Adhesive restorations in primary dentition: A retrospective analysis of survival rate and associated factors.

BACKGROUND: Several clinical and individual factors may play a role in the survival rate of dental restorations, such as characteristics related to the child's age and oral hygiene, and factors associated with the tooth, such as the type of material and number of surfaces to be restored. AIM: To analyse the survival rate of adhesive restorations on primary teeth and factors associated with restoration survival. DESIGN: The study included dental records of children aged 3-12 years having received adhesive restorations on primary teeth at a Brazilian dental school between 2009 and 2019. A Kaplan-Meier survival curve was used to plot survival rates using the log-rank test. A multivariate Cox regression model was run to identify individual and dental factors associated with restoration failure. RESULTS: The sample comprised 269 restored teeth in 111 children. Survival curves were similar for all materials (p = .20) and types of isolation (p = .05). The annual failure rate was 3.60% for glass ionomer cement, 1.23% for resin-modified glass ionomer cement and 0.40% for composite resin. The following variables were associated with more failures: Class II restoration compared with Class I (HR = 1.96; 95%CI: 1.28-2.99, p < .001), proportion of decayed teeth (HR = 11.89; 95%CI: 2.80-50.57, p < .001) and child's age (HR = 1.17; 95%CI: 1.06-1.29, p < .001). CONCLUSION: The different materials and types of isolation had similar survival rates. Children with more decayed teeth have an increased risk of restoration failure.

Association of Papacarie Duo® and low-level laser in antimicrobial photodynamic therapy (aPDT).

Dental caries is a multifactorial, non-communicable disease. Effective treatment options for minimally invasive removal of carious tissue include Papacarie Duo® gel and antimicrobial photodynamic therapy (aPDT). aPDT involves a combination of a light source and photosensitizer. Given that Papacarie Duo® contains a percentage of blue dye, this study aims to explore the antimicrobial potential of Papacarie Duo® when associated with a light source against Streptococcus mutans strains. The chosen light source was a low-power diode laser (λ = 660 nm, E = 3 J, P = 100 mW, t = 30 s). To assess antimicrobial capacity, planktonic suspensions of Streptococcus mutans were plated on Brain Heart Infusion Agar (BHI) to observe the formation of inhibition halos. The studied groups included methylene blue (0.005%), Papacarie Duo®, distilled water (negative control), 2% chlorhexidine (positive control), Papacarie Duo® + laser, and methylene blue (0.005%) + laser. Following distribution onto plates, each group was incubated at 37 °C for 48 h under microaerophilic conditions. Inhibition halos were subsequently measured using a digital caliper. The results showed that chlorhexidine had the greatest antimicrobial effect followed by the group of irradiated methylene blue and irradiated Papacarie Duo®. All experimental groups demonstrated antimicrobial potential, excluding the negative control group. The study concludes that Papacarie Duo® exhibits antimicrobial properties when associated with a low-power diode laser.

Translation and cultural adaptation of the Children's Experiences of Dental Anxiety Measure (CEDAM) to Brazilian Portuguese / Tradução, adaptação cultural e análise das propriedades psicométricas da "Children's Experiences of Dental Anxiety Measure" para uso em crianças brasileiras

Objetivo: A escala Children's Experiences of Dental Anxiety Measure (CEDAM) foi originalmente desenvolvida em Inglês para avaliar importantes aspectos da ansiedade odontológica em crianças. Os objetivos do estudo foram traduzir e realizar a adaptação cultural da CEDAM para o Português Brasileiro. Material e Métodos: A CEDAM consiste de 14 itens, medidos por escala Likert de 3 pontos, que indica a intensidade da ansiedade odontológica. O questionário foi traduzido para o Português Brasileiro, retraduzido para o Inglês, revisado por um Comitê de Especialistas e pré-testado em 10 escolares de oito a doze anos. Resultados: O Comitê Revisor de Especialistas comparou as versões original, traduzida (T1, T2) e retraduzida (BT1, BT2) e recomendou algumas mudanças a fim de obter uma boa compreensão dos itens. No pré-teste, somente a questão 8 não foi compreendida por uma criança, isto é, a versão traduzida foi bem compreendida por mais de 85% dos participantes. Conclusão: A versão brasileira da CEDAM foi culturalmente adaptada para a população avaliada de crianças.(AU)

