Oral rehabilitation in pediatric dentistry: a clinical case report / Reabilitação bucal em Odontopediatria: relato de caso clínico

ABSTRACT Despite the emphasis and effort devoted to preventive dentistry, massive coronal destruction caused by dental caries or trauma is still seen in pediatric dentistry practice today. The technical difficulties related to dental treatment are compounded by problems related to the behavior of young patients in these circumstances, which brings the need for a broader understanding of behavior management techniques and certain skills in dealing with patients by dental practitioners, aimed at ensuring the well-being of both patient and dentist during treatment. This case report presents and discusses the scientific rationale for the treatment options adopted, considering the techniques and materials already established for aesthetic rehabilitation of adult patients (such as resins, glass-fiber posts, and glass ionomers), and now employed and adapted for pediatric dental care, that would best suit the clinical situation described. At the end of treatment, the patient achieved full rehabilitation and a restored smile, through the use of modern techniques and materials, while the dental practitioner gained a better understanding of the optimal treatment possibilities and strategies for similar cases.

RESUMO Apesar da ênfase e esforço dedicados à Odontologia preventiva, as grandes destruições coronárias causadas por cárie ou traumatismos dentários ainda são hoje problemas que ocorrem na prática clínica da odontopediatria. Além das dificuldades técnicas relacionadas a tais tratamentos, soma-se a isso, os problemas inerentes ao controle da conduta de um paciente muito jovem, o que traz a necessidade de um maior conhecimento de técnicas de manejo comportamental e uma habilidade no trato odontológico por parte do profissional, visando o bem-estar de ambos nestas circunstâncias. O relato de caso a seguir tem como objetivo apresentar e discutir o embasamento científico da opção de tratamento adotada, considerando os materiais, pinos de fibra de vidro, ionômeros de vidro, resinas, e as técnicas disponíveis atualmente, ou seja, procedimentos já consagrados na reabilitação estética em adultos, agora aplicados e adaptados à odontologia de bebês, e que melhor solucionariam a situação clínica descrita, visando sua aplicabilidade em clínica. Ao final obtemos um paciente reabilitado, gozando de um tratamento com técnicas e materiais bastante modernos, com seu sorriso restabelecido, e um profissional informado das possibilidades e técnicas mais adequadas para o tratamento de pacientes em situações semelhantes.

Clinical and radiographic outcomes of the use of capping materials in vital pulp therapy of human primary teeth / Resultados clínicos e radiográficos do uso de materiais de capeamento na terapia de polpa vita de dentes decíduos humanos

O objetivo deste estudo foi comparar os resultados clínicos e radiográficos de hidróxido de cálcio (CH), hidróxido de cálcio precedido de solução corticosteróide / antibiótico (O + CH) e formocresol diluído (FC) na terapia de polpa vital de dentes decíduos humanos. Material e Métodos: Quarenta e cinco molares decíduos inferiores de crianças com idade entre 5-9 anos foram divididos aleatoriamente em três grupos: FC, CH e O + CH e receberam tratamento convencional de pulpotomia. Acompanhamento clínico e radiográfico foi realizado após 3, 6 e 12 meses. Resultados: Nenhum sinal de falha clínica foi observado nos três grupos de estudo durante todos os períodos de avaliação. A análise radiográfica mostrou um total de seis falhas de reabsorção radicular interna nos grupos CH e O + CH após 12 meses de acompanhamento, com diferença estatisticamente significativa em comparação com o grupo FC. O grupo FC não mostrou formação da barreira de tecido duro, o que foi observado nos grupos CH e O + CH em todos os períodos de acompanhamento. Conclusão: Todos os materiais empregados apresentaram taxas de sucesso clínico e radiográfico aceitáveis. Os resultados mostraram que o uso de uma solução anti-inflamatória antes do material de capeamento tem propriedades terapêuticas que ajudam na cicatrização pulpar. São recomendadas investigações clínicas contínuas utilizando estes medicamentos no tratamento de pulpotomia vital em molares decíduos...

