sistemática e estudo de coorte histórico / Uses and prognosis of splints in traumatized deciduous teeth: systematic review and historical cohort study

Esta tese tem por objetivo identificar, analisar e sintetizar evidências científicas quanto ao uso e prognóstico de contenção após traumatismo na dentição decídua. Apresentamos dois capítulos contendo uma revisão sistemática e um estudo de coorte histórico. A revisão sistemática buscou estudos que relataram traumatismo em humanos nas bases MEDLINE / PubMed, SCOPUS, SciELO e Embase até 2019. Artigos de opinião, revisão, trauma na dentição permanente ou trauma ósseo foram excluídos. 14 artigos foram incluídos e o prognóstico foi categorizado de acordo com o período de permanência do dente tratado. O estudo de coorte histórico analisou 2683 prontuários de pacientes do centro de traumatismo em dentes decíduos da FOUSP (1998 - 2019), com aprovação do comitê de ética dessa instituição. Foram incluídos casos de incisivos superiores tratados com contenção e excluídos prontuários com dados incompletos. Coletou-se dados quanto ao sexo, idade, tipo de trauma, dente traumatizado, tipo e período de contenção, redução de mobilidade, necrose e tratamento endodôntico. O desfecho foi a permanência do dente após um ano do trauma e os resultados foram avaliados através de análise multinível de Poisson. 103 pacientes com 184 dentes traumatizados foram tratados com contenção, sendo 144 acompanhados pelo período de um ano. Em nossos achados, a contenção mais utilizada e com melhores prognósticos foi realizada com fio de aço e resina composta. Lesões de luxações foram os traumas com maior uso de contenção e apresentaram piores resultados quando houve deslocamento. Crianças acima de 3 anos tiveram maior chance de insucesso e o tratamento endodôntico foi fator de proteção ao dente decíduo traumatizado. Palavras-chave: Traumatismo dentário. Dente decíduo. Contenção dental. Revisão sistemática. Odontopediatria.

Does the hybrid light source (LED/laser) influence temperature variation on the enamel surface during 35% hydrogen peroxide bleaching? A randomized clinical trial.

OBJECTIVE: The present study investigated how a hybrid light source (LED/laser) influences temperature variation on the enamel surfaces during 35% hydrogen peroxide (HP) bleaching. Effects on the whitening effectiveness and tooth sensitivity were analyzed. METHOD AND MATERIALS: Twenty-two volunteers were randomly assigned to two different treatments in a split-mouth experimental model: group 1 (control), 35% HP; group 2 (experimental), 35% HP + LED/laser. Color evaluation was performed before treatment, and 7 and 14 days after completion of bleaching, using a color shade scale. Tooth sensitivity was assessed using a visual analog scale (VAS; before, immediately, and 24 hours after bleaching). During the bleaching treatment, thermocouple channels positioned on the tooth surfaces recorded the temperature. Data on color and temperature changes were subjected to statistical analysis (α = 5%). Tooth sensitivity data were evaluated descriptively. RESULTS: Groups 1 and 2 showed mean temperatures (± standard deviation) of 30.7 ± 1.2 °C and 34.1 ± 1.3 °C, respectively. It was found that there were statistically significant differences between the groups, with group 2 showing higher mean variation (P < .0001). The highest temperature variation occurred for group 2, with an increase of 5.3 °C at the enamel surface. The color change results showed no differences in bleaching between the two treatment groups (P = .177). The variation of the average temperature during the treatments was not statistically associated with color variation (P = .079). Immediately after bleaching, it was found that 36.4% of the subjects in group 2 had mild to moderate sensitivity. In group 1, 45.5% showed moderate sensitivity. In both groups, the sensitivity ceased within 24 hours. CONCLUSION: Hybrid light source (LED/ laser) influences temperature variation on the enamel surface during 35% HP bleaching and is not related to greater tooth sensitivity.