Conservative approach for molar-incisor hypomineralization: a case report and 7-year follow-up.

Molar-incisor hypomineralization (MIH) can result in minor injuries or major structural loss, especially in incisors and molars. Patients with MIH seek dental treatment early, usually in childhood. Choosing the best treatment option during this stage can be a challenge. Because these patients still present a mixed dentition, the use of prosthetic appliances is not usually the best option. This case report with a 7-year follow-up presents an overview of a conservative approach for the restoration of teeth affected by MIH. A 10-year-old girl presented with permanent molars and incisors that exhibited qualitative defects of enamel characteristic of MIH. During the restoration phase, direct resin-modified glass ionomer cement (RMGIC) restorations were placed in all 4 first molars with the aid of acetate crowns, which were used to facilitate reconstruction of the tooth morphology. The maxillary incisors were previously treated by another dentist, and the mandibular incisors were treated later, since they were not the main complaint of the patient at the time. During 7 years of follow-up, the RMGIC restorations proved to be a good option, presenting greater longevity in a molar with minor structural defects and requiring repair or replacement in molars with larger structural defects. Despite some failures and the necessity for new restorations, the patient conveyed satisfaction with the treatment and reported no tooth sensitivity, and there was no recurrence of caries. During this follow-up period, the defective mandibular incisors were treated first with enamel microabrasion, which proved esthetically unsatisfactory, and then with direct composite resin veneers. The results in this patient suggest that use of RMGIC may be a feasible conservative option for tooth restoration in young patients with a mixed dentition when permanent molars exhibit extensive structural loss associated with MIH.

Epidemiological survey of oral lesions in children and adolescents in a Brazilian population.

OBJECTIVES: To identify the most frequent oral lesions in children and adolescents in Reference Units of Oral Lesions of Public Universities of Bahia, Brazil, in the period between 1996 and 2010, and estimate the association between socio-demographic factors and type of oral lesions found. METHODS: Cross-sectional study using secondary data obtained from medical records, records of requests and reports of biopsies from patients aged between 0 and 19 years treated in Reference Units of Oral Lesions of Public Universities in Bahia, Brazil, in the period between 1996 and 2010. For data analysis, we used descriptive analysis of the variables, bivariate analysis by calculating the prevalence ratios (PR) to assess the association between oral lesions and gender, age and skin color, and the analysis of potential modifying and confounding effects by logistic regression modeling. To calculate the p-value of associations, we used the chi-square test, and p<0.05 was considered statistically significant. RESULTS: There were 360 records of patients between 0 and 19 years (8.7% of total records). The results revealed 72 different types of lesions. The most prevalent lesions were mucoceles (14.2%), fibroma (5.6%) and pyogenic granuloma (5.3%). The variable "age" was the only socio-demographic characteristics among those analyzed that showed a statistically significant association with both neoplastic and non-neoplastic lesions, according to bivariate analysis, considering the rates adjusted for potential confounders. Neoplastic lesions appeared more often in the age group 0-9 years, while the non-neoplastic lesions were more prevalent in individuals 10-19 years. There was no effect modification noted in the predictive models analyzed. CONCLUSIONS: The study identified the existence of a broad range of oral lesions affecting children and adolescents. Most of the lesions found were of the non-neoplastic type. The age of individuals was associated with the type of oral lesion found.

Mantenedor fixo estético-funcional como tratamento para perda precoce de dentes decíduos anteriores / Aesthetic-functional fixed appliance as treatment of premature of primary anterior teeth

A perda precoce de dentes decíduos pode acarretar dano à oclusão e outras sequelas estético-funcionais indesejáveis. Nesses casos, tão importante quanto a reabilitação do paciente, é a escolha adequada do tipo de aparelho mantenedor de espaço. Este trabalho é um relato de caso clínico no qual uma criança de três anos de idade apresentou perda precoce dos incisivos superiores decíduos onde foi instalado um aparelho mantenedor estético-funcional fixo. Em um período inicial de quatro meses de acompanhamento a mãe relatou boa aceitação quanto à adaptação e higienização do aparelho. Consultas de proservação do caso serão feitas mensalmente até o início da erupção dos incisivos permanentes.

The premature loss of primary teeth can cause damage to occlusion and other undesirable aesthetic-functional sequelaes. ln such cases, as important as the rehabilitation of the patient, is the accurate choice of space maintenance appliance. This work is a case report in which a child of three years old showed premature loss of deciduous incisors and a aesthetic-functional fixed appliance was installed. ln an initial follow-up of 4 months, the mother reported good acceptance on the adjustment and cleaning of the device. The clinical visits of proservation of the case will be scheduled monthly until the eruption of the permanent incisors.

