Factors involved in the treatment sought immediately after traumatic dental injuries in Brazilian children.

AIM: The aim of this study was to evaluate demographic and clinical factors involved in the immediate seeking of care after traumatic dental injury (TDI) in Brazilian children. MATERIALS AND METHODS: Records from 74 patients, age ranged 1-11 years, who sought treatment at the School of Dentistry of Ribeirão Preto at University of São Paulo, Brazil, were collected. Data was analyzed using the Epi Info 7.0 software by t-test, odds ratio calculation, Chi-square, or Fisher's exact tests. RESULTS: Twenty-three (31.1%) sought dental treatment immediately and 51 (68.9%) did not seek dental treatment immediately. The most common type of trauma was lateral luxation (44.6%). In primary teeth, 31 cases (60.78%) involved the soft tissue and 16 (39.2%) involved hard tissue injuries. While in permanent teeth, 20 cases (40%) involved soft tissue and 24 (60%) involved hard tissue injuries had more traumas in the hard tissue (P = 0.04). The type of injury and dentition was not associated with the time that the guardians sought dental treatment (P > 0.05). None of the factors were involved in immediately seeking care after TDI. CONCLUSION: Moreover, the majority of parents/caregivers did not immediately seek dental treatment after TDI, regardless of the type of injury.

Effect of manual and electrical brushing on the enamel of sound primary teeth and teeth with induced white spot lesions.

PURPOSE: To evaluate the effect of different electrical brushing systems on the surface roughness and wear profile of the enamel of sound primary teeth and teeth with induced white spot lesions. METHODS: 45 specimens were obtained from sound primary incisors, and the buccal surface was divided into four parts: sound enamel; enamel with white spot lesions; sound enamel with brushing; and enamel with white spot lesions and brushing. Specimens were randomly divided into three groups (n =15), according to the different brushing systems: Group 1 - Electric rotating toothbrush (Kid's Power Toothbrush - Oral B); Group 2 - Sonic electric toothbrush (Baby Sonic Toothbrush); and Group 3 - Manual toothbrush (Curaprox infantil) (control). The specimens were analyzed for surface roughness and wear profile. Data were analyzed by appropriate statistical tests, with a significance level of 5%. RESULTS: Regarding the surface roughness, no significant difference was observed between the groups. However, with respect to the wear profile, Group 1 caused significantly higher wear in the sound tooth enamel and in the presence of white spot lesions, in comparison to the other brushing systems (2 and 3) (P< 0.05), which did not cause wear. Manual and electric brushing (rotational and sonic) did not increase surface roughness in primary tooth enamel. However, the electric rotational brushing caused significant wear of the sound and demineralized enamel surface of primary teeth. CLINICAL SIGNIFICANCE: None of the toothbrushing systems tested caused significant alterations on sound dental enamel. However, rotational toothbrushing on enamel of primary teeth with white spot lesion increased wear.

Oestrogen receptor alpha, growth hormone receptor, and developmental defect of enamel.

BACKGROUND: Oestrogen (ES) and growth hormone (GH) are hormones that may have a role in caries aetiology and developmental defects of enamel (DDE) since their receptors (ERs and GHR) are expressed during amelogenesis. AIM: To evaluate whether genetic polymorphisms in the genes that codify the ERα (ESR1) and GHR are associated with caries experience and DDE in children. DESIGN: Two hundred and sixteen children of both genders, aged 9-12 years, were examined and classified according to caries and DDE phenotype. Genomic DNA was extracted from buccal cells in saliva. Genetic polymorphisms in ERS1 (rs1884051 and rs12154178) and GHR (rs297305, rs2940913, rs2910875, and rs1509460) were genotyped using TaqMan chemistry. Data were analysed by PLINK, while the chi-square test was used to compare allele and genotype distributions (alpha of 5%). RESULTS: A total of 131 children (60.7%) had caries experience, and 43 (19.9%) presented DDE. Genotype and allele distributions were not associated with caries experience (P > 0.05). Genotype and allele distributions between DDE, affected and unaffected, were associated with the polymorphism rs12154178 in ESR1 (P = 0.01 and P = 0.001, respectively) and with the polymorphism rs1509460 in GHR (P = 0.05 and P = 0.02, respectively). CONCLUSIONS: Genetic polymorphisms in ERS1 (rs12154178) and GHR (rs1509460) are associated with DDE.

