Association between Pacifier Use, Bottle-Feeding, and Pre-Postnatal Variables: A Cohort Study

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby's gender, BF in the first hour of the newborn's life, baby's weight, mother's return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one's own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother's return to work (OR=2.48; 95%CI: 1.54-3.97), baby's lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother's prenatal intention to offer them to their babies and socioeconomic factors.

Glass Ionomer Cement Modified by Resin with Incorporation of Nanohydroxyapatite: In Vitro Evaluation of Physical-Biological Properties.

Resin-modified glass ionomer cement (RMGIC) has important properties. However, like other restorative materials, it has limitations such as decreased biocompatibility. The incorporation of nanoparticles (NP) in the RMGIC resulted in improvements in some of its properties. The aim of this study was to evaluate the physical-biological properties of RMGIC with the addition of nanohydroxyapatite (HANP). MATERIAL AND METHODS: Vitremer RMGIC was used, incorporating HANP by amalgamator, vortex and manual techniques, totaling ten experimental groups. The distribution and dispersion of the HANP were evaluated qualitatively by field emission scanning electron microscope (SEM-FEG). The evaluation of image porosity (SEM-FEG) with the help of imageJ. Cell viability 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazoline bromide (MTT) and cell morphology analyses were performed on MDPC-23 odontoblastoid cells at 24 and 72 h. RESULTS: It was possible to observe good dispersion and distribution of HANP in the samples in all experimental groups. The incorporation of 5% HANP into the vortex stirred RMGIC resulted in fewer pores. The increase in the concentration of HANP was directly proportional to the decrease in cytotoxicity. CONCLUSIONS: It is concluded that the use of a vortex with the incorporation of 5% HANP is the most appropriate mixing technique when considering the smallest number of pores inside the material. A higher concentration of HANP resulted in better cell viability, suggesting that this association is promising for future studies of new restorative materials.

Esthetic rehabilitation of anterior teeth with molar-incisor hypomineralization and dental fluorosis: a case report.

This case report describes the treatment of a patient who had molar-incisor hypomineralization associated with dental fluorosis, a diagnosis established through a comprehensive review of the clinical record, an intraoral clinical examination, and assessment of photographic records. First, dental hypersensitivity was treated with fluoride varnish, which was applied separately to each dental quadrant. Subsequently, the functional and esthetic reconstruction of the permanent maxillary central incisors was completed in a single session through the placement of direct composite resin veneers. After the treatment, the patient was reexamined monthly for 12 months to evaluate the durability of the restorations. At the 12-month follow-up, no fractures or pigmentations were observed, and only a slight loss of brightness of the restorations was noted. The dental hypersensitivity had been eliminated. When an adhesive restorative technique with composite resin is well executed, it is possible to obtain satisfactory and long-lasting esthetics and relief of painful symptoms.

Esthetic reconstruction of teeth with enamel hypoplasia.

Hypoplasia is an enamel developmental defect characterized by a quantitative disturbance in the formation of mineralized tissue. Among its etiologic factors are local and systemic causes, trauma and dental infections being the most common. This case report presents the functional and esthetic rehabilitation of a 12-year-old boy diagnosed with hypoplasia in the maxillary central incisors. His chief complaints were the unesthetic appearance and sensitivity of the affected teeth. The teeth were restored with composite resin placed with the aid of a direct silicone palatal guide, and the patient was followed up for 12 months. The treatment plan allowed the restoration and improvement of function and esthetics, resulting in patient satisfaction.

Effect of Rubber Dam Clamps on Demineralized Cervical Enamel of Permanent Teeth.

PURPOSE: To evaluate the effect of two molar clamps on artificially demineralized enamel of permanent teeth after three periods of isolation. METHODS: Twenty extracted third molars were immersed in a biological solution for development of artificial white spot lesions and then were equally divided into two groups according to the clamp being placed (Group G205: clamp no. 205; Group G26: clamp no. 26). The loss of fluorescence and lesion area of demineralized surface after each isolation were assessed by quantitative light-induced fluorescence. RESULTS: There were significant statistical differences in artificially induced white spot lesions after the second and third clamp placement with both clamps. There was also a significant difference in quantitative light-induced fluorescence readings between groups when molar clamps were placed for the third time. CONCLUSION: It is possible to lose dental structure when using rubber dam clamps on teeth with white spot lesions in the cervical enamel.

