Late Eruption of Mandibular Central Incisor in Small for-Gestational-Age Infants: A Cohort Study.

Purpose: To evaluate the chronology of the eruption of primary mandibular central incisors in infants born preterm and with low weight (PLBW) and its association with weight/length ratio for gestational age (GA) at birth, individual characteristics and hospitalization at birth. Methods: A cohort of 46 infants was followed at a multidisciplinary reference center at a university hospital in Belo Horizonte, Brazil. The inclusion criteria were infants born preterm with low/very low/extreme low birth weight and at least four months of age. Oral clinical examinations were carried out by a calibrated dentist for a total of eight months, with a one-month interval between each examination, to verify the chrono- logy of eruption of the primary mandibular central incisors. Caregivers completed a sociodemographic and health questionnaire. Data on neonatal hospitalization were collected from medical records. Data were analyzed with the Kaplan-Meier method and log rank test, and bivariate analysis was done using the Mann-Whitney method and Kruskal-Wallis test (P <0.05). Results: The average age at eruption of primary lower central incisors was 11 months for both sexes. No association was found between tooth eruption and child hospitalization or individual characteristics (P >0.05). Infants large for gestational age had earlier tooth eruption (9.3±1.41 months) than infants small for gestational age (13.6±3.29 months; P <0.05).Conclusion: The most likely age for the eruption of the first primary teeth in infants born preterm and with low weight was 11 months, and there was no influence of individual characteristics and hospitalization at birth. Small-for-gestational age infants experienced delayed tooth eruption compared to large-for-GA infants.

Hipoclorito de sódio na pulpotomia de dentes decíduos: uma revisão sistemática e meta-análise / Sodium hypochlorite in pulpotomy of deciduous teeth: a systematic review and meta-analysis

Justificativa /objetivos: A pulpotomia é uma terapia pulpar conservadora que visa manter a vitalidade da polpa sem a necessidade de procedimentos mais radicais como a pulpectomia ou exodontia. O objetivo desta revisão foi fornecer uma síntese da literatura avaliando a eficácia clínica e radiográfica do uso de hipoclorito de sódio (NaOCl) na pulpotomia de dentes decíduos e compará-lo com outros materiais utilizados para este procedimento. Metodologia: As buscas bibliográficas foram realizadas nas bases de dados Medline via PubMed, Medline via Ovid, Scopus, Lilacs, Embase, Biblioteca Cochrane e Web of Sciences. A busca na literatura cinzenta também foi realizada no Google Scholar, OpenGray, National Institute for Health and Care Excellence (NICE) e ProQuest. Foram incluídos ensaios clínicos randomizados, ensaios clínicos não randomizados e estudos de coorte nos quais a pulpotomia em dentes decíduos com hipoclorito de sódio era comparada com a pulpotomia em dentes decíduos com outros materiais. Não foram colocadas restrições quanto ao idioma ou data de publicação ao pesquisar nas bases de dados eletrônicas. Os dados foram agrupados e analisados descritivamente. A avaliação qualitativa foi realizada de acordo com a ferramenta Cochrane de risco de viés. Foi utilizado o Rob-2 para ensaios clínicos randomizados, o ROBINS-I para ensaios clínicos não randomizados e a Escala de Newcastle-Ottawa para estudos de coorte. No software RevMan, foram realizadas meta-análises incorporando estudos metodologicamente homogêneos. Desfechos dicotômicos foram usados e incluíram sucesso clínico e radiográfico. O I2 foi utilizado para calcular a heterogeneidade dos estudos. Os resultados foram fornecidos em odds ratio e intervalo de confiança. Resultados: Um total de 2654 estudos foram inicialmente identificados por meio de buscas eletrônicas. Após descarte das duplicatas e leitura dos títulos e resumos dos artigos selecionados, 19 estudos foram considerados para leitura do texto completo. Após a leitura do texto completo, 14 estudos preencheram os critérios de elegibilidade. Foram incluídos 12 artigos na meta-análise. Em relação aos sucessos clínicos e radiográficos, não houve diferença significativa entre a pulpotomia com NaOCl e a pulpotomia com formocresol, sulfato férrico, MTA e soro fisiológico. A maioria dos ensaios clínicos randomizados apresentou problemas metodológicos que levaram a uma classificação de médio risco de viés. Todos os ensaios clínicos não randomizados foram classificados com alto risco de viés. Já em relação aos estudos de coorte, todos os dois estudos foram considerados com evidência forte. Conclusão: Os resultados deste estudo apontam que o NaOCl não difere de outros medicamentos como formocresol, sulfato férrico, MTA e soro fisiológico, no sucesso clínico e radiográfico da pulpotomia de dentes decíduos.

Rationale/Objectives: Pulpotomy is a conservative pulp therapy that aims to maintain the vitality of the pulp without the need for more radical procedures such as pulpectomy or extraction. The aim of this review was to provide a synthesis of the literature evaluating the clinical and radiographic efficacy of the use of sodium hypochlorite (NaOCl) in pulpotomy of primary teeth and to compare it with other materials used for this procedure. Methodology: Bibliographic searches were performed in Medline via PubMed, Medline via Ovid, Scopus, Lilacs, Embase, Cochrane Library and Web of Sciences. The gray literature search was also performed on Google Scholar, OpenGray, National Institute for Health and Care Excellence (NICE), and ProQuest. Randomized clinical trials, non-randomized clinical trials, and cohort studies in which pulpotomy in primary teeth with sodium hypochlorite was compared with pulpotomy in primary teeth with other materials were included. No restrictions were placed on language or publication date when searching electronic databases. Data were grouped and analyzed descriptively. Qualitative assessment was performed according to the Cochrane risk of bias tool. Rob-2 was used for randomized clinical trials, ROBINS-I for non-randomized clinical trials and the Newcastle-Ottawa Scale for cohort studies. In the RevMan software, meta-analyses were performed incorporating methodologically homogeneous studies. Dichotomous outcomes were used and included clinical and radiographic success. The I2 was used to calculate the heterogeneity of the studies. Results were given in odds ratio and confidence interval. Results: A total of 2654 studies were initially identified through electronic searches. After discarding duplicates and reading the titles and abstracts of the selected articles, 19 studies were considered for reading the full text. After reading the full text, 14 studies met the eligibility criteria. Twelve articles were included in the metaanalysis. Regarding clinical and radiographic successes, there was no significant difference between pulpotomy with NaOCl and pulpotomy with formocresol, ferric sulfate, MTA and saline solution. Most randomized controlled trials had methodological problems that led to a classification of medium risk of bias. All non-randomized clinical trials were classified as having high risk of bias. As for the cohort studies, all two studies were considered to have strong evidence. Conclusion: The results of this study show that NaOCl does not differ from other drugs such as formocresol, ferric sulfate, MTA and saline solution, in the clinical and radiographic success of pulpotomy in primary teeth.