Objective: The aim of this study was to compare the clinical and radiographic outcomes of Calcium Hydroxide (CH), Calcium Hydroxide preceded by corticosteroid/antibiotic solution (O+CH) and diluted formocresol (FC) in the vital pulp therapy of human primary teeth. Material and methods: Forty-five mandibular primary molars of children aged between 5-9 years were randomly assigned in the three study groups, FC, CH and O+CH and received conventional pulpotomy treatment. Clinical and radiographic follow-up was made at 3, 6 and 12-months. Results: No sign of clinical failure was observed in the three study groups during all the periods of evaluation. Radiographic analysis showed a total of six failures of internal root resorption in CH and O+CH groups after the 12 months follow-up, with statistically significant difference as compared with FC group. FC group did not show hard tissue barrier formation, which was observed in CH and O+CH groups in all the followup periods. Conclusion: All employed materials showed acceptable clinical and radiographic success rates. The results showed that the use of an antiinflammatory solution prior the dressing material has therapeutic properties that help with pulpal healing. Continued clinical investigations using these medicaments as vital pulpotomy treatment in primary molars are recommended...

Terapia pulpar em dentes decíduos: possibilidades terapêuticas baseadas em evidências / Pulp therapy in deciduous teeth: therapeutic possibilities based on evidences

Introdução: A pulpotomia em dentes decíduos é uma técnica conservadora de terapia pulpar amplamente utilizada em Odontopediatria, sendo de fundamental importância para evitar a perda prematura desses dentes, quer seja por alterações provocadas pela cárie dentária ou traumatismo dentário. Apesar de ser uma técnica estudada há muitos anos, causa muitas controvérsias e discussões, principalmente em termos de biocompatibilidade dos medicamentos empregados e pelas dificuldades e falhas no diagnóstico da condição pulpar. Objetivo: Por meio de uma revisão sistemática da literatura, no período compreendido entre 2000 e 2011, e com enfoque em estudos clínicos randomizados, revisões sistemáticas e meta-análises, este trabalho teve como objetivo discutir, com base em evidências científicas, alternativas para o tratamento de pulpotomia em dentes decíduos humanos. Conclusão: As evidências científicas fidedignas com o uso de materiais capeadores pulpares e as técnicas de Eletrocirurgia e Laser de Baixa Potência foram escassas. Desta forma, sugere-se a realização de estudos complementares bem delineados estatisticamente para maiores esclarecimentos. As informações geradas em tais experimentos poderão contribuir para um melhor entendimento dos mecanismos da terapia pulpar, podendo gerar o desenvolvimento de protocolos com novas formas terapêuticas, que visam a melhorar a terapia pulpar em dentes decíduos.

Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.

Perfil de tratamento de urgência de crianças de 0 a 12 anos de idade, atendidas no Serviço de Urgência Odontológica da Faculdade de Odontologia de Bauru da Universidade de São Paulo. (AU) / Urgency treatment profile of 0 to 12 year-old-children assisted at urgency dental service from Bauru Dental School, University of São Paulo

Foram avaliados os prontuários de atendimentos de crianças de 0 a 12 anos de idade, atendidas no Setor de Urgência Odontológica (SUO) da Faculdade de Odontologia de Bauru, da Universidade de São Paulo, no período compreendido entre os anos de 2004 a 2008 que continham informações completas sobre o paciente e o tipo de atendimento realizado. Os dados analisados foram: idade, gênero, motivo da visita, exames, tratamentos realizados e tipo de encaminhamento. As crianças foram divididas em dois grupos de acordo com a injúria sofrida: traumáticas e não-traumatícas. Os dados foram tabulados e submetidos a uma análise descritiva. Do total de pacientes atendidos no SUO, nesse intervalo de 60 meses, 1236 (9,05%) eram crianças, sendo que a maoria apresentava idade ente 7 e 12 anos (62,78%). Enquanto as lesões traumáticas foram responsáveis por 18,52% (229) dos atendimentos, as injúrias não-traumáticas foram responsáveis por 81,47% (1007). O tratamento para ambos estava de acordo com o preconizado para esse tipo de serviço. Por meio do presente estudo, pôde-se concluir que a cárie dentária foi a lesão que gerou a maior ocorrência dos atendimentos realizados pelo SUO, o que indica uma maior necessidade de orientação em saúde bucal da população, com ênfase nas ações preventivas.

