Is catechol-O-methyltransferase gene associated with temporomandibular disorders? A systematic review and meta-analysis.

BACKGROUND: Temporomandibular disorder (TMD) is a condition, in which multiple factors act synergistically to determine the outcome of the disorder. AIM: A systematic review and meta-analysis was conducted to evaluate the association between genetic polymorphisms in catechol-O-methyltransferase (COMT) and TMD. DESIGN: Observational studies that investigated this association were included. The risk of bias and study quality were evaluated according to the Newcastle-Ottawa tool. The meta-analysis was performed for each polymorphism associated with TMD signs and symptoms. RESULTS: A total of 1903 articles were identified. Ten remained in the qualitative analysis: six were classified as low risk of bias and four with moderate risk of bias, and three were included in the meta-analysis. The polymorphism rs6269, in the genotypic model (0.65; CI = 0.44-0.97; P = .04) and in the allelic model (0.73; CI = 0.54-0.98; P = .04), was associated with myofascial pain. The rs9332377 was associated with myofascial pain in the genotypic model (2.69; CI = 1.51-4.76; P = .0007) and in the allelic model (1.46; CI = 1.01-2.13; P = .05) and with painful TMD in the genotypic model (2.08; CI = 1.27-3.40; P = .004) and in the allelic model (1.34 CI = 0.98-1.82; P = .06). CONCLUSION: The polymorphisms in COMT were significantly associated with TMD.

Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study.

BACKGROUND: Temporomandibular Disorders (TMD) is a multifactorial condition, which could be associated to occlusal and psychological factors, such as anxiety. OBJECTIVE: Investigate if anxiety and malocclusion are associated with the prevalence of TMD in adolescents. METHODS: To ensure a population-based representative sample, 934 adolescents aged 10 to 14 years old from Curitiba-PR, Brazil were randomly selected and examined according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and malocclusion by a single-calibrated examiner (Kappa > 0.80). Anxiety was assessed according to trait anxiety (STAI-T), categorised as high, moderate and low levels. For occlusal exam, it was considered: Angel's molar relationship, anterior and posterior crossbite, excessive overjet, open and deep bite. The associations were analysed by the crude and adjusted prevalence ration (RPa ) of TMJ, calculated by a Poisson multivariate regression with robust variance (α = 0.05). RESULTS: The prevalence of at least one type of malocclusion was found in 52.3%. Anxiety was found in high level (12.2%), moderate (70.4%) and low (17.5%). Presence of high anxiety was significantly associated with the prevalence of TMD symptoms (RPa  = 4.06, P < 0.001), as well as the prevalence of myofascial pain (RPa  = 24.78; P < 0.001) and prevalence of disc displacement with reduction (RPa  = 11.08, P < 0.001). Adolescents Class II had higher prevalence of myofascial pain (Class II RPa  = 1.73; P < 0.015) than adolescents Class I. Adolescents Class III presented higher prevalence of myofascial pain (PRa 2.53; P = 0.004) than adolescents Class I. CONCLUSION: Anxiety is strongly associated with TMD in adolescents. Presence of Class II or III is associated with higher prevalence of myofascial pain in adolescentsPLESAE check and approve the edit made in the article title.

Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents.

BACKGROUND: The prevalence of signs and symptoms of temporomandibular disorders (TMD) increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents. AIM: To investigate the prevalence of TMD in Brazilian adolescents. METHODS: A representative population-based sample of 934 adolescents (10-14-years-old) was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD-Axis-I). Examinations were performed by a single calibrated examiner (kappa > 0.80). RESULTS: The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%), followed by joint sounds (18.5%). Myofascial pain was the most prevalent type (10.3%), followed by disc displacement with reduction (8.0%) and arthralgia (3.5%). There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14-1.65; p = 0.001). Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively). CONCLUSION: TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%). TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

