Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Brazilian Schoolchildren Aged 8 to 10 Years

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

Identification of dental calcification stages as a predictor of skeletal development phase.

OBJECTIVE: This study aimed to establish a correlation between the stages of tooth calcification of mandibular canines and second molars with the phases of skeletal development. METHODS: In a consecutive series of panoramic, cephalometric and hand-wrist radiographs of 113 individuals (60 females and 53 males) with an average age of 12.24 ± 1.81 years, the stages of mandibular canine and second molar calcification, cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI) were classified. The variables were correlated by means of the Spearman's Rank test: chronological age, SMI, CVMI and tooth calcification stages. In order to assess whether the CVMI and tooth calcification stages were significant predictors of the SMI, an ordinal regression analysis was carried out. RESULTS: The stages of CVMI (OR = 16.92; CI 95% = 6.45-44.39; p< 0.001) and calcification of the second molars (OR = 3.22; CI 95% = 1.50-6.92; p= 0.003) were significant predictors of SMI, however similar result was not observed for canines (OR = 0.52, CI 95% = 0.18-1.54; p= 0.239). Calcification stage E for boys, and E and F for girls corresponded to the pre-peak phase of pubertal growth. Stages G and H for boys, and F and G for girls coincided with peak of growth. In the final growth phase, the majority of second molars presented with root apex closure (stage H). CONCLUSION: The stages of calcification of the second molar may be considered predictors of the stage of skeletal development in the population studied.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren.

This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Identification of dental calcification stages as a predictor of skeletal development phase

ABSTRACT Objective: This study aimed to establish a correlation between the stages of tooth calcification of mandibular canines and second molars with the phases of skeletal development. Methods: In a consecutive series of panoramic, cephalometric and hand-wrist radiographs of 113 individuals (60 females and 53 males) with an average age of 12.24 ± 1.81 years, the stages of mandibular canine and second molar calcification, cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI) were classified. The variables were correlated by means of the Spearman's Rank test: chronological age, SMI, CVMI and tooth calcification stages. In order to assess whether the CVMI and tooth calcification stages were significant predictors of the SMI, an ordinal regression analysis was carried out. Results: The stages of CVMI (OR = 16.92; CI 95% = 6.45-44.39; p< 0.001) and calcification of the second molars (OR = 3.22; CI 95% = 1.50-6.92; p= 0.003) were significant predictors of SMI, however similar result was not observed for canines (OR = 0.52, CI 95% = 0.18-1.54; p= 0.239). Calcification stage E for boys, and E and F for girls corresponded to the pre-peak phase of pubertal growth. Stages G and H for boys, and F and G for girls coincided with peak of growth. In the final growth phase, the majority of second molars presented with root apex closure (stage H). Conclusion: The stages of calcification of the second molar may be considered predictors of the stage of skeletal development in the population studied.

RESUMO Objetivo: O presente estudo objetivou estabelecer uma correlação entre os estágios de calcificação dentária de caninos e segundos molares inferiores e as fases do desenvolvimento esquelético. Métodos: Em uma série consecutiva de radiografias panorâmicas, cefalométricas e de mão e punho de 113 indivíduos (60 meninas e 53 meninos) com idade média de 12,24 ± 1,81 anos, foram classificados os estágios de calcificação do canino e do segundo molar inferiores, indicadores de maturação das vértebras cervicais (IMVC) e indicadores de maturação esquelética (IME). As variáveis foram correlacionadas pelo teste de Correlação de Rank de Spearman: idade cronológica, IME, IMVC e estágios de calcificação dentária. A fim de avaliar se os estágios do IMVC e da calcificação dentária foram preditores significativos do IME, foi realizada uma análise de regressão ordinal. Resultados: Os estágios de IMVC (OR = 16,92; IC 95% = 6,45-44,39; p< 0,001) e calcificação dos segundos molares (OR = 3,22; IC 95% = 1,50-6,92; p= 0,003) foram preditores significativos de IME; no entanto, esse não foi o caso com dentes caninos (OR = 0,52, IC 95% = 0,18-1,54; p= 0,239). Os estágios de calcificação E para meninos e E e F para meninas corresponderam à fase pré-pico de crescimento puberal. Os estágios G e H para meninos e F e G para meninas coincidiram com o pico de crescimento. Na fase final de crescimento, a maioria dos segundos molares apresentou fechamento do ápice radicular (estágio H). Conclusão: Os estágios de calcificação do segundo molar podem ser considerados preditores do estágio de desenvolvimento esquelético na população estudada.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Dental Fear in Children: Association with Dental Caries and Molar Incisor Hypomineralization.