The attendance's records of children between 0 to 12 years old assisted at Urgency Dental Service (UDS) from Bauru Dental School, University of São Paulo were assessed in the period among the years 2004 and 2008, which only the records that containing all information completed about the patient or type of treatment were analyzed. The analyzed data were age, gender, main complaint, exams, performed treatmente records and follow-up care. They were divided into two groups in relation to the involved injury: traumatic and non-traumatic. Data were plotted and submitted to a descriptive statistical analysis. Among the total of patients attended at UDS at this period of 60 months, 1236 (9.05%) were children the majority was between 7 and 12 years old (62.78%). While traumatic lesions were the cause of 229 (18.52%) of treatments, the non-traumatic injuries were the cause of 1007 (81.47%). The treatment performed in both situations was done according to the indicated protocol for each case. Through this study it was concluded that dental caries was the most frequent lesion of the treatments provided by UDS, which indicates a higher need for oral health orientation of the population with emphasis in preventive measures.

Perfil de tratamento de urgência de crianças de 0 a 12 anos de idade, atendidas no Serviço de Urgência Odontológica da Faculdade de Odontologia de Bauru da Universidade de São Paulo / Urgency treatment profile of 0 to 12 year-old-children assisted at urgency dental service from Bauru Dental School, University of São Paulo

Foram avaliados os prontuários de atendimentos de crianças de 0 a 12 anos de idade, atendidas no Setor de Urgência Odontológica (SUO) da Faculdade de Odontologia de Bauru, da Universidade de São Paulo, no período compreendido entre os anos de 2004 a 2008 que continham informações completas sobre o paciente e o tipo de atendimento realizado. Os dados analisados foram: idade, gênero, motivo da visita, exames, tratamentos realizados e tipo de encaminhamento. As crianças foram divididas em dois grupos de acordo com a injúria sofrida: traumáticas e não-traumatícas. Os dados foram tabulados e submetidos a uma análise descritiva. Do total de pacientes atendidos no SUO, nesse intervalo de 60 meses, 1236 (9,05%) eram crianças, sendo que a maoria apresentava idade ente 7 e 12 anos (62,78%). Enquanto as lesões traumáticas foram responsáveis por 18,52% (229) dos atendimentos, as injúrias não-traumáticas foram responsáveis por 81,47% (1007). O tratamento para ambos estava de acordo com o preconizado para esse tipo de serviço. Por meio do presente estudo, pôde-se concluir que a cárie dentária foi a lesão que gerou a maior ocorrência dos atendimentos realizados pelo SUO, o que indica uma maior necessidade de orientação em saúde bucal da população, com ênfase nas ações preventivas.

The attendance's records of children between 0 to 12 years old assisted at Urgency Dental Service (UDS) from Bauru Dental School, University of São Paulo were assessed in the period among the years 2004 and 2008, which only the records that containing all information completed about the patient or type of treatment were analyzed. The analyzed data were age, gender, main complaint, exams, performed treatmente records and follow-up care. They were divided into two groups in relation to the involved injury: traumatic and non-traumatic. Data were plotted and submitted to a descriptive statistical analysis. Among the total of patients attended at UDS at this period of 60 months, 1236 (9.05%) were children the majority was between 7 and 12 years old (62.78%). While traumatic lesions were the cause of 229 (18.52%) of treatments, the non-traumatic injuries were the cause of 1007 (81.47%). The treatment performed in both situations was done according to the indicated protocol for each case. Through this study it was concluded that dental caries was the most frequent lesion of the treatments provided by UDS, which indicates a higher need for oral health orientation of the population with emphasis in preventive measures.