Avaliação do índice de biofilme dentário em pacientes sob tratamento ortodôntico corretivo / Biofilm evaluation index in patients under orthodontic treatment

A presença do aparelho ortodôntico fixo dificulta a higienização bucal, tornando comum o aparecimento de problemas periodontais e cárie dentária. O presente estudo avaliou o acúmulo de biofilme dentário em 23 pacientes portadores de aparelhos ortodônticos corretivo utilizando o IHO-S (Índice de Higiene Oral Simplificado) submetidos a dois diferentes tipos de ligaduras do arco (elástica e metálica). Uma hemiarcada recebeu ligadura elástica e a contralateral ligadura metálica, divididas de forma aleatória. O IHO-S foi avaliado em dois períodos, sendo o Tempo 1 (T1) 30 dias após a ativação do arco e o Tempo 2 (T2) 30 dias após o T1. Todos os indivíduos foram orientados quanto à higiene bucal em T1 para posterior análise do IHOS em T2. As ligaduras não apresentaram diferença estatisticamente significativa quando comparadas tanto em T1 quanto em T2 em relação ao acúmulo de biofilme dentário. Já os índices IHOS quando comparados em T1 e T2 apresentaram redução de 67% após a instrução de higiene bucal. A forma de ativação do arco ortodôntico não sugere aumento significativo de biofilme dentário, mas o incentivo e a atenção do profissional na orientação da saúde bucal têm grande importância na prevenção da cárie dentária e gengivite durante o tratamento ortodôntico. (AU)

The presence of fixed orthodontic appliances impedes the maintence of oral hygiene and result in biofilm accumulation. The aim of this study was evaluate the Oral Hygiene Index in twenty-three subjects scheduled for fixed orthodontic treatment. Two commonly used auxiliaries (elastomeric rings and ligature wires) for trying archwires were tested. Brackets in one side were ligated with elastomeric rings, and brackets in a contralateral side were ligated with steel ligatures in a randomizate trial. The OHI were divided in two blocks, Time 1 (T1) that corresponds thirty days after archwire ligation and Time 2 (T2) that corresponds thirty days after T1. All of subjects received a oral health instruction in T1 and another evaluation of OHI in T2. The two archwire ligation techniques showed no significant differences in OHI for T1 or T2. The OHI presents 67% of reduction in T1 and T2 after oral health instruction. The archwire ligation does not represents a significant factor of a pathogenic dental plaque and a oral hygiene instruction can be important to prevent periodontal disease and enamel demineralization. (AU)

Oral health status in victims of child abuse: a case-control study.

BACKGROUND: Few studies have evaluated the oral health status of children with a history of maltreatment. AIM: This case-control study evaluated oral health in children who were victims of abuse and in child protective services in Curitiba, Brazil. DESIGN: One hundred twenty-two children who were victims of abuse and 240 children with no history of abuse (mean ages, 8.56 and 8.24 years, respectively) were included in the study. Dental caries were assessed according to the Decayed, Missing, or Filled Teeth index (dmft index and DMFT index) by two calibrated examiners. The presence of anterior open bite and posterior crossbite was recorded. Data were analyzed using bivariate and adjusted odds ratios using a multivariate logistic regression model analyses. RESULTS: In the case group, we found a higher DMFT index (P < 0.001) and a significantly higher prevalence of missing primary teeth (P = 0.04), untreated decayed permanent teeth (P < 0.001), filled permanent teeth (P < 0.001), and anterior open bite (P = 0.04). Children who were victims of abuse presented an odds ratio of 6.48 (95% CI: 3.52-11.95) for caries in permanent teeth and an odds ratio of 2.28 (95% CI: 1.04-4.99) for open bite. CONCLUSION: Victims of child abuse had a worse oral health status, demonstrating the need to establish special policies for oral healthcare for this population.