Objective: The Children's Experiences of Dental Anxiety Measure (CEDAM) was originally developed in English to assess important aspects of dental anxiety for children. The aims of the study were to translate and perform the cultural adaptation of the CEDAM to Brazilian Portuguese. Material and Methods: The CEDAM consists of 14 items, measured by a Likert scale of 3 points, that indicates the intensity of dental anxiety. The questionnaire was translated to Brazilian Portuguese, back-translated to English, reviewed by an Expert Committee and pretested in 10 eight- to twelve-year-old schoolchildren. Results: The Expert Committee Review compared the original, translated (T1, T2) and back-translated (BT1, BT2) versions and recommended some changes in order to achieve good understanding of the items. In the pretest, only question 8 was misunderstood by one child, i.e., the translated version was well-understood by more than 85% of the participants. Conclusion: The Brazilian CEDAM was culturally adapted for the evaluated population of children(AU)

Morphological changes and viability of Streptococcus mutans biofilm treated with erythrosine: A confocal laser scanning microscopy analysis.

Antimicrobial photodynamic therapy (a-PDT) is a modality that aims to induce microorganisms through visible light, a photosensitizer, and molecular oxygen. This therapy has shown promising results in controlling cariogenic biofilm in vitro and in vivo counterparts. This study investigated bacterial viability and morphological characterization of Streptococcus mutans mature biofilms after combination of erythrosine and a high potency dental curing light. Biofilms were formed on saliva-coated hydroxyapatite disks in batch culture. The samples were performed in triplicates. Fresh medium was replaced daily for five days and treated using 40 µM of E activated by HL 288 J/cm2 and total dose of 226 J at 1200 mW/cm2. Phosphate buffer saline and 0.12% of chlorhexidine were used as negative and positive control, respectively. After treatment, biofilms were assessed for microbial viability and morphological characterization by means of bio-volume and thickness. COMSTAT software was used for image analysis. Data were analyzed using two-way ANOVA followed by Tukey test with significance level 5%. The application of a-PDT and CHX treatments decreased S. mutans bacterial viability. The image analysis showed more red cells on biofilms when compared to other groups, demonstrating photobacterial killing. Erythrosine irradiated with a high potency curing light can potentially act as an antimicrobial tool in the treatment of cariogenic biofilms. The morphology and viability of microorganisms were impacted after treatment. Treatment with photodynamic therapy may be able to reduce the bio-volume and viability of bacteria present in biofilms. CLINICAL RELEVANCE AND RESEARCH HIGHLIGHTS: The use of the a-PDT technique has been applied in dentistry with satisfactory results. Some applications of this technique are in stomatology and endodontics. In the present study, we sought to understand the use of photodynamic therapy in the control of biofilm and the results found are compatible with the objective of microbiological control proposed by this technique, thus raising the alert for future studies in vivo using the combination of a-PDT with erythrosine, since they are easily accessible materials for the dental surgeon and can be applied in clinical practice.

Developmental Defects of Enamel: A Bibliometric Analysis of the Top 100 Most-Cited Papers.

BACKGROUND: Developmental defects of enamel (DDE) are a result of disturbances during formation and maturation of the enamel. Evaluating the most-cited DDE papers can provide important tools that point to the gaps and strengths of this important topic in dentistry. SUMMARY: This bibliometric study analyzed the 100 most-cited papers on DDE. Using a combined keyword search strategy, the 100 most-cited papers were selected in the Web of Science Core Collection. Papers that addressed any type of DDE were included. The extracted data were title, number of citations, study theme, authorship, journal, type of DDE, type of dentition (primary or permanent), type of diagnosis, study design, year, and country of publication. The bibliometric networks were generated through VOSviewer software. The 100 papers had a range from 78 to 459 citations. The main themes of studies were etiopathogenesis (53%), prevalence and incidence (22%), and diagnosis (8%). The authors with the highest number of citations were Goodman AH and Rose JC (459 citations). Most articles were published in dental journals (47%). The most studied types of DDE were fluorosis and amelogenesis imperfecta in the permanent dentition (47%). Observational (24%) and non-systematic reviews (24%) were the most common study designs and ranged from 1977 to 2019. The country with the highest number of publications was the USA (41%). KEY MESSAGES: Most of the top 100 DDE papers were about fluorosis and amelogenesis imperfecta, with top papers from three continents with English as the native language. This topic is of great importance in dentistry, and the need for further studies is highlighted, especially regarding the diagnosis and treatment of some DDEs.

Roughness assessment of colored compomers: Results after an erosive-abrasive in vitro cycling test.