Estudo clínico e radiográfco do formocresol de Buckley a 1/5 e do cimento Portland utilizados para pulpotomias em dentes decíduos humanos / Clinical and radiographic study on 1/5 dilution of Buckley?s formocresol and Portland cement used for pulpotomies of human primary teeth

O objetivo deste estudo foi comparar a eficácia clínica e radiográfca do formocresol de Buckley diluído a 1/5 e do cimento Portland como agentes capeadores pulpares em dentes decíduos humanos acometidos por cárie extensa, tratados pela técnica convencional de pulpotomia. Sessenta e oito primeiros molares inferiores em 52 crianças com idades entre 5 e 9 anos foram criteriosamente selecionados. De forma randômica, formaram-se dois grupos de 34 molares, cada qual sendo tratado com um dos agentes capeadores a serem comparados. Após a realização das pulpotomias, avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6 e 12 meses do pós-operatório. Nenhum sinal de falha clínica foi observado, para ambos os grupos, em todos os períodos avaliados. Diferença estatisticamente signifcativa entre os grupos foi observada apenas quando avaliada a coloração da coroa dentária e a obliteração do canal radicular, visto que todos os dentes tratados com o cimento Portland apresentaram discreta coloração acinzentada e estenose radicular. O cimento Portland foi tão efetivo quanto o formocresol como capeador pulpar em pulpotomias de dentes decíduos. Embora os resultados sejam encorajadores, estudos futuros e com acompanhamentos a longo prazo são necessários para se determinar a indicação clínica segura do cimento Portland.

This study aimed at comparing the clinical and radiographic effectiveness of 1:5 dilution of Buckley?s formocresol and Portland cement as pulp dressing agents in carious primary teeth treated by conventional pulpotomy. Sixty eight primary mandibular molars in 52 children between 5 and 9 years old were criteriously selected. Clinical and radiographic evaluations were recorded 3, 6 and 12-months postoperatively. No signs of clinical failure were observed at all follow-up appointments in both groups. Statistically signifcant difference between both groups was only observed when assessing tooth crown discoloration and pulp canal obliteration since all of the teeth treated with Portland cement presented dicrete grayish discoloration and root stenosis. Portland cement was equally effective as formocresol as pulp capping agent in pulpotomies of deciduous teeth. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement.

Pulpotomies with portland cement in human primary molars

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended.

Pulpotomies with Portland cement in human primary molars.

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended.

Mineral trioxide aggregate as an alternative treatment for intruded permanent teeth with root resorption and incomplete apex formation.

A case of extensive crown fracture associated with intrusion of the permanent maxillary central incisors in an 8-year-old boy is reported. The treatment of both injured teeth included attempts of apexification and arrest of root resorption with calcium hydroxide. After 8 months of the trauma, there was no calcified barrier formation in the apex. Mineral trioxide aggregate (MTA) was then used as a filling material. At 15-month follow up, the teeth were asymptomatic and correctly sealed, the external inflammatory root resorption had stopped, and the radiolucent image had disappeared, which meant the initial healing of the periapical lesion. MTA may be considered as an alternative option for the treatment of traumatized and immature permanent teeth.

Replantation of an avulsed maxillary primary central incisor and management of dilaceration as a sequel on the permanent successor.

This case report outlines the sequel and possible management of a permanent tooth traumatized through the predecessor, a maxillary right primary central incisor that was avulsed and replanted by a dentist 1 h after the trauma in a 3-year-old girl. Three years later, discoloration and fistula were present, so the primary tooth was extracted. The patient did not come to the scheduled follow-ups to perform a clinical and radiographic control of the succeeding permanent incisor, and only returned when she was 10 years old. At that moment, the impaction and dilaceration of the maxillary right permanent central incisor were observed through radiographic examination. The dilacerated permanent tooth was then surgically removed, and an esthetic fixed appliance was constructed with the crown of the extracted tooth. Positive psychological influence of the treatment on this patient was also observed.