Reduced salivary flow rate and high levels of oxidative stress in whole saliva of children with Down syndrome.

AIM: To investigate salivary parameters between children with Down Syndrome (DS) and without DS. MATERIALS AND METHODS: Stimulated whole saliva was collected from 18 children with DS and 23 without DS. Salivary flow rate, pH, and salivary buffering capacity were determined. Cariogenic microorganisms were quantified by culture, and periodontopathogens by quantitative real-time polymerase chain reaction. The antioxidant profile was quantified spectrophotometrically, while malondialdehyde (MDA) was quantified by high-performance liquid chromatography. Data were analyzed by Mann-Whitney test and Spearman correlation (α = 0.05). RESULTS: Salivary flow rate was significantly lower in DS than in controls (p < 0.0001). Significant higher difference was observed for total protein dosage (p < 0.0001), superoxide dismutase activity (SOD) (p = 0.0002), and MDA (p < 0.001) in DS group. CONCLUSIONS: Reduced salivary flow rate might be an important factor in oral diseases development. High salivary levels of SOD and MDA show the significant influence of the oxidative stress and the early-onset periodontal disease in DS people.

Long-term influence of associating an antibacterial agent with GIC on bond strength to caries-affected dentin

Aim: To evaluate the bond strength of a GIC associated with chlorhexidine (CHX) to sound and caries-affected dentin, immediately and after six months of storage. Methods: Sixty molars were assigned to two groups of 30 teeth. One had flat dentin surfaces produced and submitted to caries induction to obtain a caries-affected dentin. In the other group dentin was maintained sound. Teeth of each group were randomly reassigned to three subgroups (n=10) according to the concentration of CHX added to the GIC (0%, 1% and 2% by weight). Two specimens (1mm diameter x 1 mm high) of the same material were constructed on each dentin surface. One was submitted to the microshear bond strength (µSBS) test after 24 hours and the other after 6 months of storage in water at 37oC. Failure modes were analyzed under a stereomicroscope. Bond strength data were analyzed by three-way ANOVA followed by Games-Howell tests for multiple comparisons, and failure modes by the Chi-square test (α = 0.05). Results: The µSBS values obtained to sound dentin were higher compared with those to caries-affected dentin (p≤0.001). In sound dentin, the group with 2% CHX showed lower µSBS values compared with 0% and 1% CHX after 24 hours (p=0.005 and p=0.032 respectively). In caries-affected dentin, after 24 hours, µSBS in group with 1% CHX was statistically higher than the values in groups with 2% CHX after 24 hours (p=0.001) and 1% CHX after 6 months (p=0.024). Irrespective of the condition of substrate, comparisons showed no statistically significant differences between the other groups (p≥0.053). Cohesive in material and mixed failures prevailed for all groups. Conclusions: The addition of CHX at concentrations of up to 2% to the GIC did not affect the bond strength of the material to sound and caries-affected dentin in a long-term evaluation (AU)

Brazilian Dental Students' Attitudes About Provision of Care for Patients Living in Poverty.

The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions.

Perfil do atendimento odontológico no Serviço de Urgência para crianças e adolescentes da Faculdade de Odontologia de Araraquara (FOAr) - UNESP / Treatment profile at dental urgent care clinic for children and teenagers from Faculdade de Odontologia de Araraquara (FOAr) - UNESP

Introdução: Atendimentos de urgência são uma prática comum em Odontopediatria, porém pouco se sabe sobre o perfil desses atendimentos. Objetivo: Avaliar o perfil dos atendimentos de urgência de crianças de 0 a 13 anos de idade realizados na Clínica Infantil da FOAr, no período de 1997 a 2012, a fim de se quantificarem os pacientes e os procedimentos realizados no Serviço, além de identificar os tratamentos mais realizados. Material e método: Neste estudo transversal observacional, os relatórios desse Serviço, fornecidos pelo Sistema Integrado de Clínicas, foram analisados quanto ao número de pacientes, aos atendimentos e ao tipo de procedimentos realizados. Os procedimentos foram classificados em sete categorias: Diagnóstico, Preventivos, Anestesia, Endodônticos, Restauradores, Cirúrgicos e Outros. Esses dados foram tabulados e submetidos a uma análise descritiva. Resultado: De 1997 a 2012, foi atendido um total de 13.849 pacientes e foram realizados 25.786 atendimentos e 86.279 procedimentos. Houve diminuição do número de pacientes atendidos a partir de 2001, mas o número de consultas e de procedimentos não diminuiu na mesma proporção. Observou-se que, durante o período de 2007 a 2012, os procedimentos de diagnóstico foram os mais realizados, seguidos pelos preventivos. Dentre os procedimentos operatórios, o mais realizado foi o restaurador, seguido dos endodônticos. Procedimentos cirúrgicos estão entre os menos realizados. Conclusão: Conclui-se que houve uma mudança no perfil dos atendimentos dentro desse Serviço. Apesar de haver uma redução no número de pacientes atendidos, o número de consultas e a quantidade de procedimentos realizados permaneceram estáveis. Os procedimentos realizados estão de acordo com o perfil do Serviço de Urgência.

