Dental procedures cause stress in children with cerebral palsy?

BACKGROUND: To evaluate the level of stress during dental care in children and preadolescents with cerebral palsy through biological and psychological parameters. MATERIAL AND METHODS: A total of 38 children aged 7 to 12 years were divided into two groups: one with 18 children with cerebral palsy and the other with 20 healthy children (control group). Saliva was noninvasively collected before and after dental care to analyze salivary biomarkers. The Frankl Behavior Scale and the Facial Image Scale were applied. RESULTS: After the dental procedure, cortisol levels were significantly higher (p = 0.02) in the cerebral palsy group than in the control group. Salivary alpha-amylase was not significantly different between groups. Regarding psychological parameters, anxiety was significantly higher (p = 0.00012) in the cerebral palsy group than in the control group. CONCLUSIONS: There was a change in physiological parameters (salivary cortisol and salivary alpha-amylase) and in psychological parameters (Frankl Behavioral Scale and Facial Image Scale) in patients with cerebral palsy, who exhibited higher stress and anxiety levels than did children without cerebral palsy. Key words:Ortisol, physiological stress, dental care, cerebral palsy, dental treatment anxiety.

Infiltrante resinoso vs Microabrasão no manejo de lesões de mancha branca: relato de caso / Resin infiltration vs microabrasion in white-spot lesions treatment: case report

Objetivo: Apresentar caso clínico de tratamento estético das lesões de mancha branca após tratamento ortodôntico nos dentes superiores anteriores através de duas técnicas minimamente invasivas usando o sistema de infiltração de resina e microabrasão. Relato de caso: Paciente com 18 anos de idade apresentava lesões de manchas brancas inativas nos dentes 11, 12, 13, 21, 22, 23. O sistema de infiltrante de resina Icon (DMG, Hamburgo, Alemanha) foi utilizado nos dentes 11, 12, 13, enquanto os dentes 21, 22, 23 foram submetidos à microabrasão com Whiteness RM (FGM, Joinville, Santa Catarina, Brasil).Ambos os protocolos foram utilizados de acordo com as recomendações do fabricante.Nos dentes 21 e 22, o produto para microabrasão foi aplicado com espátula que acompanha o kit, enquanto que no dente 23 utilizou-se o mesmo produto aplicado com taça de borracha em baixa rotação, todos os procedimentos executados por um único operador. A microabrasão com taça de borracha proporcionou uma superfície mais lisa e homogênea.Ambos os produtos tiveram resultados satisfatórios na resolução estética das lesões de mancha branca após um ano de acompanhamento. Conclusão: Os dois produtos apresentam bom desempenho e resolutividade para os problemas estéticos de lesões de manchas brancas inativas, entretanto deve-se levar em conta o tempo clínico, toxicidade, a atividade da lesão e a possibilidade de desgaste da estrutura dentária.

Objective: To present a case report of aesthetic treatment of post orthodontic white--spot lesions in the anterior superior teeth through two minimally invasive technique susing resin infiltration system or microabrasion. Case report: Patient 17 years of age had inactive white-spots lesions on teeth 11, 12, 13, 21, 22, 23. The teeth 11, 12, 13 received the resin infiltrating system Icon (DMG, Hamburg, Germany) while the teeth 21, 22, 23were submitted to microabrasion with Whiteness RM (FGM, Joinville, Santa Catarina, Brazil). Both protocols were used according to manufacturer’s recommendations. In the teeth 21 and 22, the product of the microabrasion was applied with a spatula that accompanied the kit, while the tooth 23 received the same product applied with a rubbercup at low speed turbine, all by a single operator. The microabrasion with rubber cupoccasioned a more smooth and homogeneous surface. Both products had satisfactory results in aesthetic resolution of the white-spots lesions, for a 1-year follow-up. Conclusion:Although both products are able to resolve aesthetic problems of inactive white-spots lesions, it should be taken into account the clinical time, toxicity, the activity ofthe lesion and the possibility of wear of the tooth structure.

Compromised salivary parameters of children with juvenile idiopathic arthritis.