Resin-modified glass ionomer cement and a resin-based material as occlusal sealants: a longitudinal clinical performance.

PURPOSE: The aim of this study was to compare retention, effectiveness in caries prevention and superficial characteristics in 2 different materials used as an occlusal sealant. METHODS: The sample consisted of 108 school children with a mean age of 7.5+/-1.25 years, in which 364 first permanent molars were divided into 6 groups: (1) group 1=Delton + rubber dam (used only for this group); (2) group 2=Delton + cotton rolls; (3) group 3=Prime & Bond 2.1 + Delton; (4) group 4=Vitremer with a 0.25:1 powder/liquid proportion; (5) group 5=Primer + Vitremer with a 0.25:1 powder/liquid proportion; and (6) group 6=Vitremer with a 1:1 powder/liquid proportion. RESULTS: After 12 months, the total retention rate for groups 6, 1, 2, 3, 4, and 5 was, respectively: 92%, 79%, 67%, 52%, 41% and 12%. For the 3 occlusal areas, retention was: 97%, 92%, 86%, 77%, 69%, and 36%. For the modified criterion, the proportion test showed a statistically significant difference (P<.05) between: groups 1 and 4; groups 6 and 2; and group 3, 4, and 5 with all others groups. Considering the total of 3 areas, there was a statistically significant difference (P<.05) between: groups 1 and 6 with groups 3 and 4; group 2 with group 4; and groups 6 and 5 with the others. CONCLUSION: The resin-modified glass ionomer cement may be a promising alternative as an occlusal sealant.

Evaluation of superficial microhardness in dental enamel with different eruptive ages.

This study evaluated the superficial microhardness of enamel in teeth at different posteruptive ages (before eruption in the oral cavity, 2-3 years after eruption, 4-10 years after eruption and more than 10 years after eruption). The study sample was composed of 134 specimens of human enamel. One fragment of each tooth was obtained from the flattest central portion of the crown to produce specimens with 3 x 3 mm. The enamel blocks were minimally flattened out and polished in order to obtain a flat surface parallel to the base, which is fundamental for microhardness testing. Microhardness was measured with a microhardness tester and a Knoop diamond indenter, under a static load of 25 g applied for 5 seconds. Comparison between the superficial microhardness obtained for the different groups was performed by analysis of Student's t test. The results demonstrated that superficial microhardness values have a tendency to increase over the years, with statistically significant difference only between unerupted enamel and that with more than 10 years after eruption. According to the present conditions and methodology, it was concluded that there were differences between the superficial micro-hardness of specimens at different eruptive ages, revealing an increasing mineralization. However, this difference was significant only between unerupted specimens and those with more than 10 years after eruption.

Evaluation of superficial microhardness in dental enamel with different eruptive ages

This study evaluated the superficial microhardness of enamel in teeth at different posteruptive ages (before eruption in the oral cavity, 2-3 years after eruption, 4-10 years after eruption and more than 10 years after eruption). The study sample was composed of 134 specimens of human enamel. One fragment of each tooth was obtained from the flattest central portion of the crown to produce specimens with 3 x 3 mm. The enamel blocks were minimally flattened out and polished in order to obtain a flat surface parallel to the base, which is fundamental for microhardness testing. Microhardness was measured with a microhardness tester and a Knoop diamond indenter, under a static load of 25 g applied for 5 seconds. Comparison between the superficial microhardness obtained for the different groups was performed by analysis of Student's t test. The results demonstrated that superficial microhardness values have a tendency to increase over the years, with statistically significant difference only between unerupted enamel and that with more than 10 years after eruption. According to the present conditions and methodology, it was concluded that there were differences between the superficial micro-hardness of specimens at different eruptive ages, revealing an increasing mineralization. However, this difference was significant only between unerupted specimens and those with more than 10 years after eruption.

