Treatment of intrabony periodontal defects in controlled diabetic patients with an enamel matrix derivative: a split-mouth randomized clinical trial.

OBJECTIVE: This split-mouth randomized controlled trial aimed to evaluate the effect of enamel matrix derivative (EMD) associated with a simplified papilla preservation flap (SPPF) compared to SPPF alone in the surgical treatment of intrabony defects (ID) in type 2 diabetic mellitus (T2DM) patients. MATERIAL AND METHODS: Thirteen patients with controlled T2DM presenting with ID in at least two quadrants were included. In each patient, the test site (TS) was treated with SPPF plus EMD, whereas the control site (CS) was treated only with SPPF. Prior to surgery and at 6 months after intervention, the following parameters were evaluated: clinical attachment level (CAL), probing pocket depth (PPD), and gingival recession (GR). RESULTS: The TS and CS demonstrated a mean CAL gain of 3.31 ± 0.96 mm and 1.61 ± 1.12 mm, and a PPD reduction from 8.15 ± 0.98 to 3.00 ± 0.57 mm and 7.53 ± 0.96 to 4.69 ± 0.63 mm after 6 months, respectively. In both sites, the mean CAL gain and PPD reduction improved significantly after 6 months compared to baseline; however, the improvement was higher in the TS (p < 0.001). CONCLUSIONS: Both surgical procedures presented with clinical improvements in controlled T2DM patients. However, the additional use of EMD showed enhanced clinical results after 6 months with regard to CAL gain and PPD reduction. CLINICAL RELEVANCE: This study showed a better PPD reduction and CAL gain when an EMD was applied in addition to SPPF. Therefore, EMD may be used to enhance clinical outcomes in periodontal ID of controlled T2DM patients.

Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial.

AIM AND OBJECTIVE: To compare the arresting caries effectiveness of two different silver nanoparticle (AgNP) concentrations of nano-silver fluoride (NSF), namely 400 and 600 ppm. The hypothesis is that in posterior primary teeth with occlusal and approximal active dentin carious lesions, NSF 600's effectiveness will be higher than that of the NSF 400 solution over a 6-month follow-up period. MATERIALS AND METHODS: This was a double-blind randomized clinical trial (RCT) conducted in the city of Recife, Brazil. A total of 337 children aged 5-7 years who attended the University of Pernambuco Dental School's clinics were examined. A single-blinded investigator conducted the examinations and treatment of the children. After baseline examination and recording of the dmft index, children were allocated to one of two study groups (NSF 600-intervention and NSF 400-positive control). In both groups, each tooth received two drops of NSF and treatments were performed only once in 6 months. The follow-up examinations were visual and tactile, performed in 30, 90, and 180 days to determine the activity of caries. The carious lesions that were not arrested in 30 days were recorded and referred for restorative treatment. RESULTS: The NSF 600 showed higher rate of success in arresting caries (72.7%, p = 0.025) compared with NSF 400 (56.5%). CONCLUSION: The higher rate of success of NSF 600 can be explained by the higher concentration of AgNPs. CLINICAL SIGNIFICANCE: Nano-silver fluoride has emerged as an excellent alternative to silver diamine fluoride (SDF), as it adds a high antibacterial effect to better esthetic results. Treatment is simple, non-invasive, and incurs low cost. It is ideal for use in community-based programs to increase the access to dental care without staining teeth black like other silver products. HOW TO CITE THIS ARTICLE: Arnaud M, Junior PCM, Lima MGS, et al. Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(2):207-211.

Association between symptoms of depression and oral health conditions.

AIMS: To investigate the symptoms of depression and oral health status in Brazilian public healthcare system users. MATERIALS AND METHODS: Analysis of a cross-sectional study conducted with a sample of 776 individuals aged 15 years or older, in the urban areas of Recife (Brazil), obtained by multistage sampling. Committee on Ethics in Research with Human Beings (CAAE) 0538.0.172.172-11. Depression symptoms were verified by means of Axis II of the Research Diagnostic Criteria in Temporomandibular Disorder. For the socioeconomic level, the economic classification criteria of the Brazilian Association of Research Companies and clinical exam record charts were used to establish variables related to oral health conditions. RESULTS: The variables discomfort on occlusion (OR = 1.882 CI = 1.384-2.560), gingival bleeding (OR = 1.384 CI = 1.002-1.912), and self-perception of oral health (OR = 1.549 CI = 1.054-2.277), remained in the regression model. CONCLUSION: Discomfort on occlusion, self-perception of oral health, gingival bleeding, sex, and skin color were shown to be associated with the presence of depressive symptoms.