Child abuse: perception and knowledge by Public Health Dentistry teams in Brazil

Abstract Aim: To evaluate the experience, knowledge and attitudes of dentists and oral health technicians (OHTs) who work in Basic Health Units in the city of Curitiba, PR, Brazil, regarding cases of abuse against children and adolescents. Methods: In this observational study, three hundred eighty-three questionnaires (validated for Brazilian Portuguese) were sent to dentists and OHTs who work in public health units. The response rate was 38.12% (n = 146) for dentists and 40% (n = 77) for OHTs. Results: The mean age of the dentists was 40±8.29 years, and 53.43% treated more than 10 children per week. The OHTs' mean age was 45.39±9.71 years, and 62.35% attended to more than 10 children per week. Although the dentists perceived 185 suspected cases of maltreatment, only 35.67% were reported to authorities. In the OHT group, 22.08% were reported to authorities. Sixty-eight dentists (47%) and 11 OHTs (14.28%) reported having treated at least one case of orofacial trauma in the previous 6 months, totalizing 166 orofacial traumas. About the mechanism for reporting suspected cases, 83% of the respondents knew how to report. Over 50% of the responses concerning why the professionals did not report cases of physical violence against children included fear of retaliation and difficulties in diagnosis. Conclusions: Suspected cases of maltreatment against children and adolescents are underreported. More information is required to recognize suspected maltreatment cases and notify authorities.

Shear bond strength of brackets bonded with nanofilled flowable resins

Introduction and Objective : To evaluate the shear bond strength of brackets fixed with different materials (two light-cured nanofilled low-viscosity resins - Transbond Supreme LV and Flow Tain LV and two light-cured traditional resins - Transbond XT and Transbond Plus Color Change) after 10 min and 24 h, and to evaluate the type of failure. Material and methods : Eighty bovine incisors were selected and randomly divided into groups (n = 10) according to the material and fixation period. The brackets were bonded following the manufacturer's instructions and stored in deionized water at 37oC for 10 min or 24 h. After, the specimens were submitted to shear bond strength test at 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to Kruskal Wallis and Wilcoxon tests (p < 0.05) and the ARI scores to Chi-Square test. Results: There was a significant difference among the materials (p < 0.05) (after 10 min - Transbond XT > Transbond Plus Color Change > Transbond Supreme LV = Flow Tain LV and after 24 h - Transbond XT > Transbond Plus Color Change = Transbond Supreme LV = Flow Tain LV). There was no significant difference in resistance values between 10 min and 24 h, except for Transbond Plus Color Change. Most groups showed adhesive remaining adhered to the enamel (scores 2 and 3) without statistical significant difference (p > 0.05). Conclusion: The light-cured traditional resins showed higher resistance than the nanofilled materials. The period of fixation had no influence on the resistance for different materials, except for Transbond Plus Color Change.

Mesiodens surgery at deciduous and permanent dentition

Introduction and Objective:To report a rare case of a patient who presented two mesiodens and the treatment performed at two moments. Case report: A 7 year-old male patient reported a supernumerary tooth extracted at age 4. The dental clinical exam revealed giroversion of permanent maxillary right central incisor. Cone-beam computed tomography (CBTC) revealed a presence of a mesiodens located at the buccal surface mesially to the permanent maxillary left central incisor and also indicated that the mesiodens was located close to the f loor of the nasal cavity. The surgery was performed with a conservative intervention and osteotomy by preserving the adjacent structure. The one-year following-up postoperative x-ray indicated new bone deposition and a more favorable eruption position of the right permanent maxillary lateral incisor. Conclusion: It can be concluded that an early diagnosis by CBTC allowed an adequate treatment planning, which avoid the formation of cysts and a prolonged retention of permanent tooth.

Domestic violence against children and adolescents: prevalence of physical injuries in a southern Brazilian metropolis.

Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

Effect of different surface treatments for ceramic bracket base on bond strength of rebonded brackets.