Background: The present in vitro study aimed to evaluate and compare the surface roughness of a colored compomer and a composite resin, after 15 days of erosive-abrasive cycling. Material and Methods: The sample included ninety circular specimens, randomly divided (n = 10): G1 Berry, G2 Gold, G3 Pink, G4 Lemon, G5 Blue, G6 Silver, G7 Orange and G8 Green, referring to the different colors of compomer (Twinky Star®, VOCO, Germany) and G9 for composite resin (Z250®, 3M ESPE). The specimens were submerged in artificial saliva and stored at 37°C for 24 hours. After polishing and finishing, the specimens were submitted to initial roughness (R1). Then, the specimens were submerged in an acidic cola-based drink for 1 minute and then exposed to electric toothbrushing for 2 minutes for 15 days. After this period, the final roughness (R2) and the ΔRa were performed. Data were submitted to ANOVA and Tukey's test for intergroup comparison and paired T-test for intragroup comparison (p<0.05). Results: Among compomers, the green color presented the higher/lower initial and final roughness values (0.94 ± 0.44, 1.35 ± 0.55) with lemon color presenting the most prominent real roughness increase (ΔRa = 0,74) whereas composite resin showed the lower values (0,17 ± 0.06, 0,31 ± 0.15; ΔRa = 0,14). Conclusions: All compomers, after the erosive-abrasive challenge, presented an increase in roughness values when compared to composite resin with a highlight to green tones. Key words:Compomers, composite resins, surface properties.

Frequency of missing data in clinical records in pediatric dentistry: a descriptive study.

The aim of the present study was to investigate the frequency of missing data on routine dental care appointments and restorative procedures from the clinical records of children treated at a pediatric dental clinic. A descriptive retrospective study was conducted involving the clinical records of children three to 12 years of age treated only with restorations. The inclusion criteria were clinical records from the past 10 years of children with at least one restored tooth. Data collection was performed by a trained examiner who extracted information from the clinical records on appointments for routine dental care and restorative procedures. The frequency of missing data on clinical records was submitted to descriptive analysis. Among the 249 clinical records analyzed, boys accounted for little more than half (54.2%) and mean patient age was 6.9 ± 1.8 years. Ninety-four of the 249 clinical records were of appointments for routine dental care. Missing data were found for the gingival bleeding index (18.1%), visible plaque index (22.3%) and dietary logs (74.5%). Forty-seven children were submitted to a total of 618 restorative procedures. Information was missing on the type of restorative material (5%), brand of the material used (65.2%), the type of isolation (50.8%) and whether pulp capping was performed (75.9%). The percentage of missing data from clinical records was substantial, demonstrating that important information is not recorded during routine dental care or restorative procedures.

Application of lasers in dentistry: a bibliometric study of the top 100 most-cited papers.

This bibliometric study analyzed the 100 most-cited papers about the use of lasers and their modalities in dentistry. A search strategy was created using specific keywords related to the topic. A comprehensive search was then conducted in the Web of Science Core Collection (WoS-CC) database up to July 2021. Papers that addressed the application of any type of laser and its modalities in dentistry were included. Each paper was cross-matched with the number of citations on Scopus and Google Scholar. The following data were extracted from papers: title, number of citations, authorship, country, year of publication, journal, study design, subject, laser type, and oral health outcomes. The VOSviewer software was used to generate bibliometric networks. The total number of citations ranged from 120 to 4,124 and 23 papers received more than 200 citations. Papers were published from 1964 to 2015. Most papers were from Europe (42%) and Anglo-Saxon America (27%). The USA was the country with more top 100 papers (25%). Papers were published mainly in Lasers in Surgery and Medicine (15%) and Lasers in Medical Science (7%). VOSviewer maps demonstrated the existence of national and international research collaborations among institutions and authors. Most studies had a laboratory design (57%) and were about restorative dentistry (32%) and periodontics (21%). This bibliometric study of the top 100 most-cited papers on lasers in dentistry allowed a quantitative and qualitative analysis of this very promising research field, revealing a net of collaboration and the importance of this topic in dentistry.

