Performance of resin composite restorations placed in high caries risk children: a clinical retrospective study / Performance of resin composite restorations placed in high caries risk children: a clinical retrospective study / Rendimiento de las restauraciones de resina compuesta colocadas en niños con alto riesgo de caries: un estudio clínico retrospectivo

Background: Resin composite has been usually used for restoring primary teeth. Nevertheless, there is a lack of supporting clinical data regarding the survival of resin composite restorations and risk factors that may dictate the service time of the treatment in children. Aim: To evaluate the survival and factors associated with composite resin restoration failure in high caries risk children treated under risk-factor management clinical protocol for dental caries prior to restorative therapy. Design: A total of 230 restorations in primary teeth from records of 48 patients were included in the study. Restoration longevity, up to 3-year follow-up, was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (p<0.05). Results: Mean survival time was 2.7 -year (95 percent CI: 0.75-0.87). Restoration survival reached 82.5 percent up to 3-year evaluation, with an overall annual failure rate of 6.2 percent. The unadjusted model showed restorations performed in children with dmf-t greater than 10 had more restoration failure risk (HR 5.59, 95 percent CI 1.03-30.34; p=0.04) However, this association lost significance in the adjusted analysis (p=0.08). Conclusions: Composite resin restorations in primary teeth presented satisfactory survival after 3-year follow-up (AU)

Antecedentes: El composite de resina se ha utilizado habitualmente para restaurar dientes primarios. Sin embargo, se carece de datos clínicos de apoyo sobre la supervivencia de las restauraciones de resina compuesta y los factores de riesgo que pueden dictar el tiempo de servicio del tratamiento en los niños. Objetivo: Evaluar la supervivencia y los factores asociados al fracaso de las restauraciones de resina compuesta en niños con alto riesgo de caries tratados con un protocolo clínico de gestión de factores de riesgo de caries dental antes del tratamiento restaurador. Diseño: Se incluyeron en el estudio un total de 230 restauraciones en dientes primarios de registros de 48 pacientes. La longevidad de las restauraciones, hasta los 3 años de seguimiento, se evaluó mediante la prueba de supervivencia de Kaplan-Meier. Se utilizó un análisis multivariante de regresión de Cox con fragilidad compartida para evaluar los factores asociados a los fracasos (p<0,05). Resultados: El tiempo medio de supervivencia fue de 2,7 -años (IC95 por ciento: 0,75-0,87). La supervivencia de la restauración alcanzó el 82,5 por ciento hasta la evaluación a los 3 años, con una tasa global anual de fracasos del 6,2 por ciento. El modelo no ajustado mostró que las restauraciones realizadas en niños con dmf-t superior a 10 tenían más riesgo de fracaso de la restauración (HR 5,59; IC 95 por ciento: 1,03-30,34; p=0,04). Sin embargo, esta asociación perdió significación en el análisis ajustado (p=0,08). Conclusiones: Las restauraciones de resina compuesta en dientes primarios presentaron una supervivencia satisfactoria tras un seguimiento de 3 años (AU)

Caries and fluorosis in the Santiago metropolitan region in Chile: The impact of the fluoridation of the water / Cárie e fluorose na região metropolitana de Santiago, Chile: impacto da fluoretação da água

PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolescents in the metropolitan area after 8 years of drinking water fluoridation and to compare them with the baseline study. METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis. RESULTS: No cavity damage was found in 23.68 percent of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These differences were statistically significant. There were also significant differences in the DMFT index for each socioeconomic status group. The average number of dams was higher among children of low socioeconomic status. Of the studied children, 14.3 percent of children had dental fluorosis. Fluorosis was very mild in 12.35 percent of the cases, mild in 1.98 percent and moderate in 0.26 percent. There were no cases of severe fluorosis (classified according to Dean's index). CONCLUSION: We conclude that after 8 years drinking water fluoridation in the metropolitan area, the number of children with no history of caries has increased by approximately 100 percent. The number of cases significantly affected by caries has also decreased significantly. The incidence of dental fluorosis has increased, but to milder degrees.