The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

In Situ Effect of Intra-Oral Application of Pastes Containing CPP-ACP or CPP-ACPF Against Initial Enamel Erosion

Objective: To evaluate in situ the effect of toothpastes containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate associated to fluoride (CPP-ACPF) on initial erosion prevention. Material and Methods: Bovine enamel blocks (n = 192) were randomly assigned into 4 phases according to the baseline surface hardness: GI: CPP-ACP Paste (MI Paste™), GII: CPP-ACPF Paste (MI Paste Plus™), GIII: Fluoridated paste and GIV: Placebo Paste. In each of the 4 crossover phases, twelve volunteers wore intraoral palatal appliances containing 4 enamel blocks for 2 hours, then the tested treatments were applied intraorally (3 min) and the appliance was maintained in the mouth for another 3 hours. After, the appliances were removed and immersed in hydrochloric acid (0.01 M, pH 2.3) for 30 seconds to promote erosive demineralization. The final surface hardness was evaluated and percentage of surface hardness loss was calculated. The data were analyzed by ANOVA and Tukey's test (α = 5%). Results: The application of CPP-ACP paste, independent of fluoride content, resulted in significant lower enamel hardness loss (GI: 9.26% ±3.48 and GII: 9.14% ±1.73) compared to NaF (GIII: 15.5% ± 3.94) and placebo (GIV: 16.7% ± 4.07) pastes, which did not show difference between them. Conclusion: The CPP-ACP pastes were able to reduce initial erosive demineralization in relation to fluoride and placebo pastes. Nevertheless the formulation of CPP-ACP with fluoride did not provide an additional benefit.

Craniofacial trauma in older adults victims of road traffic accidents: a cross-sectional study

Introduction: Among the determinant factors for the implant-supported prosthesis longevity is the exact and comprehensive process of impression which results is the passive prosthesis fitting. Objective: To compare the accuracy of transfer coping impression techniques with or without splinting, after the isolation of the factors associated to the passive fitting. Method: Based on the control group composed by an edentulous mandibular master model (self-cured acrylic resin) with four external hexagon parallel implants splinting with a metallic bar, four customized open trays were constructed with self-cured acrylic. Ten impressions were made with condensation silicone ( Xantopren ®), poured with type IV plaster ( Durone ®), and then divided into two groups: Group 1 (n=5) ­ non-splinting multi unit transfer copings; and Group 2 (n=5) ­ splinting multi unit transfer copings with a bar constructed with self-cured acrylic resin ( Palavit G ®) and dental floss, with the aid of an addition silicon mold ( Elite Double ® Zhermack) . Next, the bar was cut and splinted again. The ten transfer molds were measured at the center of the labial surface of each implant with the aid of Stereoscopic Magnifying Glass ( Physis ®) with x60 magnification. The results were tabulated and submitted to non-parametric statistics through Kruskal-Wallis test (p<0.05). Results: The means were: 22.44 µm (±7) for control group, 26.86 µm (±10) for direct splinting, and 24.70 µm (±13) for direct non-splinting technique. Conclusion: No statistically significant differences were found between the tested techniques.

Introdução: Entre os fatores determinantes para a longevidade de uma prótese implanto suportada, está o processo exato e meticuloso de moldagem dos implantes osseointegrados, implicando diretamente no assentamento passivo da prótese. Objetivo: Comparar a precisão das técnicas de moldagem com e sem união dos transferentes isolando os fatores que podem estar associados ao ajuste passivo. Métodos: A partir de um grupo controle composto por um modelo mestre (em resina acrílica quimicamente ativada) mandibular desdentado com quatro implantes de conexão externa posicionados paralelamente e unidos por uma barra metálica. Foram confeccionadas dez moldeiras em resina acrílica quimicamente ativada (todas abertas). Dez impressões foram feitas com silicone de condensação Xantopren ®, e vertidas com gesso tipo IV, Durone ®, divididas em dois grupos: Grupo 1 (n=5) ­ Pilares multi unit não unidos e Grupo 2 (n=5) ­ Pilares multi unit unidos por uma barra confeccionada com fio dental e resina acrílica autopolimerizável, Palavit G ®, através de um molde de silicone de adição, Elite Double ® Zhermack . Em seguida, a barra foi seccionada e reunida. Os dez modelos de transferência foram mensurados no centro da face vestibular de cada um dos implantes através de uma lupa estereoscópica ( Physis ®) com ampliação de 60 vezes. Os resultados foram tabulados e submetidos à análise estatística não paramétrica, teste Kruskal-Wallis (p<0,05). Resultados: As médias aritméticas encontradas foram de 22,44 µm (±7) para grupo controle, 26,86 µm (±10) para técnica direta com esplintagem e 24,70 µm (±13) para técnica direta sem esplintagem. Conclusão: Não foi identificado diferenças estatísticas significantes entre as técnicas experimentadas.