Fechamento de diastema intra-ósseo e tracionamento cirúrgico de incisivos centrais / Intraosseous diastema and surgical traction the impact of central incisors

A falha na erupção de dentes permanentes é um problema encontrado freqüentemente, sendo a etiologia multifatorial. Quando o dente impactado é anterior superior, poderá afetar a mastigação, deglutição e fonação. Há inúmeras alternativas de tratamento, desde conservadoras, quando ocorre a abertura do espaço ou remoção da barreira física, até cirurgias que permitem exposição da coroa do dente para a colagem de acessórios permitindo o tracionamento deste. A combinação do conceito da exposição da coroa do dente e a fixação do artifício de tração sugerem a importância do tracionamento em determinadas retenções dentárias. Portanto, o presente trabalho tem como objetivo apresentar caso clínico de incisivos centrais permanentes impactados pela presença de dois dentes supranumerários.

The flaw in the eruption of permanent teeth is a problem found with certain frequency. The aetiology is multifactorial. There are countless treatment alternatives from conservatives, when it happens the opening of the space or removal of the physical barrier to surgeries that allow the exhibition of the crown of the tooth for the collage of accessories allowing the traction of this. The combination of the concept of the exhibition of the crown of the retained tooth and the fixation of the traction artifice suggest the importance of the traction in certain dental retentions. Therefore, the present work has as purpose to present a clinical case impact of incisors permanent central in function of the presence supernumerary of two teeth.

Estudo in vitro da microinfiltração de materiais resinosos em dentes permanentes / Dental leakege in vitro evaluation of dental materials in permanent teeth

O objetivo deste estudo foi avaliar in vitro a microinfiltração de duas resinas compostas Filtek Z100 e Filtek Z250, dois cimentos de ionômero de vidro modificados por resina Vitremer e Fuji II LC, duas resinas compostas modificadas por poliácidos Dyract AP e F-2000 e duas resinas compactáveis Solitaire e Alert. Foram confeccionadas cavidades estritamente proximais em quarenta pré-molares. Após esta fase foram realizados os procedimentos de termociclagem, penetração do corante e seccionamento no sentido longitudinal, visando à análise da microinfiltração. A análise estatística utilizada foi Anova e teste de Tukey com significância de 5% e 1 %. Observou-se, neste estudo, que nenhum dos materiais foi capaz de impedir completamente a microinfiltração.

The purpose of this study was to evaluate, in vitro, dental leakage in restorations strictly proximal, confected with two types of composite resin Filtek Z100 e Filtek Z250, two types of resin modified glass ionomer cement Vitremer e Fuji II LC, two polyacid modified composite resin Dyract e F2000 and two "condensable" composite resins Solitaire e Alert. Forty extracted bicuspeds molar teeth. The specimens were restored with the materiaIs listed above, finished, polished, and prepared for the dental leakage tests. It was proceeded the thermocycling seccioned for analysis of the dental leakage. The results from ANOVA and Tukey's test demonstrated that none of the materials tested was capable to completely eliminate the dental leakage in the gengival wall of these restorations.

Effect of different prophylaxis methods on sound and demineralized enamel

Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet - Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI - 15 sound blocks treated with pumice and brush; GII - 15 sound blocks treated with Profident; GIII - 15 demineralized blocks treated with pumice and brush, and GIV - 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50 percent saturated with bovine enamel powder at 37°C for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91æm - GI; 0.42æm - GII; 1.6æm - GIII, and 0.94æm - GIV. The two-way ANOVA and Tukey's test (p<0.05) revealed significant difference between all groups. Scanning electron microscopy images were employed to illustrate the wear pattern, with observation of larger alteration on the demineralized enamel surface (GIII; GIV), round-shaped wear on GI and GIII and blasted aspect on GII and GIV. The study indicated that the demineralized enamel presented more wear than the sound enamel, and the brush led to larger wear when compared to Profident.