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

Effect of Different Surface Treatments for Ceramic Bracket Base on Bond Strength of Rebonded Brackets

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

O objetivo do estudo foi avaliar o efeito de tratamentos da base de bráquetes cerâmicos monocristalinos na resistência de união ao esmalte após recolagem. Setenta e cinco pré-molares foram selecionados e aleatoriamente distribuídos em 5 grupos (n=15) de acordo com o tratamento da base do bráquete: I - sem tratamento, primeira colagem (controle), II - jateamento com óxido de alumínio, III - jateamento seguido da aplicação de silano, IV - jateamento com partículas de dióxido de sílica (silicatização) seguido de silano, V - silicatização realizada em laboratório (Sistema Rocatec). Os bráquetes foram colados no esmalte com Transbond XT sem condicionamento ácido. Em seguida, os bráquetes foram removidos e suas bases foram submetidas aos diferentes tratamentos. Os bráquetes foram recolados, armazenados por 24 h e submetidos ao ensaio mecânico de cisalhamento com velocidade de 0,5 mm/min. Após, o índice de remanescente adesivo (IRA) foi avaliado em cada espécime. Os dados foram submetidos à análise de variância e teste de Tukey (α=0,05). Pode-se observar que houve diferença significativa apenas entre o sistema Rocatec e os demais grupos, o qual apresentou os menores valores de resistência. Os maiores valores de resistência foram observados para o grupo I (controle), sem diferença significativa dos grupos II, III e IV. A maioria dos grupos apresentou maior porcentagem de falhas na interface esmalte/resina (escore 1). Pode-se concluir que os tratamentos da base do bráquete cerâmico foram efetivos, apresentando valores similares ao grupo controle, exceto para o grupo em que foi usado Rocatec.

Domestic Violence Against Children and Adolescents: Prevalence of Physical Injuries in a Southern Brazilian Metropolis

Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

A violência contra crianças e adolescentes é um grave problema mundial e de saúde pública, que ameaça o bem estar físico e mental, deixando sequelas irreparáveis. A notificação desta violência permite sua prevenção e proteção das crianças e adolescentes. Assim, o objetivo desse estudo foi avaliar a prevalência de lesões na região de cabeça e pescoço contra crianças e adolescentes, bem como caracterizar o tipo das lesões, o agressor e unidades notificadoras. Essa pesquisa retrospectiva foi realizada no Centro de Epidemiologia da Prefeitura Municipal de Curitiba. Um total de 10.483 notificações dos anos de 2010 (5.112) e 2011 (5.371) foi analisado, para compor a amostra das lesões físicas ocorridas no ambiente intrafamiliar, na faixa etária de 0 a 17 anos de idade. Em 2010, a frequência de abuso físico intrafamiliar foi de 322 casos. Destas, 57,1% eram do sexo masculino e 42,9% do sexo feminino, e 58% (187) delas tiveram lesões em cabeça e pescoço. No ano de 2011 foram 342 notificações, sendo que 49% eram do sexo masculino e 51% do sexo feminino e as lesões em cabeça e pescoço corresponderam a 65% (222) dos casos notificados. Houve aumento na prevalência de 6% das lesões físicas e 19% das lesões na região de cabeça e pescoço, do ano de 2010 para 2011. Conclui-se que é alta a prevalência de lesões na região de cabeça e pescoço, áreas facilmente observadas pelo profissional de saúde e da educação. A criação de órgãos notificadores em hospitais e unidades de saúde é fundamental para a vigilância epidemiológica e para definição de políticas adequadas.

Assessment of anxiety in patients who undergo surgical procedures for tooth implants: a prospective study.