The role of occlusal factors on the occurrence of temporomandibular disorders.

AIMS: The aim of this study was to investigate the relationship between occlusal factors and temporomandibular disorders (TMD). METHODOLOGY: One hundred patients were selected among those who sought medical or dental care in public practice in Recife, Brazil. The presence of malocclusions and absence of five or more posterior teeth were evaluated by the clinical exam. TMD diagnosis was given using Research Diagnostic Criteria (RDC/TMD). Statistics were carried out using Fisher and Mann-Whitney methods with 5% significance level, as well as multiple logistic regression analysis. RESULTS: The sample was mainly comprised of women (83%), individuals over 30 years old (57%) and singles (53%). The percentage of TMD and malocclusion in total sample was 42% and 50%, respectively, while in TMD subjects, malocclusion was present in 38.1%. There was no association between TMD and the occlusal factors studied. CONCLUSION: It can be concluded that malocclusion and loss of five or more posterior teeth does not contribute to TMD.

Longitudinal study of dental caries in Brazilian children aged from 12 to 30 months.

OBJECTIVE: The purpose of the present study was to investigate caries in a sample of young children in Brazil. METHODS: A prospective longitudinal study of dental caries was carried out on a sample of 186 children aged from 12 to 30 months in Feira de Santana, Bahia, where the water supply is optimally fluoridated. The sample was composed of children accompanied by their mother or guardian and was part of a public health child care programme. After 11 months, all the mothers or guardians and children who took part in the initial examination were contacted, of whom 85.7% attended follow-up. Oral examinations for the detection of dental caries, visible plaque (VP) and white spots (WS) were performed at the beginning of the study and after one year. The statistical analysis consisted of frequency distributions, means and standard deviations, bivariate analysis, and calculation of relative risk, adopting confidence intervals of 95%. RESULTS: The prevalence of dental caries at the initial examination was 6.4%, rising approximately threefold by 12 months. When the presence of WS also took the form of dental caries, the prevalence of the disease almost doubled. A statistically significant difference was seen between the decayed, missing and filled primary teeth (dmft) found at the initial examination and that at the end of the study. In addition, there was an increase in the dmft index during the course of the study, both for the children who presented with WS and VP, and for those without these conditions. CONCLUSIONS: A low prevalence of dental caries was observed among the children studied at the initial examination, but around 20% of these children presented with new disease during the period of the study. Amongst children with lesions at the start, the presence of caries almost doubled between examinations.

Geriatric dentistry in Brazilian universities.

OBJECTIVE: The purpose of this study was to investigate the teaching of geriatric dentistry in Brazilian universities. MATERIALS AND METHODS: This study consisted of questionaires regarding the training in geriatric dentistry in 104 dental schools included in the National Institute of Education Research (INEP) in 2001. In order to calculate the sample (a random stratified one), the confidence interval was set at 99% and a maximum permitted error of 3% was adopted. Pearson's chi-square test was used in the inferential analysis. RESULTS: From the 64 dental courses which were studied, only 25 included geriatric dentistry in the curriculum. From 1857 students who were involved in the study, 41% sought knowledge outside the dental school and 98% considered that it was important that this subject should be included in the curriculum. There was statistical significance between geriatric dentistry teaching and the students' preference as well as the prospect of working with this group of the population. Geriatric dentistry as an individual subject was absent from the curriculum in two-thirds of the dental courses investigated. Knowledge was often transmitted as part of dental prosthetics and most of the students stated that they would want to be able to treat elderly people. It was relevant to note that senior students expected to work in this field. CONCLUSION: Dental students in Brazil do not have adequate training in geriatric dentistry.