Percepção e práticas de pais/responsáveis sobre questões atuais da odontopediatria: um estudo piloto / Perceptions and practices of parents and guardians on current issues of pediatric dentistry: a pilot study

Objetivo: Investigar as percepções e atitudes de pais/responsáveis sobre cuidados relacionados à saúde bucal das crianças por meio de um estudo descritivo. Métodos: Foi aplicado um questionário semiestruturado aos pais/responsáveis de crianças atendidas nas clinicas de Odontopediatria da Pontifícia Universidade Católica de Minas Gerais (PUC-MG) em 78 pais/responsáveis. O questionário apresentava questões sociodemográficas, assim como questões específicas relacionadas aos cuidados e atitudes para a saúde bucal de seus filhos/crianças. Análise descritiva e exploratória, por meio de médias, frequências e porcentagens foram realizadas e ilustradas por meio de figuras. Resultados: Embora a maioria dos entrevistados tenha alegado já terem recebido informações a respeito dos cuidados bucais infantis, pais/responsáveis consideraram o momento propício para a primeira visita ao dentista somente após o 1º ano de vida, período inadequado para o aleitamento materno, além da utilização inadequada de chupeta e mamadeira por longos períodos e do período para a inserção do hábito da escovação. Além disso, temáticas relacionadas à erosão dentária, teste da linguinha e a importância do íon fluoreto para a saúde bucal foram os assuntos classificados com mais dúvidas. Conclusão: Em geral, as atitudes dos pais e responsáveis não se mostraram adequadas, apesar de possuírem informações prévias no que tange a saúde bucal das crianças. Com isso, verifica-se a necessidade de enfatizar mais a fundo questões referentes a esta temática e diferentes meios para a difusão deste tipo de informação.

Aim: To investigate the perceptions and attitudes of parents/guardians about oral health care for children through a descriptive/cross-sectional study. Methods: A semi-structured questionnaire was applied to 78 parents/guardians of children seen at the Pediatric Dentistry Clinics of the Pontific Catholic University of Minas Gerais (PUC-MG). The questionnaire presented sociodemographic questions, as well as specific questions related to the care and attitudes towards the oral health of their children. Exploratory and descriptive analyses by means of means, frequencies,and percentages were performed and illustrated in figures. Results: Although most of the interviewees claimed to have already received information regarding children's oral care, they considered the proper time for the first visit to the dentist only after the 1st year of life, an inadequate period for breastfeeding, as well as the inappropriate use of pacifiers and bottles for long periods and an improper period for the insertion of the habit of tooth brushing. Furthermore, issues related to dental erosion, the tongue test, and the importance of fluoride ions for oral health were the subjects classified with the most doubts. Conclusion: In general, the attitudes of parents and guardians proved to be inappropriate, although they have previous information regarding the oral health of children. Thus, there is a need to offer a more in-depth emphasis on issues related to this theme and different means through which to disseminate this type of information.

O método de fotopolimerização é capaz de influenciar nos valores de microdureza das resinas compostas? Um estudo in vitro / Is the photopolimerization method able to influence on the microhardness values of composite resins? An in vitro study

Introdução: a inovação dos métodos de fotopolimerização foi proposta na tentativa de diminuir o estresse de contração de polimerização das resinas compostas e proporcionar maior conforto ao paciente, reduzindo o tempo de atendimento odontológico. Objetivo: avaliar a microdureza de duas resinas compostas nanoparticuladas submetidas a diferentes técnicas de polimerização. Material e método: quarenta espécimes foram divididos em quatro grupos (n=10) da seguinte forma: Filtek Z350 XT® + técnica imediata (GI); Filtek One Bulkfill® + técnica imediata (GII); Filtek Z350 XT® + técnica de pulso tardio (GIII); Filtek One Bulkfill® + técnica de pulso tardio (GIV). Após o armazenamento em água destilada à temperatura ambiente, os corpos de prova foram direcionados para a medição de microdureza. Utilizou-se teste T para comparação de técnicas e teste Two-Way ANOVA para calcular os efeitos das resinas compostas, técnicas de polimerização e interações referentes à variável dependente (p ≤0,05). Resultado: a resina Filtek Z350 XT® apresentou maior dureza na técnica imediata (GI - 312,45 ± 64,37) e pulso tardio (GIII - 244,50 ± 75,63) comparado à resina Filtek One Bulkfill®, em ambas as técnicas. Observaram-se maiores valores de dureza referentes à técnica imediata, com diferença estatística significativa em relação à resina testada (p = 0,04 - Filtek Z350 XT®; p = 0,03 - Filtek One Bulkfill®). Ambos os fatores isolados (resina e técnicas) apresentaram efeito nos valores de microdureza (p = 0,02 e p < 0,01, respectivamente). Conclusão: a técnica convencional demonstrou atingir maiores valores de dureza quando comparada à técnica de polimerização alternativa.

