Fluoride release and remineralizing potential of varnishes in early caries lesions in primary teeth.

This study evaluated the fluoride (F) release and remineralizing potential of varnishes containing sodium fluoride (5% NaF), 5% NaF with CPP-ACP and 5% NaF with TCP in early caries lesions in primary teeth. To determine the F release at 1, 4, 6, 24, 72, and 168 hr, strips were covered with the varnishes and immersed in purified water (n = 7). The varnishes and purified water (negative control) were applied on enamel blocks with early caries lesions (n = 16). Enamel blocks were stored in artificial saliva and submitted to a pH-cycling. The area of enamel hardness loss (ΔS) was analyzed by microhardness, lesion depth by polarized light microscopy (PLM) and the chemical analysis by Energy-dispersive X-ray spectroscopy. Data were submitted to Shapiro-Wilk, two-way and one-way ANOVA, Tukey and paired t-tests (α = 5%). All varnishes released F, but 5% NaF with CPP-ACP had the highest release at 4, 6, 24, and 72 hr (p < .05) followed by 5% NaF with TCP and 5% NaF. No significant difference in ΔS was observed among varnishes (5% NaF = 4,098.4 ± 1,407.9; 5% NaF with CPP-ACP = 4,164.0 ± 1,019.3; 5% NaF with TCP = 4,183.2 ± 1,527.2; p = .999), but all of them differed from the negative control group (6,757.8 ± 2,274.7; p < .001). Lesion depth was lower in varnishes groups compared to negative control (% reduction: 5% NaF = 41.8%, 5% NaF with CPP-ACP = 38.8%, and 5% NaF with TCP = 36.3%; p < .001). Similar Ca, P, and Ca/P ratio percentages among groups and F was not detected after the treatments. All fluoride varnishes showed potential to enhance remineralization of early caries lesions in primary teeth.

Reabilitação estética e funcional na primeira infância: relato de caso / Aesthetic and functional rehabilitation in infancy: a case report

A perda precoce dos dentes decíduos pode ocorrer pela falta de diagnóstico e tratamento na fase inicial da cárie dentária. O objetivo foi relatar o tratamento reabilitador estético e funcional de uma criança de 4 anos e 5 meses de idade, do gênero feminino, com cárie precoce da infância severa. Durante a anamnese, além da queixa de dor nos dentes, notou-se apatia da criança e constrangimento da mesma ao falar e sorrir. Ao exame clínico inicial, a paciente apresentou ausência dos dentes 55, 54, 75, 84 e 85; lesões de cárie ativa do 73 ao 83; lesões cariosas ativas extensas (53, 52, 51, 61, 62, 63, 64, 65, 74) e presença de fístula na região dos dentes 51 e 52. Após o exame radiográfico, o tratamento proposto foi a realização da exodontia dos elementos dentários não passíveis de receber tratamento restaurador (53, 52, 51, 61, 62, 63, 64, 65, 74); restauração com resina composta do 73 ao 83; e posterior colocação de prótese total superior e prótese parcial inferior. Orientações sobre higiene bucal e dieta não-cariogênica foram realizadas em todas as etapas do tratamento para incentivar a criança e familiares à prática de hábitos saudáveis. Diante do tratamento realizado, concluiu-se que a reabilitação estética-funcional recuperou as funções estéticas, fonéticas e mastigatórias da paciente; colaborando para a melhora da autoestima da criança o que gerou satisfação dos familiares. O trabalho educativo em estimular a criança e os cuidadores foi essencial para o sucesso do tratamento e manutenção da saúde bucal...

Dental caries is a disease related with sucrose rich diet and poor oral hygiene. During childhood, if caries disease is misdiagnosed, it can lead to early loss of primary teeth. This study aimed to report the aesthetic and functional rehabilitation treatment in a female child aged 4 years and 5 months, with severe early childhood caries. In the case history, as well as complaints of toothache, the child showed apathy and embarrassment to talk and smile. In initial clinical examination, it was noticed lack of teeth 55, 54, 85, 84 and 75; active caries lesion on teeth 71, 73, 81, 82 and 83; the dental elements 51, 52, 53, 61, 62, 63, 64, 65 and 74 presented with extensive coronary destruction bellow the gingival margins, and the teeth 51 and 52 with the presence of fistula. After radiographic evaluation, the treatment proposed was comprised by destroyed teeth extraction, resin composite restoration of all cavities and subsequent placement of upper denture and lower partial denture. Oral hygiene and non-cariogenic diet orientations were accomplished since the initial treatment to encourage the child and her family to practice healthy habits. After accomplished the treatment, it could be concluded that aesthetic and functional rehabilitation recovered the patient aesthetic, phonetic and mastication functions. This fact contributed to improve the child’s self-esteem and it promoted satisfaction of her family. The dentist educational work and the stimulus of child and her caregivers were essential for treatment successful and for patient oral health maintenance...

Uprighting impacted mandibular second molars with orthodontic elastic separating rings.

A 16-year-old girl presented with complaints of recurrent spontaneous pain in the mandibular second molar region. Treatment favored use of a simple uprighting technique involving orthodontic elastic separating rings.