Associação entre severidade de cárie dentária e aspectos sociocomportamentais em escolares de 12 anos no município de Feira de Santana, Bahia / Association between severity of dental carie and social-behavior aspects on 12 years-old students of Feira de Santana city, Bahia / Asociaciones entre severidad de cárie dentaria y aspectossocio-comportamentales en escolares de 12 años del municipio de Feira de Santana, Bahia

Estudos recentes sobre cárie dentária observam que fatores sociais, econômicos e ambientais têm um impacto fundamental na etiologia dessa doença. O objetivo deste estudo foi verificar a existência de associação entre severidade de cárie dentária e aspectos sociocomportamentais numa amostra de 670 escolares de 12 anos de Feira de Santana, Bahia.Trata-se de um estudo epidemiológico de corte transversal, que utilizou dados secundários do banco de dados do Laboratório de Odontologia Preventiva da Universidade Estadual de Feira de Santana. A severidade de cárie dentária foi medida pelo índice Cariados, Perdidos e Obturados Dentes (CPO-D) e os aspectos sociocomportamentais foram referidos em formulários respondidos pelos pais e pelas crianças. Os resultados apontam que o CPO-D médio encontrado foi 2,22. Mais de 30 porcento dos escolares estavam livres de cárie, 73,44porcento apresentaram CPO-D < 3 e 26,54 porcento um CPO D > 3. A análise bivariada encontrou associação entre CPO-D e renda familiar (p igual 0,02). A análise multivariada pelo Modelo de Poisson com Superdispersão não encontrou associação estatisticamente significativa a 5 porcento entre os aspectos estudados e CPO-D. Os resultados evidenciaram a necessidade de novas pesquisas e a formulação de políticas em saúde bucal coletiva para os escolares no município.

Recent studies on dental caries observed that social, economic and environmental factors have a fundamental impact on the etiology of this disease. The aim of this study was to verify the association between severity of dental carie and social-behavior aspects of 670 12 years old students of Feira de Santana, Bahia. This research is a cross-action study where was used data from University of Feira de Santana Laboratory of Preventive Dentistry. After this, was make statistical analysis about carie attack, was measured for the DMFT index and the social-behavior aspects was refer on forms for parents and children. The results show that the mean DMFT of the students was 2.22. It was observed more than 30 percent of the students were free of carie (DMFT equal 0), 73.44v of schoolchildren showed DMTF <3 and 26.54 percent had DMTF > 3. The two way statistical analysis found association between DMTF and layered familiar wealth (p equal 0,02). The many-way statistical analysis when used Overdispersion Poisson Model, didnït find 5 percent significant statistical association between the studied aspects and DMFT. The results evidenced the need of new researches and coletive oral care policies for students in the city.

Estudios recientes sobre la caries dental observó que los factores sociales, econômicos y medioambientales tienen un impacto fundamental sobre la etiología de esta enfermedad. El objetivo de este estudio fue verificar la existencia de asociación entre severidad de cárie dentaria y aspectos socio-comportamentales en una muestra de 670 escolares de 12 años de Feira deSantana, Bahia. Se trata de un estudio epidemiológico de corte transversal, que utilizó datos secundarios del banco de datos del Laboratorio de Odontología Preventiva de la Universidad Estatal de Feira de Santana. La severidad de cárie dentaria fue medida a través de índice Dientes Cariados, Perdidos y Obturados Dientes (CPO-D) y los aspectos socio-comportamentales fueron referidos en formularios respondidos por los padres y por los niños. Los resultados muestran que el CPO-D médio encontrado fue 2,22. Más de 30 por ciento de los escolares estaban libres de cárie, 73,44 por ciento presentaron CPO D /<3 y 26,54 por ciento un CPO-D > 3. El análisis bivariado encontró asociación entre CPO D y renta familiar (p igual 0,02). El análisis multivariado mediante el Modelo de Poisson con Superdispersión no encontró asociación estadísticamente significativa a 5 por ciento entre los aspectos estudiados y el CPO-D. Los resultados evidenciaron la necesidad de nuevos estudios y de la formulación de políticas de salud bucal colectiva para los escolares del municipio analisado.

Instrumentos utilizados na avaliação do impacto da dor na qualidade de vida de pacientes com dor orofacial e disfunção temporomandibular / Instruments used to estimate the pain impact on orofacial pain patients quality of life and temporomandibular disorder

A dor está intimamente relacionada à qualidade de vida do indivíduo. Por ser a dor orofacial e as disfunções têmporo-mandibulares cada vez mais freqüentes na população mundial, este artigo tem como objetivo realizar uma breve revisão da literatura sobre os instrumentos utilizados para mensurar o impacto da dor na qualidade de vida de pacientes com DTM e demonstrar a importância da utilização dessas ferramentas pelos profissionais de Saúde no diagnóstico, tratamento e controle dessa patologia, considerando-se o aspecto doloroso como uma experiência multidimensional.