Caracterização do modelo de atenção básica à saúde bucal na região nordeste no período de 2015-2017 / Characterization of the primary care model in oral health in northeast region in the period 2015-2017 / Caracterización del modelo de atención básica a la salud bucal en la región nordeste en el período de 2015-2017

Introdução: Os Sistemas de informação têm como finalidade promover a elaboração e facilitar a avaliação de políticas, planos e programas de saúde, uma vez que seus indicadores refletem a saúde da população. Objetivo: O presente estudo tem como objetivo caracterizar o modelo de atenção básica à saúde bucal na região Nordeste do Brasil, a partir de dados secundários da produção ambulatorial em saúde bucal, disponíveis no SIA-SUS. Material e método: Tratou-se de estudo descritivo e quantitativo, utilizando dados secundários a partir da produção ambulatorial da atenção básica em saúde bucal, disponíveis no Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS). A coleta dos dados foi feita a partir do banco de dados do Departamento de Informática do SUS (DATASUS) e considerou o período de janeiro de 2015 a dezembro de 2017. Foram incluídos no estudo os dados sobre os procedimentos curativos e preventivos realizados em ambiente ambulatorial pelos cirurgiões-dentistas. Os dados foram apresentados por meio de estatística descritiva. Resultados: Obteve-se em 2015, o maior número total de procedimentos realizados (52.801.784). Do total de procedimentos curativos entre 2015-2017, tem-se maioria de procedimentos restauradores (22,7%) e minoria de procedimentos cirúrgicos (15,2%). Observa-se que, nos três anos estudados, a produção de procedimentos curativos superou a de procedimentos preventivos. Conclusão: O modelo básico de atenção à saúde bucal no Nordeste apresentou caráter curativo, com predominância dos procedimentos restauradores, seguidos pelos periodontais, ficando em menor número os procedimentos cirúrgicos(AU)

Introduction: Information systems aim to promote the elaboration and facilitate the evaluation of policies, health plans and programs, since their indicators reflect the health of the population. Objective: The objective of this study is to characterize the primary care model for oral health in the Northeast region of Brazil, based on secondary data on ambulatory oral health production available at SIA-SUS. Material and method: This was a descriptive and quantitative study, using secondary data from the outpatient production of primary care in oral health, available in the Outpatient Information System of the Unified Health System (SIA-SUS). Data collection was done from the database of the Department of Information Technology of the SUS (DATASUS) and considered the period from January 2015 to December 2017. Data were included in the study on curative and preventive procedures performed in an outpatient setting by dentists. The data were presented through descriptive statistics. Results: The highest number of procedures performed (52,801,784) was obtained in 2015. Of the total curative procedures between 2015-2017, a majority of restorative procedures (22.7%) and minority of surgical procedures (15.2%) were performed. It is observed that in the three years studied, the production of curative procedures surpassed that of preventive procedures. Conclusion: The the primary care model for oral health in the Northeast was curative, predominantly restorative procedures, followed by periodontal procedures, with fewer surgical procedures(AU)