Tendo em vista a importância do controle profissional da placa na prevenção da cárie, este estudo avaliou in vitro o desgaste de dois métodos de profilaxia (jato de bicarbonato de sódio-Profident e escova de Robinson com pasta de pedra pomes) sobre o esmalte bovino hígido e com lesões artificiais de cárie. Foram utilizados 60 fragmentos de esmalte (4 X 4mm), divididos em 4 grupos: GI- 15 blocos hígidos tratados com escova de Robinson e pasta de pedra pomes; GII- 15 blocos hígidos tratados com Profident; GIII- 15 blocos desmineralizados tratados com escova de Robinson e pedra pomes e GIV- 15 blocos desmineralizados tratados com Profident. Nos fragmentos dos grupos III e IV foram simuladas lesões artificiais de cárie através da imersão em solução de ácido acético 0,05M, 50 por cento saturada com pó de esmalte bovino, a 37°C por 16 h. Os espécimes foram submetidos aos tratamentos profiláticos durante 10 segundos. A análise do desgaste foi feita por meio de perfilometria, encontrando-se os seguintes resultados: 0,91æm-GI; 0,42æm-GII; 1,6æm-GIII e 0,94æm-GIV. Através do teste ANOVA a dois critérios e do teste de Tukey (p<0,05) detectou-se diferença significativa entre todos os grupos. Imagens de microscopia eletrônica de varredura foram utilizadas para ilustrar o padrão de desgaste, sendo observada uma maior alteração de superfície no esmalte desmineralizado (GIII; GIV), um desgaste com aspecto circular nos GI e GIII e aspecto jateado nos GII e GIV. O estudo indicou que o esmalte desmineralizado desgastou mais do que o esmalte hígido e a escova de Robinson foi responsável por um maior desgaste quando comparada ao Profident.

Effect of different prophylaxis methods on sound and demineralized enamel%Efeito de diferentes métodos de profilaxia sobre o esmalte hígido e desmineralizado

Tendo em vista a importância do controle profissional da placa na prevenção da cárie, este estudo avaliou in vitro o desgaste de dois métodos de profilaxia (jato de bicarbonato de sódio-Profident e escova de Robinson com pasta de pedra pomes) sobre o esmalte bovino hígido e com lesões artificiais de cárie. Foram utilizados 60 fragmentos de esmalte (4 X 4mm), divididos em 4 grupos: GI- 15 blocos hígidos tratados com escova de Robinson e pasta de pedra pomes; GII- 15 blocos hígidos tratados com Profident; GIII- 15 blocos desmineralizados tratados com escova de Robinson e pedra pomes e GIV- 15 blocos desmineralizados tratados com Profident. Nos fragmentos dos grupos III e IV foram simuladas lesões artificiais de cárie através da imersão em solução de ácido acético 0,05M, 50 por cento saturada com pó de esmalte bovino, a 37ºC por 16 h. Os espécimes foram submetidos aos tratamentos profiláticos durante 10 segundos. A análise do desgaste foi feita por meio de perfilometria, encontrando-se os seguintes resultados: 0,91µm-GI; 0,42µm-GII; 1,6µm-GIII e 0,94µm-GIV. Através do teste ANOVA a dois critérios e do teste de Tukey (p<0,05) detectou-se diferença significativa entre todos os grupos. Imagens de microscopia eletrônica de varredura foram utilizadas para ilustrar o padrão de desgaste, sendo observada uma maior alteração de superfície no esmalte desmineralizado (GIII; GIV), um desgaste com aspecto circular nos GI e GIII e aspecto jateado nos GII e GIV. O estudo indicou que o esmalte desmineralizado desgastou mais do que o esmalte hígido e a escova de Robinson foi responsável por um maior desgaste quando comparada ao Profident