OBJECTIVE: To evaluate the salivary parameters of individuals with juvenile idiopathic arthritis (JIA) and determine if there is a correlation with the simplified oral hygiene index (OHI-S). STUDY DESIGN: Stimulated whole saliva was collected from children, aged 6 to 12 years, with JIA (n = 36) and compared with saliva from a control group (CG) composed of healthy children matched by demographic characteristics (n = 36). Salivary parameters evaluated were amylase and peroxidase activities, calcium, phosphate, and total sialic acid concentration. Data were compared by two-tailed Student's t test, and salivary parameters were evaluated for correlations with OHI-S by Spearman's correlation. RESULTS: The JIA group had a statistically significant reduction in all salivary parameters: α-amylase (20%) (CG, 9.84 ± 4.23; JIA 4.80 ± 3.10) and peroxidase (55%) (CG, 35.05 ± 14.97; JIA, 15.78 ± 6.44) activities, total sialic acid (25%) (CG, 0.024 ± 0.01; JIA, 0.010 ± 0.04), calcium (13%) (CG, 6.26 ± 2.26; JIA, 5.44 ± 2.26) and phosphate (50%) (CG, 10.88 ± 1.49; JIA, 5.45 ± 0.88) concentration compared with the CG (P ≤ .05). There were no significant correlations between the salivary parameters and OHI-S in either group. CONCLUSION: JIA patients showed a reduction of different salivary parameters involved in maintaining oral health.

Eficácia das manobras de desbridamento no preparo químico-mecânico quanto à desinfecção no terço apical em molares humanos / Efficacy of chemo-mechanical preparation debridement procedures in disinfection of the apical third of human molar root canals

Objetivo: Avaliar a eficácia das manobras de desbridamento no preparo químico-mecânico (PQM) quanto a limpeza e desinfecção no terço apical em molares humanos. Material e método: Cinquenta raízes mesiais de molares inferiores humanos com dois canais radiculares foram inoculadas com E. faecalis e distribuídas aleatoriamente em cinco grupos (n=10). O PQM foi realizado com o sistema Protaper associado ao desbridamento com as limas Kerr #10 (G1 e G3) e as limas Kerr #15 (G2 e G4). O G5 representou o controle positivo, o qual foi submetido apenas ao PQM, sem receber o desbridamento. Outra variável foi o uso da medicação intracanal (MIC) à base de hidróxido de cálcio (Calen), que foi aplicada aos grupos G3 e G4. A irrigação foi feita com hipoclorito de sódio 2,5% e EDTA 17%. A análise da ação antimicrobiana se deu através da contagem das unidades formadoras de colônias (UFC). Resultado: Foram aplicados o Teste Kruskal-Wallis (nas análises imediatas) e o Teste Mann-Whitney (nas análises mediatas), ambos com p=0,01. A análise imediata ao PQM apresentou-se sem diferença estatística entre os grupos (p=0,11). No G4 (#15 + MIC), os resultados das coletas mediatas foram estatisticamente significantes (p=0,01). Conclusão: O desbridamento com as limas Kerr #10 e #15 não apresentou diferença significativa quanto à redução das colônias de E. faecalis quando comparado ao grupo em que não se realizou o desbridamento. Nos espécimes em que se aplicou a MIC, o desbridamento com a lima Kerr #15 (G4) foi mais eficiente do que a lima Kerr #10 (G3) em reduzir as UFC.

Aim: The aim of this in vitro study was to evaluate the efficacy of chemo-mechanical preparation (CMP) debridement procedures in regard to cleansing and disinfection of the apical third of human molar canals using different protocols. Material and method: Fifty mesial roots of human mandibular molars containing two canals were inoculated with E. faecalis strains and randomly allocated to five groups (n=10). CMP was carried out with the rotatory Protaper system associated with Kerr files #10 (G1 and G3) and #15 (G2 and G4). G5, the positive control, was subjected to CMP without debridement. Another variable studied was the use of calcium hydroxide-based temporary intracanal medication (Calen) prior to the chemo-mechanical performed in the G3 and G4 groups. Irrigation was performed with 2.5% sodium hypoclorite and 17% EDTA. Antimicrobial activity was quantified by counting the number of colony-forming units (CFU). Result: Kruskal-Wallis was used for immediate analyses and Mann-Whitney for mediate analyses both with a stipulated value of significance of p=0.01. In the imediate analyses following CMP there were no significant differences among the groups (p=0.11). In the G4 (#15 + MIC) the results of the mediate collections were statistically significant (p=0.01). Conclusion: Debridement with #10 and #15 Kerr files did not produce significant differences in regard to reduction of E. faecalis when compared to the positive control. In samples where Calen intracanal medication was used debridement with #15 Kerr files was more efficient in reducing the number of CFUs than #10 Kerr files.