PURPOSE: The purpose of this study is to evaluate general anxiety using the State-Trait Anxiety Inventory (STAI) and dental anxiety using the Corah Dental Anxiety Scale (Corah-DAS) in patients who underwent surgical procedures for dental implants. METHODS: The study was performed with 55 patients who underwent implant surgery, of whom 37 were treated at a university and 18 were treated at a private office. General anxiety (STAI) and dental anxiety (Corah-DAS) were assessed at three different time points: appointment prior to clinical procedures (T1), day of procedures (just before the procedures; T2), and first post-procedure appointment (T3). The data were analyzed using analysis of variance followed by the Duncan test or Student's t-test. RESULTS: State anxiety increased on the day of surgery (T2), whereas trait anxiety was higher at T1 (both p < 0.05). Women (n = 41) presented higher state anxiety at T2 than men (n = 14). Patients who were treated at the university (n = 37) exhibited higher state anxiety at both T1 and T3 than patients who were treated in a private practice (n = 18). Individuals with lower dental anxiety at T1 were those who reported having good experiences with dental treatment. CONCLUSIONS: An increase in state anxiety was observed immediately before surgical procedures, and this increase was more pronounced in females. Although the Corah-DAS has been used as an indicator of dental anxiety, the STAI appears to be more sensitive for the measurement of anxiety. The application of appropriate methods is essential for ascertaining anxiety in patients, which should be considered in oral surgeries.

Maus tratos infantis: avaliação do currículo dos cursos em odontologia / Child abuse: curriculum evaluation of dental courses in Brazil

O objetivo desta pesquisa foi avaliar se o tema maus tratos infantis é abordado nos cursos de graduação em Odontologia no Brasil. Trata-se de um estudo exploratório transversal descritivo, desenvolvido com todos os cursos de Odontologia do país. Foram enviados questionários aos 201 coordenadores e 174 foram recebidos, porém somente 28 retornaram respondidos (taxa de resposta de 16,09%). Destes, 19 (67,8%) correspondem a instituições privadas, 06 (21,4%) públicas e 03 (10,7%) de gestão compartilhada. A temática é abordada em 21 cursos (75%), principalmente nas disciplinas de odontopediatria, odontologia legal e saúde coletiva. Quanto à carga horária destinada a este tema, 16 cursos (21,19%) afirmaram ser igual ou menor que 08 horas e 14 coordenadores (66,66%) declararam ser obrigatória a abordagem de tal tema dentro do conteúdo programático do curso. Devido à importância do tema maus tratos infantis e frente aos resultados deste estudo, é pertinente concluir que este assunto tem sido trabalhado de forma incipiente nos cursos de odontologia no Brasil (AU).

The aim of this study was to evaluate whether the theme child abuse is addressed in the undergraduate dentistry in Brazil. This is a cross-sectional exploratory study, in which all universities in the country with the course of dentistry were questioned. Questionnaires were forwarded to all 201 coordinators of education of dentistry in Brazil, which consist in all existing courses at the time of the research. 174 questionnaires were received by the coordinators; however, only 28 were answered (response rate of 16.09%). Of these, 19 (67.8%) were private institutions, 06 (21.4%) public and 03 (10.7%) were joint management. The theme is approached by 21 institutions (75%), mainly in the disciplines of Dentistry, Forensic Dentistry and Public Health. Regarding the amount of hours designated for this theme, 16 institutions (21.19%) mentioned to reserve 08 hours or less during the course, on the other hand, 14 institutions (66.66%) stated that they were required to approach this issue within the course. Due to the importance of the theme child abuse and compared to the results of this study, it seems reasonable to conclude that this matter has been worked very incipient in Dental Courses in Brazil (AU).

Surgery management of rare hypertrophic frenum in an infant.

To report a rare case of a lateral frenum hypertrophy in an infant, this paper describes the case of a girl who came to a first dental appointment when she was 4 months old. A hypertrophic lateral frenum in the upper left canine region was detected. A great depression in the gingival rodet separated the anterior maxillary segment from the posterior one and also decreased the lip mobility in this region. A frenectomy was performed when the patient was 11 months old and the clinical follow-up was done up to the age of 30 months. There was normalization in the vestibular insertion of the lateral frenum, lip mobility, physiological development of the maxilla, and eruption of the upper incisors, canines, and first primary molars. Infants should go to a dental examination precociously in order to detect possible congenital and development alterations.