Introducción: Los sistemas de información tienen como finalidad promover la elaboración y facilitar la evaluación de políticas, planes y programas de salud, ya que sus indicadores reflejan la salud de la población. Objetivo: El presente estudio tiene como objetivo caracterizar el modelo de atención básica a la salud bucal en la región Nordeste de Brasil, a partir de datos secundarios de la producción ambulatoria en salud bucal, disponibles en el SIA-SUS. Métodos: Se realizó un estudio descriptivo y cuantitativo, con datos secundarios obtenidos a partir del tratamiento ambulatorio de atención dental básica disponible en el Sistema de Información Ambulatoria del Sistema Único de Salud (SUS-SIA). La recolección de los datos fue hecha a partir del banco de datos del Departamento de Informática del SUS (DATASUS) y consideró el período de enero de 2015 a diciembre de 2017. Se incluyeron en el estudio los datos sobre los procedimientos curativos y preventivos realizados en ambiente ambulatorio por los cirujanos-dentistas. Los datos fueron presentados por medio de estadística descriptiva. Resultados: Obtuvo en 2015, el mayor número total de procedimientos realizados (52.801.784). Del total de procedimientos curativos entre 2015-2017, se tienen mayoría de procedimientos restauradores (22,7%) y minoría de procedimientos quirúrgicos (15,2%). reveló que, en los tres años estudiados, la producción de procedimientos curativos superó la de procedimientos preventivos. Conclusión: El modelo básico de atención a la salud bucal en el Nordeste presentó carácter curativo, con predominio de los procedimientos restauradores, seguidos por los periodontales, quedando en menor número los procedimientos quirúrgicos(AU)

Effect of palm oil alone or associated to stannous solution on enamel erosive-abrasive wear: A randomized in situ/ex vivo study.

OBJECTIVE: Palm oil has demonstrated preventive potential against initial erosive demineralization in vitro. This in situ study evaluated the effect of palm oil alone or associated with stannous-containing (Sn) solution on preventing enamel loss from an erosive/abrasive challenge. DESIGN: This single-blind, randomized, crossover in situ/ex vivo study was developed in four phases (one per group of five days) with sixteen volunteers. Enamel blocks (n = 256) were allocated to groups according to the treatment: Palm oil; Palm oil plus Sn solution; Sn solution - positive control; and Deionized water - negative control. Half of the enamel blocks of each group was subjected to erosion and the other half to erosion + abrasion. The daily ex vivo protocol consisted of four citric acid immersions (2 min). Before the first and third acid exposure, the blocks were treated with the test solutions (1 drop/block) for 1 min followed by acid immersion and abrasive challenge (toothpaste was applied on all blocks and half were brushed for 15 s/block). Enamel loss was quantified profilometrically and data were analyzed by two-way ANOVA and Tukey's test (p < 0.05). RESULTS: A significant difference was found for type of treatment (p < 0.001); wear condition (p = 0.38) and the treatment x condition interaction (p = 0.33) was non-significant. Palm oil associated or not to Sn solution significantly reduced enamel wear in comparison with the negative control but did not differ from the positive control (p > 0.05). CONCLUSIONS: Palm oil was able to prevent enamel loss under erosive and erosive + abrasive challenges in a similar extend to stannous-containing commercial solution.

Caracterização dos ensaios clínicos sobre cárie dentária desenvolvidos no Brasil e registrados no clinical trials: uma análise de 15 anos (2003-2017) / Characterization of clinical trials about caries developed in Brazil and registered on clinical trials: an analysis of 15 years (2003-2017)

Objetivo: Caracterizar os ensaios clínicos sobre cárie dentária desenvolvidos por pesquisadores brasileiros e registrados na plataforma Clinical Trials. Material e método: Tratou-se de estudo bibliográfico sobre a cárie dentária por meio da análise dos registros feitos na plataforma Clinical Trials. O período de busca compreendeu todos os estudos registrados entre os anos de 2003 a 2017. Para a estratégia de pesquisa foi utilizada a palavra-chave "Dental caries" na seção "Condition or disease" e "Brazil" na seção "Country". Os dados foram apresentados por meio de estatística descritiva. Resultados: Foram obtidos 55 ensaios clínicos, constituindo- se o Estado de São Paulo como principal local de execução (51,8%). A amostra variou de três a 800 indivíduos. Quanto à análise do período de registro, a maioria dos ensaios clínicos foram registrados nos últimos cinco anos (2013-2017) (63,6%). A maioria dos ensaios clínicos analisados recrutou crianças entre 0-12 anos (67,7%). Com relação à alocação dos grupos, apenas um estudo (1,8%) não se caracterizou como randomizado. O modelo de intervenção mais frequente foi o paralelo (70,9%). Quanto ao tipo de mascaramento, o estudo cego (34,5%) foi o mais prevalente e os estudos com finalidade terapêutica foram predominantes (67,3%). A maior parte dos estudos dividiu os participantes em dois grupos (67,3%) e não usou grupo placebo (80,0%). Conclusões: Os ensaios clínicos desenvolvidos por pesquisadores brasileiros voltados à temática da cárie dentária são majoritariamente desenvolvidos em crianças, predominando o desenho paralelo e a finalidade terapêutica. Existe grande variabilidade no número amostral, sendo baixo o uso de grupo placebo.