Single vs Two-session Root Canal Treatment: A Preliminary Randomized Clinical Study using Cone Beam Computed Tomography.

AIMS: To compare root canal treatment of teeth with apical periodontitis (AP) in a single or two visits, using cone beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty-six pairs of teeth (13 patients) were assigned to two groups: Group single-session (GSS): Instrumentation and root canal filling in the same session; and group two-session (GTS): A calcium hydroxide intracanal medication (Calen(®) paste) was used for 14 days between two sessions. Cone beam computed tomography scans were obtained before and 12 months after treatment. The pre- and postoperative volume of the AP lesions was measured in mm(3). The percentages of volume reduction was compared using Student's t-test and the existence of significant difference between the groups for cases with ≤ 50% or > 50% lesion volume reduction was assessed by chi-squared test ratio likelihood test (α = 5%). RESULTS: The volume reduction was greater in GTS (79.25%) than GSS (68.35%), though without significant difference (p > 0.05). After 12 months, complete repair was not observed in any specimen. Lesion volume reduction > 50% was significantly greater with the use of an intracanal medication (p < 0.05). CONCLUSION: Twelve months posttreatment, CBCT did not show complete repair in any of the teeth, suggesting that this follow-up period is not sufficient for complete lesion regression. In both groups, similar AP lesion volume reduction was observed after 12 months, with a more advanced repair (> 50% volume reduction) in the teeth medicated with calcium hydroxide intracanal dressing. CLINICAL SIGNIFICANCE: Calcium hydroxide intracanal dressing provided clinical evidence to indicate its use in teeth with apical periodontitis prior to definitive root canal filling.

Direct pulp capping with a self-etching adhesive system: histopathologic evaluation in dogs' teeth.

OBJECTIVE: This study evaluated histopathologically the response of pulp and periradicular tissues after pulp capping with an all-in-one self-etching adhesive system in dogs' teeth. STUDY DESIGN: Forty teeth of 4 dogs were assigned to 3 groups according to the pulp capping material: G1 (n = 20): self-etching adhesive system; G2 (n = 10): Ca(OH)(2); G3 (n = 10): zinc oxide-eugenol. The animals were killed 7 and 70 days after pulp capping. The pieces containing the pulp-capped teeth were removed and processed for histologic analysis. RESULTS: At 7 days, no dentin bridge formation was observed; G1 and G3 exhibited inflammatory pulpal alterations, whereas G2 presented only mild inflammatory infiltrate in the pulp tissue adjacent to the capping material, the remainder being intact. At 70 days, no specimen in G1 or G3 presented dentin bridge formation. The remaining pulp tissue exhibited severe inflammatory alterations and areas of necrosis. In G2, all specimens showed dentin bridge formation and absence of inflammation and mineralized tissue resorption. No bacteria were identified using Brown and Brenn staining techniques in all 3 groups at any observation period. CONCLUSION: According to the conditions of this study, direct pulp capping with the self-etching adhesive system did not allow pulp tissue repair and failed histopathologically in 100% of the cases.

Dental findings and dental care management in trisomy 18: case report of a 13-year-old "long-term survivor".

Trisomy 18 is a disorder characterized by psychomotor disabilities, dysmorphic features and organ malformations, including mental disabilities, growth deficiency, poor motor ability, micrognathia, microcephaly, low-set and malformed ears, distinctively clenched fists with overlapping fingers, and congenital heart defects. The prognosis is poor: 90% of infants with trisomy 18 do not survive beyond the first year of life and 99% die before the age of 10. This paper reports on a 13-year-old child diagnosed with trisomy 18. The major clinical features are cleft lip/palate, high-arched narrow palate, micrognathia, anterior open bite, posterior crossbite and taurodontism. Dental care management of these patients with special needs is discussed and the dental treatment for this child with trisomy 18 is described.