Introduction: the innovation of photopolymerization methods was proposed in an attempt to reduce the polymerization shrinkage stress of composite resins and also provide more comfort to patient reducing the chair time. The aim of this in vitro study was to assess the microhardness of two nanofilled composite resins subject to different curing techniques. Objective: assess the microhardness of two nanofilled composite resins subject to different curing techniques. Material and method: forty specimens were divided into four groups (N=10) as follows: Filtek Z350 XT® + immediate technique (GI); Filtek One Bulkfill® + immediate technique (GII); Filtek Z350 XT® + delayed pulse technique (GIII); Filtek One Bulkfill® + delayed pulse technique (GIV). After storage in distilled water at room temperature the specimens were assessed for microhardness measurement. T-test was used for comparison of techniques and two-way ANOVA used to calculate the effects of composite resins, curing techniques and their interactions on dependent variable (p set at 0.05). Result: Filtek Z350 XT® resin presented greater hardness on immediate technique (GI - 312,45 ± 64.37) and delayed pulse (GIII - 244,50 ± 75.63) compared to Filtek One Bulkfill® under both techniques. Overall, it was observed greater hardness values under immediate technique with a significant statistical difference apart of tested resin (p = 0.04 - Filtek Z350 XT®; p = 0.03 - Filtek One Bulkfill®). Both isolated factors (resin and techniques) presented effect on microhardness values (p = 0.02 and p < 0.01, respectively). Conclusion: the conventional technique demonstrated to reach higher hardness values when compared to the alternative polymerization technique

Application of lasers in dentistry: a bibliometric study of the top 100 most-cited papers

Abstract This bibliometric study analyzed the 100 most-cited papers about the use of lasers and their modalities in dentistry. A search strategy was created using specific keywords related to the topic. A comprehensive search was then conducted in the Web of Science Core Collection (WoS-CC) database up to July 2021. Papers that addressed the application of any type of laser and its modalities in dentistry were included. Each paper was cross-matched with the number of citations on Scopus and Google Scholar. The following data were extracted from papers: title, number of citations, authorship, country, year of publication, journal, study design, subject, laser type, and oral health outcomes. The VOSviewer software was used to generate bibliometric networks. The total number of citations ranged from 120 to 4,124 and 23 papers received more than 200 citations. Papers were published from 1964 to 2015. Most papers were from Europe (42%) and Anglo-Saxon America (27%). The USA was the country with more top 100 papers (25%). Papers were published mainly in Lasers in Surgery and Medicine (15%) and Lasers in Medical Science (7%). VOSviewer maps demonstrated the existence of national and international research collaborations among institutions and authors. Most studies had a laboratory design (57%) and were about restorative dentistry (32%) and periodontics (21%). This bibliometric study of the top 100 most-cited papers on lasers in dentistry allowed a quantitative and qualitative analysis of this very promising research field, revealing a net of collaboration and the importance of this topic in dentistry.

Photobiomodulation therapy for hypersensitivity associated with molar-incisor hypomineralization: a case report.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the dental enamel on permanent first molars and may be associated with permanent incisors. There is currently no defined therapeutic protocol for managing the hypersensitivity associated with this condition. The present case report describes the treatment of a patient with MIH and the impact on the patient's quality of life as assessed using the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14). The maxillary central incisors, maxillary and mandibular first molars, and mandibular right canine of an 11-year-old girl were compromised by MIH. The long version of the CPQ11-14 was self-administered before treatment. Initially, the patient reported hypersensitivity of her maxillary right central incisor, maxillary and mandibular left first molars, and mandibular right canine when consuming cold food and beverages. This was confirmed by applying a jet of air to the teeth and asking the patient to report the level of sensitivity using the Wong-Baker FACES Pain Rating Scale. The patient reported that hypersensitivity was present every day or almost every day. Desensitizing treatment included 4 applications of photobiomodulation therapy (infrared diode laser) and 4 applications of fluoride varnish. After desensitization, the maxillary central incisors received direct composite resin restorations, while the maxillary left first molar, which had an amalgam restoration and recurrent caries, received a resin-modified glass ionomer cement restoration. At the conclusion of the treatment, the patient completed the CPQ11-14 again and reported less difficulty with consuming hot and cold foods and beverages, indicating that treatment had reduced hypersensitivity and its negative impact on her quality of life.

Modified Arnold expander: an alternative for mandibular arch expansion.

INTRODUCTION: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. OBJECTIVES: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). CONCLUSION: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

Modified Arnold expander: an alternative for mandibular arch expansion

ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

Chemo-mechanical and photodynamic approach in A deep dental cavity: A case report.