Objectives: To caracterize the clinical trials about dental caries developed by brazilian resourchers and registered on Clinical Trials Plataform. Methods: A bibliographic study about dental caries theme by means of the analysis of registries made at the Clinical Trials, an international plataform for registration of clinical trials. The search included all the registered studies between the years of 2003 and 2017. The search strategy used "dental caries" as key word on section "Condition or disease" and "Brazil" on section "Country". The data were presented through a descriptive statistics. Results: The search obtained 55 (fifty five) clinical trials, having the state of São Paulo as the principal execution place (51,8%). The sample varied between 3 (three) and 800 (eight hundred) individuals. In relation to the period of registry, most of the clinical trials belong to the last 5 (five) years - 2013-2017 (63,6%). Most of clinical trials analyzed had recruited children between 0-12 years (67,7%). With regard to allocation of groups, only 1 (one) study didn't caracterize as randomized. The most frequent intervation model was the parallel (70,9%). As the type of masking, the blind study prevailed and the studies with therapeutic purpose were predominant (67,3%). The most part of studies divided the participants into 2 (two) groups (67,3%) and didn't use a placebo group. Conclusion: The clinical trials developed by brazilian resourchers toward dental caries theme are mostly developed on children, predominating the parallel design and therapeutic purpose. There is large variability on sample numbers, with low use of placebo groups.

Hipomineralização molar-incisivo: etiologia, características clínicas e tratamento / Molar incisor hypomineralization: etiology, clinical characteristics and treatment

Introdução: a Hipomineralização Molar-Incisivo (HMI) é um defeito de desenvolvimento do esmalte dentário que afeta de um até todos os primeiros molares permanentes, podendo estar presente nos incisivos permanentes. Objetivo: revisar a literatura sobre a HMI objetivando proporcionar informações ao cirurgião-dentista que realiza atendimento infantil sobre o diagnóstico, características clínicas e tratamento. Metodologia: revisão integrativa da literatura, sendo utilizado as bases de dados LILACS, PubMed, Web of Science e Scopus. Foram usadas as palavras-chaves "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" e " Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization". Resultados: fatores etiológicos associados a complicações pré, peri e pós-natais, ambientais e genéticos têm sido evidenciados e a prevalência de HMI mostra-se variada entre as populações. Apresenta-se como manchas opacas bem delimitadas e, com o aumento da gravidade, ocorre a perda do esmalte resultando em fratura, destruição coronária e indicação de exodontia. As fraturas pós-eruptivas atuam como áreas de retenção de biofilme, o que facilita seu acúmulo e aumenta a susceptibilidade à cárie dentária. A Academia Europeia de Odontopediatria (EAPD) estabeleceu critérios que facilitam o diagnóstico deste agravo por meio de pesquisas epidemiológicas. As medidas terapêuticas são direcionadas de acordo com a gravidade da lesão. Conclusão: a HMI deve receber adequada atenção do cirurgião-dentista em função das consequências clínicas e estéticas que acarreta ao paciente, interferindo negativamente na sua qualidade de vida nos casos mais graves. Novas pesquisas são necessárias com a finalidade de expandir o conhecimento acerca da HMI, objetivando ofertar ao paciente o correto diagnóstico e a melhor opção terapêutica.

ntroduction: molar Incisor Hypomineralization (HMI) is a developmental defects of enamel that affects from one to all first permanent molars and also permanent incisors. Aim: to review the literature with the aim of providing information to the pediatric dentist about the diagnosis, clinical characteristics and treatment of HMI. Methodology: integrative literature review, using the LILACS, PubMed, Web of Science and Scopus databases. The keywords "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" and "Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization" were used. Results: etiologic factors are associated with prenatal and postnatal factors, environmental and genetic complications. The prevalence of HMI is varied among the populations. It's clinically characterized as delimited opaque spots. With increasing severity, can occurs enamel loss, fracture, coronary destruction and indication of exodontia. Post-eruptive fractures act as areas of biofilm retention, which facilitates their accumulation and increases susceptibility to dental caries. European Academy of Pediatric Dentistry (EAPD) has established criteria that facilitate diagnosis of HMI in epidemiological research. Therapeutic measures are indicated according to the severity of the lesion. Conclusion: MIH should receive adequate attention from the dentist due to its clinical and aesthetic consequences, interfering negatively in quality of life of patients in the most severe cases.