Avaliação comparativa de dois métodos de análise da microinfiltração em dentes decíduos / Comparative assessment of two analysis methods for microleakage in primary teeth

O objetivo deste trabalho foi avaliar in vitro a microinfiltração de duas resinas compostas, dois cimentos de ionômero de vidro modificados por resina, duas resinas compostas modificadas por poliácidos e duas resinas compactáveis por meio de duas técnicas: medida linear em microscópio e análise computadorizada. A amostra experimental constituiu-se de quarenta primeiros molares decíduos divididos aleatoriamente em oito grupos iguais. Foram confeccionadas cavidades estritamente mesiais e distais em todos os dentes. Após o preparo, as cavidades foram restauradas com os materiais citados, sendo então procedido o acabamento e o polimento. Em seguida, foram realizados os procedimentos de termociclagem, penetração do corante e seccionamento. A microinfiltração foi medida pelas duas técnicas na margem cervical. Os resultados foram submetidos à análise pelos teste ANOVA e teste de Tukey. Observou-se, neste estudo, que nenhum dos materiais testados foi capaz de impedir completamente a microinfiltração e que não existiu diferença estatisticamente significante para os métodos de análise empregados: medida linear em microscópio e análise computadorizada.

The purpose of this study was to evaluate the microleakage of two composite resin, two resin modified glass ionomer cement, two polyacid modified composite resin and two condensable composite resins, through two techniques: optical microscopy and computer software. The experimental sample consisted of forty primary molars. The teeth were randomly divided in eight groups. Mesiais and distais cavities were prepared in all teeth. The specimens were restored with the materials listed above and polished. Soon after that, the specimes were thermocycled, immersed in dye and sectioned. The microleakage was measured by two techniques at the cervical margins. The results were submitted to the analysis by ANOVA and Tukey’s test. The results demonstrated that none of the tested materials was capable to impede the microleakage completely and there was no significant difference in relation to the two studied techniques, optical microscopy and computer software.

Effect of different prophylaxis methods on sound and demineralized enamel.

Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet - Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI - 15 sound blocks treated with pumice and brush; GII - 15 sound blocks treated with Profident; GIII - 15 demineralized blocks treated with pumice and brush, and GIV - 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50% saturated with bovine enamel powder at 37 degrees C for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91microm - GI; 0.42microm - GII; 1.6microm - GIII, and 0.94microm - GIV. The two-way ANOVA and Tukey's test (p<0.05) revealed significant difference between all groups. Scanning electron microscopy images were employed to illustrate the wear pattern, with observation of larger alteration on the demineralized enamel surface (GIII; GIV), round-shaped wear on GI and GIII and blasted aspect on GII and GIV. The study indicated that the demineralized enamel presented more wear than the sound enamel, and the brush led to larger wear when compared to Profident.

Prevalência de cárie precoce da infância / Early childhood caries prevalence

Objetivo: revisar a literatura a respeito de cárie precoce dainfância e descrever um estudo sobre sua prevalência eseveridade em crianças com até 36 meses de idade, da cidadede Cascavel Brasil. Método: O estudo transversal foi realizadono ano de 2002 com 351 crianças pertencentes aos Centros deEducação Infantil. O exame para detecção de cárie dentáriaseguiu os critérios estabelecidos pela OMS (1999),acrescendo-se como modificação o registro de superfícies comlesão inicial de cárie ou mancha branca. Resultados: Aprevalência de cárie foi nula para a faixa de 0 a 12 meses,12,3 porcentoa 36 meses. Os índices ceo-d e ceo-s médios das criançasexaminadas foram de 0,70 e 1,16. A experiência de cárie nascrianças examinadas foi expressiva, em face aos altos valoresdos índices ceo-d e ceo-s encontrados nas distintas faixasetárias. Conclusão: A prevalência de cárie dentária encontradaevidencia a necessidade do acesso de crianças a programas deatenção em saúde bucal, preferencialmente, durante o primeiroano de vida