Effect of therapeutic doses of radiotherapy on the organic and inorganic contents of the deciduous enamel: an in vitro study.

OBJECTIVES: This study evaluated the effects of radiotherapy on the composition of deciduous teeth enamel using micro-energy-dispersive X-ray fluorescence and Fourier transform Raman spectroscopy before and after a pH cycling process. MATERIALS AND METHODS: Ten deciduous molars were sectioned and divided into two groups (n = 10). The radiotherapy group (RT) was irradiated with 54 Gy at 2 Gy/day, 5 days per week for 5 weeks and 2 days, and the normal group (N) was not irradiated. The RT group was evaluated before radiotherapy (RTb), after radiotherapy (RTa), and after radiotherapy and pH cycling (RTc). The normal group was evaluated before (N) and after pH cycling (Nc). The weight percentage (wt%) of calcium (Ca), phosphorus (P), and organic content; the Ca/P ratio; and the integrated area of the Raman bands relative to the organic, carbonate, and phosphate contents were also evaluated. RESULTS: The exclusive use of RT reduced the organic content of the enamel (p = 0.000). The RTc group exhibited a decrease in P wt% (p = 0.016), an increase in the Ca/P ratio (p = 0.000), and a reduction in the integrated area of the phosphate band (p = 0.046). An increase in the Ca/P ratio (p = 0.000) and a reduction in the areas of the carbonate and phosphate bands were found in the RTb/RTc treatments. CONCLUSIONS: RT application at a therapeutic dose reduced the organic content of the deciduous enamel. CLINICAL RELEVANCE: Preventive measures should be included in the patient treatment protocol because of RT-induced chemical changes to the deciduous enamel.

Percepções, conhecimentos e representações de saúde bucal em adolescentes de escolas públicas e privadas do município de Atibaia,SP / Perceptions, knowledge and representations of oral health among adolescents in public and private schools in the city of Atibaia-SP

Estudos sobre autopercepção da saúde bucal na adolescência são raros, reforçando o mito de que na adolescência existem poucos agravos à saúde de forma geral. Objetivo: conhecer os adolescentes quanto ao perfil socioeconômico e de doenças bucais, assim como o impacto delas no cotidiano e os fatores etiológicos implicados. Sujeitos e método: foram analisados e avaliados por inquérito adolescentes (n=183) de escolas de ensino fundamental pública (EPU) e privada (EPR), de Atibaia, SP. A análise foi realizada por frequência, teste exato de Fisher e Kruskall Wallis, com IC 95%. Resultados: da amostra, 48,6% sujeitos estudam em EPR, 54,6%pertencem ao sexo feminino, 77% tem entre 12 e 15 anos e 33% entre 16 e 18 anos. Não houve diferença de ingestão diária de carboidrato entre os alunos da EPR e da EPU, mas, sim, quanto ao conhecimento da relação de tal ingestão com a cárie, sendo que os alunos da EPR os que mais correlacionam (P<0,0001) e os da EPU os que menos conhecem prevenção (p<0,0001). Quanto à correlação entre doença periodontal (DP), formas de prevenção e sinais e sintomas, houve diferença entre EPU e EPR. A não associação entre sangramento espontâneo ao escovar e mau hálito com DP foi maior para EPR, embora tenha havido maior frequência de conhecimento sobre prevenção. No tema renda, os alunos da EPR enquadraram-se na faixa entre quatro e seis, ou acima de seis, salários-mínimos, e os da EPU, de um a três, e de quatro a seis salários salários-mínimos. Conclusão: os adolescentes oriundos de famílias de menorrenda demostraram menor conhecimento em relação à etiologia das doenças, prevenção e manutenção da saúde bucal; as meninas apresentaram maior preocupação e maior informação, evidenciando autopercepção mais forte para saúde bucal.