AIM: To test a chemical-mechanical method and antimicrobial photodynamic therapy (a-PDT) in combination to manage a deep dental carious lesion in a permanent molar pediatric patient. BACKGROUND: Due to specific characteristics of early-erupted teeth, as first permanent lower molars, techniques that provide less invasive tissue removal aiming keep healthy tooth parts, such as pulp tissue, are desired. Furthermore, especially to children, provide comfort, less noise and vibration are important issues that should be considered on the management of deep caries. CASE DESCRIPTION: The following case report presents an association of Papacarie Duo® (PD) and a-PDT used in a 9-year-old patient with a deep dental caries in the mandibular right first molar. After PD application, the carious tissue was carefully removed with the cavity stained for 1 min with rose bengal solution, irradiated with a high intensity LED constituting the a-PDT technique, and definitively restored with composite resin. At 6 months of follow-up, no signs of caries were verified, showing success to applied techniques. A microbiological evaluation attested the antimicrobial effects of the alternative procedures. CONCLUSION: Although it reached optimal clinical and bacterial reduction outcomes, the approach demonstrated an excessive length of time taken for the management of carious lesion. CLINICAL SIGNIFICANCE: The use of new technologies should be encouraged, especially when treating deep caries aiming for a less invasive approach.

Does pre-irradiation time influence the efficacy of antimicrobial photodynamic therapy?

Antimicrobial photodynamic therapy (aPDT) has emerged as a promising antimicrobial treatment to control microorganisms including those involved in oral diseases, especially dental caries. Hence, the aim of this study was to evaluate the influence of aPDT - pre-irradiation time (PIT), at different periods, on antimicrobial rate of Streptococcus mutans (S. mutans). A standard suspension of S. mutans UA159 was prepared and submitted at sensitization of 0.005 % methylene blue (MB) for 0, 1, 3 and 5 min (G1 - G4 groups, respectively) and irradiated with a red laser (660 nm; 321 J/cm2; 9 J; 90 s) afterward. A control group using PBS instead of MB was performed as well (G5). The number of colony-forming units (CFU)/mL was recorded, transformed into log10 and analyzed by ANOVA and Tukey's test at a cutoff value at 0.05. Overall, the aPDT groups tested achieved a bacterial reduction > 1-log10 when compared to G5 (p < 0.05) with no statistical difference among the different PIT tested. The need of PIT before aPDT application deserves attention, since its time reduction implies on shorter clinical approaches without compromising the photodynamic antibacterial efficacy in the in vitro parameters employed.

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report.

Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders.

Antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization-controlled clinical trial.

BACKGROUND: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH. METHODS: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied. DISCUSSION: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention. TRIAL REGISTRATION: NCT03904641.

Anti-biofilm Action of Chenopodium ambrosioides Extract, Cytotoxic Potential and Effects on Acrylic Denture Surface.

Considering the challenge to control Candida-associated denture stomatitis, the search for antifungal substances derived from natural sources has become a trend in the literature. In this study the following effects of Chenopodium ambrosioides extract (CAE) were investigated: action against biofilms of Candida albicans, its cytotoxic potential, and changes caused in acrylic resin. The CAE was characterized by High Performance Liquid Chromatography (HPLC). The susceptibility of C. albicans to CAE was investigated by Minimum Inhibitory Concentration and Minimum Fungicidal Concentration (MIC and MFC) tests. Acrylic resin disks were fabricated, and C. albicans biofilms were developed on these for 48 h. Afterward the disks were immersed for 10 min in: PBS (Negative Control); 1% Sodium Hypochlorite (1% SH, Positive Control) or CAE at MIC or 5xMIC. The biofilms were investigated relative to counts and metabolic activity. The cytotoxic potential in keratinocytes and fibroblasts was verified by MTT test. Change in color and roughness of the acrylic resin was analyzed after 28 days of immersion in CAE. The data were analyzed by the ANOVA considering a 5% level of significance. The main compounds detected by HPLC were kaempferol and quercetin. Both MIC and MFC obtained the value of 0.25 mg/mL. The MIC was sufficient to significantly reduce the counts and activity of the biofilm cells (p < 0.0001), while 5xMIC resulted in almost complete eradication, similar to 1% SH. Keratinocytes and fibroblasts exposed to the MIC and 5xMIC presented cell viability similar to that of the Control Group (p > 0.05). No important changes in acrylic resin color and roughness were detected, even after 28 days. It could be concluded that the immersion of acrylic resin in C. ambrosioides extract in its minimum inhibitory concentration was effective for the reduction of C. albicans biofilms without any evidence of cytotoxic effects or changes in roughness and color of this substrate.