Noninvasive and multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta: a pediatric case report.

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

Aesthetic management of molar-incisor hypomineralization

Introduction: Molar-incisor hypomineralization (MIH) has been challenging for clinical practice. The term refers to an enamel defect that affects permanent molars and often permanent incisors. This defect may result in high sensibility, coronal destruction of the molars, aesthetic problem when incisors are affected, which can jeopardize the child`s emotional and psychological development. Objective: The aim of this paper is to report two cases in which a conservative approach was adopted using new technologies for direct restorative treatment of incisor with MIH opacities. Case report: Patients aged 11 and 12 years-old attended to the clinics of the School of Dentistry (Sao Paulo State University - Unesp) complaining about the appearance of incisors due to the presence of opacities on the labial surface. The cases were diagnosed as MIH, presenting enamel defects on the permanent molars and incisors. Direct restorations were carried out with minimal removal of the opacities using CVD diamond tip (CVDentus, São José dos Campos, São Paulo, Brazil) coupled to an ultrasonic device (CVDentus, São José dos Campos, São Paulo, Brazil) and direct restorations with composite resin. The result of the restorative treatment was satisfactory in both cases, with children showing immediate satisfaction. Conclusion: The incisors affected by MIH should be treated to improve the child`s self-esteem and avoid negative effects on their psychology development. The aesthetic treatment of the incisors should be conservative, since the replacements of restorations are needed throughout life.

Clinical setting influences physiological responses in dental implant patients

AIM: To evaluate changes in blood pressure and heart rate in patients undergoing dental implant procedures, considering the dental setting as the main variable. METHODS: Fifty-five patients who underwent dental implant surgery were evaluated. Thirty-seven were treated at a university clinic and 18 were treated at a private office. Blood pressure and heart rate were measured at the following time-points: at the appointment prior to surgery (T0), immediately before the surgical procedure (T1), during anesthesia (T2), during implant installation (T3), immediately after the surgical procedure (T4) and at the first follow-up appointment after surgery (T5). The data were analyzed by two-way analysis of variance and Student's t-test. RESULTS : The university clinic patients had an increase in heart rate at T5 (t53=2.62, p<0.05) compared with private office patients. Systolic blood pressure in university clinic patients was higher at T2 (t53=2.86, p<0.01), T3 (t53=2.64, p<0.05), and T4 (t53=3.15, p<0.01). Diastolic blood pressure at T2 (t53=3.15, p<0.01) and T3 (t53=3.86, p<0.01) were also higher in university clinic patients. CONCLUSIONS : These results suggest that the dental setting is a relevant factor when planning dental implant surgery...

In vitro analysis of ph and titratable acidity of yoghurts and milk beverages

Objective:To analyze pH, titratable acidity and carbohydrate and calcium amounts in yoghurts and milk beverages. Materials and Methods:twelve types of yoghurts and eight milk beverages were analyzed. The beverages’ pH was measured and samples were divided into two groups: Group 1: samples with pH<4.0; Group 2 samples with pH>4.0. The acidity of each drink was determined by titration. Calcium and carbohydrate rates were obtained from label information. pH, acidity, calcium and carbohydrates were compared in two groups of beverages (G1: pH<4.0; G2: pH>4.0) and analyzed according to the distribution pattern according to Shapiro-Wilk ́s test, whereas homogeneity of variances was performed by Levene's test at 0.05 significance level. Results:Overall analysis of the variables classified the beverages in 4 groups: A, B, C and D. Samples in group A had the best results: high pH, low acidity, high calcium amounts and few carbohydrates. On the other hand, samples in group D had low pH, high acidity, low calcium amounts and high carbohydrate rates. Conclusion:The three samples under analysis, two yoghurts and one milk beverage, join factors that may lead to the development of dental erosion