Hiperplasia do processo coronoide: relato de caso clínico / Mandibular coronoid process hyperplasia: case report

A hiperplasia do processo coronoide mandibular (HPCM) é uma condição rara, caracterizada pela limitação de abertura de boca. Causada pela impactação do processo coronoide na porção posterior do osso zigomático. Os autores apresentam um caso de uma criança de dois anos de idade em que a coronoidectomia por ser inviável, estimulou a busca por novos recursos terapêuticos para o tratamento e controle da condição. Sendo a coronoidectomia o tratamento de eleição sugerido pela literatura e não passível de realização, optou-se pela fisioterapia. Mediante uma revisão de literatura, foi possível concluir que os recursos fisioterápicos utilizados para as disfunções crâniomandibulares podem ser de grande ajuda para o controle da HPCM, tendo em vista que o principal sintoma da doença corresponde a um dos sintomas das DTMs...

The mandibular coronoid process hyperplasia (MCPH) is a rare condition characterized by the mouth opening limitation. Caused by an impaction of the coronoid process in the posterior portion of the zygomatic bone. The authors present a case of a child, 2 years old, which coronoidectomy treatment is unfeasible, therefore, stimulated the search for new therapeutic resources for the treatment and control the condition. Being the coronoidectomy the treatment of choice suggested by the literature and not possible to apply, we opted for the physiotherapy. Through a literature review, it was concluded that the physiotherapy resources used for craniomandibular dysfunctions can be a great help to control the MCPH, given that the main symptom of the disease corresponds to one of the symptoms of TMD...

Effects of near infrared laser radiation associated with photoabsorbing cream in preventing white spot lesions around orthodontic brackets: an in vitro study.

OBJECTIVE: The present study aims to investigate the effect of a low-power infrared laser on the inhibition of bovine enamel demineralization around orthodontic brackets. BACKGROUND DATA: Near infrared lasers have been suggested as alternative approaches because they may produce an increase in resistance to dental caries. METHODS: Forty-eight blocks of enamel obtained from bovine incisor teeth were divided into six groups: Group 1 (control), without treatment; Group 2 (C), photoabsorbing cream; Group 3 (CF), photoabsorbing cream with fluoride; Group 4 (L), irradiation with low-level infrared laser (λ=830 nm) at an energy density of 4.47 J/cm2; Group 5 (L+C), photoabsorbing cream followed by low-level infrared laser irradiation; and Group 6 (L+CF), photoabsorbing cream with fluoride followed by low-level infrared laser irradiation. After these procedures, the enamel blocks received an assortment of orthodontic brackets and were then submitted to pH cycling to simulate a highly cariogenic challenge. The enamel surface demineralization around the orthodontic brackets, according to the different treatments, was quantified by fluorescence loss analysis by quantitative light-induced fluorescence (QLF). The fluorescence loss, expressed as ΔF (percentage of loss fluorescence), was statistically examined by analysis of variance and the Tukey test. RESULTS: The control group (-10.48±2.85) was statistically similar to Group C (-14.52±7.80), which presented the lowest values of ΔF when compared with Groups FC (-3.67±3.21), L (-2.79±1.68), CL (-1.05±0:50), and CFL (-0.60±0:43). However, Groups FC, L, CL, and CFL showed no statistically significant differences among them. CONCLUSIONS: It can be concluded that both the low-level infrared laser and photoabsorbing cream with fluoride were effective in inhibiting the development of caries in enamel around orthodontic brackets, even in situations of high cariogenic challenge.

Photodynamic therapy in pediatric dentistry.