OBJETIVO: Avaliar o dano e a prevalência de cárie e fluorose em crianças e adolescentes na região metropolitana do Chile, após oito anos de fluoretação da água potável, em comparação com o estudo de base em 1996. METODOLOGIA: Desenho: estudo de prevalência. A amostra probabilística, estratificada por nível socioeconômico, constituiu-se de 2.323 escolares de 6-8 e 12 anos na Região Metropolitana. Todos os alunos foram clinicamente examinados por dentistas calibrados, utilizando critérios de seleção e indicadores propostos pela OMS para determinar cárie e fluorose dentária. RESULTADOS: Cerca de 24 por cento das crianças estavam livres de cáries. A média de CPOD foi de 3,18 em escolares de 6 a 8 anos. O CPOD foi de 0,59 em crianças de 6 a 8 anos e de 2,6 em crianças de 12 anos em relação ao estudo de base, sendo essas diferenças estatisticamente significativas. Houve diferenças significativas devido ao nível socioeconômico, sendo que os valores médios foram maiores em crianças de baixo nível socioeconômico. Cerca de 14 por cento das crianças apresentaram fluorose dentária, em geral de grau muito leve. CONCLUSÃO: Após 8 anos de fluoretação da água potável na região metropolitana, observou-se um aumento de 100 por cento de crianças sem história de cárie e significativa diminuição de danos. A fluorose dentária aumentou, mas em graus mais leves.

Periodontal status and treatment needs of children from 6 to 8 years old in the Santiago Metropolitan Region of Chile / Condição periodontal e necessidades de tratamento em crianças de 6 a 8 anos na região metropolitana de Santiago, Chile

PURPOSE: To evaluate the periodontal status and the treatment needs of Chilean school-children METHODS: Prevalence study. Sample: 1,637 schoolchildren from 6 to 8 years old belonging to 26 communes of the Santiago Metropolitan Region of Chile, stratified according to socioeconomic level in accordance with the 2003 CASEN survey (National Socioeconomic Characterization Survey). Periodontal status was estimated using the Community Periodontal Index of Treatment Needs (CPITN) and following the recommendations of the WHO (World Health Organization), along with the records of the Clinical Criteria of Gingival Inflammation. Data were analyzed using a chi-square test. RESULTS: Gingivitis prevalence was 68.42 percent, a result that is higher than the national prevalence (P<0.01; 95 percent CI=0.66-0.70). The prevalence increased with age (P<0.01) but was similar in both sexes (P=0.838). Prevalence was relatively constant among three socioeconomic levels (P=0.417). According to the CPITN, gingivitis prevalence was 29.57 percent: 27.49 percent consisting of children with gingival hemorrhage and 2.08 percent consisting of children with gingival calculus. The treatment needs of this population are that 27.49 percent of children require oral-hygiene instruction, and 2.08 percent need oral-hygiene instruction and subgingival and supragingival scaling. CONCLUSION: The gingivitis prevalence found in this study was higher than the national proportion in Chile.

OBJETIVO: Avaliar a condição periodontal e as necessidades de tratamento de crianças escolares chilenas. METODOLOGIA: Estudo de prevalência. Amostra: 1637 crianças escolares de 6 a 8 anos de idade pertencentes a 26 comunidades da região metropolitana de Santiago, Chile, que foram estratificadas de acordo com o nível socioeconômico conforme o levantamento 2003 CASEN (National Socioeconomic Characterization Survey). A condição periodontal foi estimada usando o índice Community Periodontal Index of Treatment Needs (CPITN) e seguindo as recomendações da Organização Mundial de Saúde (OMS), juntamente com os registros de critérios clínicos de inflamação gengival. Os dados foram analisados por testes qui-quadrado. RESULTADOS: A prevalência de gengivite foi de 68,42 por cento, resultado que é maior que a prevalência nacional do Chile (P<0,01; 95 por cento CI=0,66-0,70). A prevalência aumentou com a idade (P<0,01), mas foi similar em ambos os sexos (P=0,838). A prevalência foi relativamente constante entre os três níveis socioeconômicos (P=0,417). Para CPITN, a prevalência de gengivite foi de 29,57 por cento: 27,49 por cento com sangramento gengival e 2,08 por cento s com cálculo gengival. As necessidades de tratamento desta população foram de 27,49 por cento de crianças que necessitavam de instrução de higiene bucal e 2,08 por cento que necessitavam de instrução de higiene bucal e raspagem supra e subgengival. CONCLUSÃO: A prevalência de gengivite neste estudo foi maior que a proporção nacional no Chile.