Delayed tooth reimplantation with 4-year follow-up: the management of ankylosis during facial growth.

This case report describes the consequences of delayed (24 hours) reimplantation of an avulsed maxillary central incisor, findings over a 4-year follow-up period, and the management of ankylosis during facial growth. After a traumatic event, a 10-year-old boy was taken to a hospital emergency department due to injuries to his face, including avulsion of the maxillary left central incisor. Despite the short amount of time before arriving at the hospital (10 minutes) and use of the correct storage medium (milk), the tooth was not reimplanted, and the parents did not receive instructions to seek dental treatment. The next day, the child was brought to a dental school because he objected to the loss of his tooth. The treatment chosen was delayed tooth reimplantation. At the 1-year follow-up, the reimplanted tooth was infraoccluded, and periapical radiography revealed signs of ankylosis and initial replacement root resorption. At the 2- and 3-year follow-up examinations, resorption and infraocclusion of the central incisor had progressed. In this case, the delayed reimplantation resulted in ankylosis that had a significant clinical impact due to the patient's facial growth. Direct resin restoration of the reimplanted tooth was therefore performed 3 years after trauma. Despite continued resorption and infraocclusion of the tooth observed 4 years posttrauma, the esthetic, low-cost treatment was well accepted, and the patient's quality of life was improved until definitive treatment can be performed.

Effect of vegetable oils applied over acquired enamel pellicle on initial erosion.

OBJECTIVE: The prevalence of dental erosion has been recently increasing, requiring new preventive and therapeutic approaches. Vegetable oils have been studied in preventive dentistry because they come from a natural, edible, low-cost, and worldwide accessible source. This study aimed to evaluate the protective effect of different vegetable oils, applied in two concentrations, on initial enamel erosion. MATERIAL AND METHODS: Initially, the acquired pellicle was formed in situ for 2 hours. Subsequently, the enamel blocks were treated in vitro according to the study group (n=12/per group): GP5 and GP100 - 5% and pure palm oil, respectively; GC5 and GC100 - 5% and pure coconut oil; GSa5 and GSa100 - 5% and pure safflower oil; GSu5 and GSu100 - 5% and pure sunflower oil; GO5 and GO100 - 5% and pure olive oil; CON- - Deionized Water (negative control) and CON+ - Commercial Mouthwash (Elmex® Erosion Protection Dental Rinse, GABA/positive control). Then, the enamel blocks were immersed in artificial saliva for 2 minutes and subjected to short-term acid exposure in 0.5% citric acid, pH 2.4, for 30 seconds, to promote enamel surface softening. The response variable was the percentage of surface hardness loss [((SHi - SHf) / SHf )×100]. Data were analyzed by one-way ANOVA and Tukey's test (p<0.05). RESULTS: Enamel blocks of GP100 presented similar hardness loss to GSu100 (p>0.05) and less than the other groups (p<0.05). There was no difference between GP5, GC5, GC100, GSa5, GSu100, GSa100, GSu5, GO5, GO100, CON- and CON+. CONCLUSION: Palm oil seems to be a promising alternative for preventing enamel erosion. However, further studies are necessary to evaluate a long-term erosive cycling.

Effect of vegetable oils applied over acquired enamel pellicle on initial erosion