Conservation of deciduous teeth with pulp alterations caused by caries and trauma is a major therapeutic challenge in pediatric dentistry as a result of the internal anatomy and life cycle characteristic. It is essential that the root canal procedures sanitizers have a performance in eliminating bacterial. In this context, antimicrobial photodynamic therapy (PAT) is promising and emerging as adjuvant therapy in an attempt to eliminate the microorganisms persistent to chemi-mechanical preparation. Since there is presence of oxygen in cells, photosensitizer activated by light can react with molecules in its vicinity by electrons' or hydrogen's transfer, leading to microorganism death. This paper reports the case of 4-year-old patient, female, with early childhood caries. The proposed endodontic treatment incuded chemomechanical treatment allied to PAT in the decontamination of root canals using methylene blue dye 50 µg/mL during 3-5 minutes and 40 J/cm(2) as energy density, taking into account the need for tissue penetration and effectiveness of PAT inside the dentinal tubules.

Prevalence of oral manifestations in soft tissues during early childhood in Brazilian children.

This study aimed at assessing the prevalence of soft tissue oral manifestations in children during early childhood, according to age group, gender, and site in the oral cavity, and at correlating these oral manifestations with systemic alterations. A cross-sectional study was conducted involving 586 children from 0 to 3 years of age (12.4 ± 11.8 months), 316 (53.9%) male and 270 (46.1%) female, in the city of Mauá, SP, Brazil. Examination was performed by a single examiner (Kappa Index = 0.90) according to World Health Organization criteria (WHO, 1997).The prevalence of oral manifestations in the soft tissues of children during early childhood was 34.8%. The age group showing statistical significance was 0-1 months old (56.4%). Epstein's pearls were significantly present (43.2%) in 0-1-month-old babies, and gingivitis in 12-24-month-olds (15.9%). The palate was the most affected region (16.7%). Infectious alterations were the most prevalent systemic alteration (20%). An association was observed between the presence of systemic alterations and the occurrence of oral manifestations. The prevalence of oral manifestations was 34.8%, regardless of gender, and was manifested mostly in 0-1-month-old babies. The palate was the most prevalent region, and the majority of oral manifestations were associated with systemic alterations.

Fraser syndrome-oral manifestations and a dental care protocol.

Fraser syndrome is a rare genetic malformation with an autosomal recessive pattern of inheritance and an incidence of consanguinity ranging from 15% to 25%. A 5-year-old male patient who is a carrier of Fraser syndrome initiated treatment in the pediatric dentistry sector. The patient was fed parenterally since birth, experienced recurring bouts of chronic lung disease, and was referred to the pediatric dentistry sector by the medical team. Radiographic examination revealed the presence of all permanent teeth. Supragingival dental calculus, halitosis, and gingival inflammation were also observed. Dental calculus was removed by manual scraping, and chemotherapeutic agents were used, chlorhexidine 0,12%, chlorhexidine gel 2%, and PVP-I, to control the bacterial flora. The patient is still being monitored after an 8-year follow-up period, the complications associated with periodontal disease decreased, and since the initiation of treatment, the patient has not needed to be hospitalized because of chronic lung disease. This study reports the case of a patient diagnosed with Fraser syndrome and describes the clinical manifestations (general and oral).

Dental enamel irradiated with a low-intensity infrared laser and photoabsorbing cream: a study of microhardness, surface, and pulp temperature.

OBJECTIVE: The aim of this study was to assess the effect of low-intensity infrared laser light (λ=810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J) with or without indocyanine green cream fluorinated or not fluorinated, using Knoop surface microhardness analysis. BACKGROUND DATA: Lasers can be used as tools for the prevention of tooth enamel demineralization. METHODS: The surface and pulp temperatures of the human deciduous tooth enamel were measured. For the analysis of surface hardness, a total of 48 specimens were prepared and randomly assigned into six groups (n=8/group): C (+), which received laser light; C(-), which received no treatment; cream (IV); cream and fluoride (IVF); cream and light (IVL); and cream and fluoride and light (IVFL). The specimens were subjected to treatment before demineralizing challenge by pH cycling. To analyze the surface and pulp temperatures, the samples were divided into the following groups (n=10): C(+), IVL, and IVFL. RESULTS: The hardness analysis indicated that the groups that received irradiation had less hardness reduction following the demineralizing challenge (p<0.001), with IVFL and IVL presenting the lowest percentages of surface microhardness loss at 3.98% and 9.3%, respectively. Surface temperature analysis indicated a maximum increase of 74°C and a mean of 45.25°C and 45.95°C for the IVL and IVFL groups, respectively. Pulp temperature analysis indicated a higher mean increase of 2.40°C±0.65 in the IVL group. CONCLUSIONS: These results suggest that the combination of cream and laser light possibly promoted protein denaturation of the tooth enamel organic matrix, which possibly decreased the loss of hardness without causing pulp damage.

Oral manifestations of systemic alterations in early childhood.

AIM: This study aimed to describe certain common oral manifestations during early childhood that should be known by the pediatric dental surgeon. BACKGROUND: The correct diagnosis and treatment of oral manifestations during early childhood is important for children's development. The pediatric dentist is responsible for maintaining oral health in children, since they change constantly during their development and growth. CASE REPORT: Four cases of oral lesions are described, in which the diagnosis and related approach for each one is reported. The first was an acute primary herpetic gingivostomatitis, the second, pseudomembranous candidiasis, the third, chickenpox and the last was molluscum. CONCLUSION: Professionals who treat children in this age group must be able to diagnose and treat common oral manifestations when necessary and should refer the child to a pediatrician for effective treatment if the presence of any systemic alteration is suspected. CLINICAL SIGNIFICANCE: Pathognomonic signs of the most common oral manifestations in early childhood should be known by dentists to improve early diagnosis and proper management.

Effect of topical application of fluoride gel NaF 2% on enzymatic and non-enzymatic antioxidant parameters of saliva.

OBJECTIVE: The aim of the study was to evaluate the effect of topical fluoride gel NaF 2% application on antioxidant parameters of whole saliva from children. DESIGN: The saliva mechanically stimulated with parafilm was collected from 25 children (6-12 years) attending the Clinic of Paediatric Dentistry of Universidade Cruzeiro do Sul, São Paulo, Brazil, before (control group) and immediately after application of neutral fluoride gel NaF 2% (fluoride-gel group), according to the Standards for Research Using Human Subjects, Resolution 196/96 of the USA National Health Council of 10/10/1996. Afterwards, pre-post ferric-reducing antioxidant power (FRAP), trolox-equivalent antioxidant capacity (TEAC), uric acid, reduced/oxidised glutathione content (GSH/GSSG) and total peroxidase activity (TPO) were evaluated in whole saliva of both groups. RESULTS: All non-enzymatic antioxidant parameters were augmented by fluoride-gel NaF 2% application, whereas a notable reduction (31%) of peroxidase activity was concomitantly observed in the children's saliva (p ≤ 0.05). Nevertheless, the reducing power of saliva was kept unaltered under these circumstances (p ≤ 0.05). CONCLUSIONS: Despite the reduced activity of peroxidase (an important antimicrobial and antioxidant enzyme), the topical fluoride gel NaF 2% favourably stimulated the release of non-enzymatic antioxidant components of saliva, sustaining the reducing power of saliva and the natural defences of the oral cavity.

Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study.

OBJECTIVE: The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). BACKGROUND DATA: Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. MATERIALS AND METHODS: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. RESULTS: The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. CONCLUSION: micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo-absorbing agent (CL) treatment, there was a possible disorganization of organic content in the tooth enamel with hydroxyapatite crystal reordering and reorganization.

Dental enamel irradiated with infrared diode laser and photoabsorbing cream: Part 1 -- FT-Raman Study.

OBJECTIVE: The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. BACKGROUND DATA: Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. MATERIALS AND METHODS: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. RESULTS: There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). CONCLUSION: The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.

Surface morphology of sound deciduous tooth enamel after application of a photo-absorbing cream and infrared low-level laser irradiation: an in vitro scanning electron microscopy study.