Abstract Objective The prevalence of dental erosion has been recently increasing, requiring new preventive and therapeutic approaches. Vegetable oils have been studied in preventive dentistry because they come from a natural, edible, low-cost, and worldwide accessible source. This study aimed to evaluate the protective effect of different vegetable oils, applied in two concentrations, on initial enamel erosion. Material and Methods Initially, the acquired pellicle was formed in situ for 2 hours. Subsequently, the enamel blocks were treated in vitro according to the study group (n=12/per group): GP5 and GP100 - 5% and pure palm oil, respectively; GC5 and GC100 - 5% and pure coconut oil; GSa5 and GSa100 - 5% and pure safflower oil; GSu5 and GSu100 - 5% and pure sunflower oil; GO5 and GO100 - 5% and pure olive oil; CON− - Deionized Water (negative control) and CON+ - Commercial Mouthwash (Elmex® Erosion Protection Dental Rinse, GABA/positive control). Then, the enamel blocks were immersed in artificial saliva for 2 minutes and subjected to short-term acid exposure in 0.5% citric acid, pH 2.4, for 30 seconds, to promote enamel surface softening. The response variable was the percentage of surface hardness loss [((SHi - SHf) / SHf )×100]. Data were analyzed by one-way ANOVA and Tukey's test (p<0.05). Results Enamel blocks of GP100 presented similar hardness loss to GSu100 (p>0.05) and less than the other groups (p<0.05). There was no difference between GP5, GC5, GC100, GSa5, GSu100, GSa100, GSu5, GO5, GO100, CON− and CON+. Conclusion Palm oil seems to be a promising alternative for preventing enamel erosion. However, further studies are necessary to evaluate a long-term erosive cycling.

In situ effect of CPP-ACP chewing gum upon erosive enamel loss.

OBJECTIVE: This in situ study investigated the ability of a CPP-ACP chewing gum in preventing erosive enamel loss. Material and Methods: During three experimental crossover phases (one phase per group) of seven days each, eight volunteers wore palatal devices with human enamel blocks. The groups were: GI - Sugar free chewing gum with CPP-ACP; GII - Conventional sugar free chewing gum; and GIII - No chewing gum (control). Erosive challenge was extraorally performed by immersion of the enamel blocks in cola drink (5 min, 4x/day). After each challenge, in groups CPP and No CPP, volunteers chewed one unit of the corresponding chewing gum for 30 minutes. Quantitative analysis of enamel loss was performed by profilometry (µm). Data were analyzed by Repeated-Measures ANOVA and Tukey's test (p<0.05). RESULTS: The use of chewing gum (CPP and No CPP) resulted in lower erosive enamel loss compared with the control group (p<0.05). CPP-ACP chewing gum (CPP) did not improve the protection against erosive enamel loss compared with conventional chewing gum (No CPP) (p>0.05). CONCLUSION: The CPP-ACP chewing gum was not able to enhance the anti-erosive effect of conventional chewing gum against enamel loss.

In situ effect of CPP-ACP chewing gum upon erosive enamel loss

Abstract Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is able to increase salivary calcium and phosphate levels at an acidic pH. Previous studies demonstrated that a CPP-ACP chewing gum was able to enhance the re-hardening of erosion lesions, but could not diminish enamel hardness loss. Therefore, there is no consensus regarding the effectiveness of CPP-ACP on dental erosion. Objective This in situ study investigated the ability of a CPP-ACP chewing gum in preventing erosive enamel loss. Material and Methods: During three experimental crossover phases (one phase per group) of seven days each, eight volunteers wore palatal devices with human enamel blocks. The groups were: GI - Sugar free chewing gum with CPP-ACP; GII - Conventional sugar free chewing gum; and GIII - No chewing gum (control). Erosive challenge was extraorally performed by immersion of the enamel blocks in cola drink (5 min, 4x/day). After each challenge, in groups CPP and No CPP, volunteers chewed one unit of the corresponding chewing gum for 30 minutes. Quantitative analysis of enamel loss was performed by profilometry (µm). Data were analyzed by Repeated-Measures ANOVA and Tukey's test (p<0.05). Results The use of chewing gum (CPP and No CPP) resulted in lower erosive enamel loss compared with the control group (p<0.05). CPP-ACP chewing gum (CPP) did not improve the protection against erosive enamel loss compared with conventional chewing gum (No CPP) (p>0.05). Conclusion The CPP-ACP chewing gum was not able to enhance the anti-erosive effect of conventional chewing gum against enamel loss.

Effect of different salivary exposure times on the rehardening of acid-softened enamel.