OBJECTIVES: The purpose of this descriptive scanning electron microscopic study was to characterize surface alterations in deciduous tooth enamel after in vitro infrared diode laser irradiation, using a photo-absorbing agent alone and also combined with fluoride, before and after laser irradiation. BACKGROUND DATA: Previous investigations have demonstrated increased enamel caries resistance after laser irradiation. METHODS: Seven extracted or exfoliated primary molar teeth underwent soft tissue débridement and fluoride-free prophylaxis. Buccal surfaces were determined to be caries free by macroscopic examination. Sample groups were divided into: (1) control (no treatment); (2) infrared diode laser irradiation (lambda = 810 nm, 68 nm, 60 mW/mm(2), 30 W) using the photo-absorbing agent alone (IRDL + PA; 500 J/cm(2)); and (3) infrared diode laser irradiation using a photo-absorbing agent combined with 2% fluoride (IRDL + PFA; 500 J/cm(2)). Buccal surfaces were evaluated following standard scanning electron microscopy preparation techniques. Control samples of enamel surfaces were relatively smooth but presented occasional enamel prism ends. There were no areas with cavitations or surface defects. RESULTS: After the IRDL + PA treatment, irradiated surfaces became rough and mildly to moderately irregular with scarce enamel cavitations and without exposure of enamel prism ends. The surfaces had adherent granules and only occasional fine cracks and porosities in surface coatings were noted. After the IRDL + PFA treatment, there was a homogenous confluent surface that masked typical enamel surface markings. The surfaces had well-defined globules resulting from the IRDL + PFA treatment, that were not seen after IRDL + PA treatment. CONCLUSIONS: Treatment of deciduous tooth enamel with infrared diode laser irradiation using a photo-absorbing agent and a photo-absorbing agent combined with 2% fluoride created surface coatings that may act as reservoirs for mineral phases during cariogenic activity on enamel, and also provide a certain degree of protection against cariogenic challenge.

Estudo de injúrias traumáticas em crianças na faixa etária de 1 a 3 anos no municipio de Barueri, São Paulo, Brasil / Epidemiology of Traumatic Injuries in Brazilian Children Aged 1-3 Years

Objetivo: Determinar a prevalência de lesões traumáticas em dentesdecíduos, bem como verificar o tipo de traumatismo mais freqüentee quais os dentes mais envolvidos nesses eventos.Método: Foram avaliadas 1042 crianças, na faixa etária de 01(hum) a 03 (três) anos de idade, ambos os gêneros, da cidade deBarueri – SP, matriculados em creches municipais. Após a coletados dados clínicos, a análise estatística foi desenvolvida comelaboração de tabelas e gráficos. O teste do Qui-Quadrado foiutilizado para comparação de dados categóricos, dispostos emforma de freqüência (p< 0,05).Resultados: Os resultados mostraram que 398 (38,2 por cento) [x2 =46,478 (p < 0,001)] sofreram algum tipo de traumatismo dentário; otipo mais freqüente foi representado pela fratura de esmalte(69,8 por cento) e os dentes mais envolvidos foram 61 (44,3 por cento) e o 51(41,4 por cento).Conclusão: Medidas educativas e/ou preventivas devem fazerparte da rotina do Odontopediatra tanto no âmbito do consultórioparticular bem como nas orientações de saúde coletiva.Adicionalmente, remete-nos a uma nova reflexão sobre aimportância de se criar o hábito de aconselhamento e informaçõesa respeito das possibilidades de traumatismos dentários e suasindesejáveis seqüelas nas crianças de tenra idade.

Sports dentistry: buccal and salivary profile of a female soccer team.

Sports dentistry has been considered a prominent area of dentistry because dental health can limit the abilities of athletes, both professional and nonprofessional, in their training and competition. Dental decay is associated with the frequent use of carbohydrates, recommended as an energy source for exercise. Strong indications exist regarding the possibility to use saliva as a performance determinant and for evaluation and prescription of physical activity. This study evaluated the salivary profiles (pH, flow rate, mutans streptococci and Lactobacillus counts) and decayed, missing, and filled teeth of 18 female soccer players (13 to 19 years old) of the Olympic Training and Research Center of São Paulo, before and after a training session. The salivary flow rate presented a significant reduction after training; however, there was no significant alteration in pH. Fifty percent of the players presented 10(5) to 10(6) mutans streptococci, and 66% presented 10(3) Lactobacillus. Several salivary components protect against microorganisms that cause superior respiratory tract infections (common in athletes), as well as participating in the remineralization mechanism during cariogenic challenges. Thus, due to the salivary flow rate reduction in this population with a high number of cariogenic microorganisms, noncariogenic drink ingestion at regular intervals and maintenance of hydration levels during training, are suggested.