This in situ study assessed the effect of different times of salivary exposure on the rehardening of acid-softened enamel. Bovine enamel blocks were subjected in vitro to a short-term acidic exposure by immersion in 0.05 M (pH 2.5) citric acid for 30 s, resulting in surface softening. Then, 40 selected eroded enamel blocks were randomly assigned to 10 volunteers. Intraoral palatal appliances containing 4 enamel blocks were constructed for each volunteer, who wore the appliance for 12 nonconsecutive hours: initial 30 min, followed by an additional 30, and then by an additional 1 hour. For the last additional 10 hours the appliances were used at night, during the volunteers' sleep. Surface hardness was analyzed in the same blocks at baseline, after erosion and after each period of salivary exposure, enabling percentage of surface hardness recovery calculation (%SHR). The data were tested using repeated measures ANOVA and Tukey's test (α = 0.05). Increasing periods of salivary action promoted a progressive increase in the surface hardness (p < 0.001). However a similar degree of enamel rehardening (p = 0.641) was observed between 2 hours (49.9%) and 12 hours (53.3%) of salivary exposure. Two hours of salivary exposure seems to be appropriate for partial rehardening of the softened enamel surface. The use of the intraoral appliance during sleep did not improve the enamel rehardening after erosion.

Strategies for control and treatment of carious lesions in deciduous molars: a review of the literature / Estratégias para o controle e tratamento das lesões de cárie em molares decíduos: Uma revisão de literatura

ABSTRACT In recent years, a reduction has been observed in the prevalence of dental caries in the global population. However, caries is still considered a public health problem. Currently, total removal of decayed tissue has been questioned and replaced by less invasive therapeutic approaches, which offer the possibility of incomplete removal of decayed tissue in one or two clinical sessions. Other techniques aim at sealing the carious lesion or use prefabricated metal crowns on the cavitated tooth without removal of the decayed tissue, preventing direct contact of the substrates with the carious lesion. Recently, ultra-conservative treatment has gained scientific prominence, and is able to control carious lesions through the disorganization of dental biofilm via supervised brushing. Each therapeutic approach has its advantages and limitations, and it is the responsibility of dental professionals to plan their patients' treatments according to their individual needs, allowing for better functional, aesthetic and psychological conditions for patients by preserving primary teeth until their physiological exfoliation.

RESUMO Nos últimos anos, foi perceptível a diminuição na prevalência da cárie dentária na população mundial. Entretanto, a doença cárie continua sendo considerada um problema de saúde pública. Atualmente, a remoção total do tecido cariado vem sendo questionada e substituída por abordagens terapêuticas menos invasivas, as quais oferecem a possibilidade de remoção incompleta do tecido cariado em uma ou duas sessões clínicas. Outras técnicas visam o selamento da lesão cariosa ou o emprego de coroas metálicas pré-fabricadas sobre o dente cavitado sem que haja remoção de tecido cariado, impedindo o contato direto dos substratos com a lesão cariosa. Recentemente, o tratamento ultraconservador tem ganhado destaque científico, o qual tem a capacidade de conduzir o controle da lesão de cárie através da desorganização do biofilme dentário pela escovação supervisionada. Cada abordagem terapêutica apresenta suas vantagens e limitações, sendo responsabilidade do profissional planejar o tratamento do seu paciente de acordo com as suas necessidades individuais, possibilitando melhores condições funcionais, estéticas e psicológicas para o paciente através da manutenção dos dentes decíduos até a sua esfoliação fisiológica.

Effect of different salivary exposure times on the rehardening of acid-softened enamel

Abstract This in situ study assessed the effect of different times of salivary exposure on the rehardening of acid-softened enamel. Bovine enamel blocks were subjected in vitro to a short-term acidic exposure by immersion in 0.05 M (pH 2.5) citric acid for 30 s, resulting in surface softening. Then, 40 selected eroded enamel blocks were randomly assigned to 10 volunteers. Intraoral palatal appliances containing 4 enamel blocks were constructed for each volunteer, who wore the appliance for 12 nonconsecutive hours: initial 30 min, followed by an additional 30, and then by an additional 1 hour. For the last additional 10 hours the appliances were used at night, during the volunteers' sleep. Surface hardness was analyzed in the same blocks at baseline, after erosion and after each period of salivary exposure, enabling percentage of surface hardness recovery calculation (%SHR). The data were tested using repeated measures ANOVA and Tukey's test (α = 0.05). Increasing periods of salivary action promoted a progressive increase in the surface hardness (p < 0.001). However a similar degree of enamel rehardening (p = 0.641) was observed between 2 hours (49.9%) and 12 hours (53.3%) of salivary exposure. Two hours of salivary exposure seems to be appropriate for partial rehardening of the softened enamel surface. The use of the intraoral appliance during sleep did not improve the enamel rehardening after erosion.