Introduction: Urgency care is a common practice in pediatric dentistry but little is known about the profile of these visits. Objective: To evaluate the profile of patients aged between 0 and 13 years assisted at the Urgency Unit offered by FOAr, from 1997 to 2012, in order to quantify patients and procedures performed and identify the most frequently treatments performed. Material and method: In this observational transversal study, the reports of urgency service provided by the Integrated Clinical System were analyzed for the number of patients, treatments and type of procedures performed. The procedures were classified into seven categories: Diagnosis, Preventive, Anesthesia, Endodontic, Restorative, Surgical and Others. The data were organized and analyzed descriptively. Results: From 1997 to 2012, a total of 13,849 patients were treated in 25,786 visits and 86,279 procedures were conducted. A decrease in the number of patients assisted was observed. However, the number of appointments and the number of procedures did not decrease at the same ratio. Diagnosis procedures were the most frequent procedure performed, followed by preventive procedures. Restorative and endodontic treatments were the most frequent operative procedure performed. Dental surgeries were done less frequently. Conclusion: A profile change in the dental urgent treatment was observed throughout the years. Despite a reduction in the number of patients assisted, the number of visits and the amount of procedures performed remained stable. The procedures performed are in agreement with the profile of a dental urgent care clinic.

Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara - UNESP / Characterization of patients and procedures performed in the service to patients with special needs of Araraquara School of Dentistry - UNESP

Objetivo: Caracterizar os pacientes atendidos e os procedimentos realizados no Serviço de Atendimento a Pacientes com Necessidades Especiais da Faculdade de Odontologia de Araraquara (FOAr) - UNESP. Metodologia: A partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre 2007 e 2013, foram obtidas informações em relação a idade no início do tratamento, tipo de deficiência, medicamentos usados, número de sessões de atendimento e número e tipo de procedimentos odontológicos realizados. Resultado: Dos 232 prontuários analisados, observou-se que mais da metade dos pacientes (56,0%) apresentava deficiência mental, paralisia cerebral ou anomalias congênitas determinadas por agentes infecciosos, com deficiência mental associada. Entre as anomalias congênitas, a mais prevalente foi a Síndrome de Down (9,9%). Apenas 20% dos pacientes iniciaram o tratamento antes dos dez anos de idade e 62,0% faziam uso de anticonvulsivantes, antipsicóticos, ansiolíticos, antiepilépticos e antidepressivos. Foram realizados 4.506 procedimentos odontológicos, sendo 37,6% preventivos e 62,4% curativos (Restauradores, 28,0%; Periodontais, 13,9%; Endodônticos, 9,7%; Cirúrgicos, 9,1%; Protéticos, 1,7%). Observou-se também que, para a maior parte dos pacientes (63%), foram necessárias até dez sessões para a realização do tratamento. Conclusão: Os pacientes que procuraram tratamento odontológico no Serviço de Atendimento a Pacientes com Necessidades Especiais da FOAr apresentavam, na sua maioria, deficiências com envolvimento neurológico. Apesar de esse serviço priorizar os procedimentos preventivos, a maior parte dos procedimentos executados foi curativa, o que está diretamente relacionado com a procura tardia pelo tratamento odontológico.

Objective: To characterize the patients and dental procedures performed in Service to Patients with Special Needs of Araraquara School of Dentistry (FOAr) - UNESP. Methodology: From the dental records of patients treated at outpatient basis between 2007 and 2013, information regarding age at the beginning of treatment, type of disability, controlled medications used, number of dental sessions, and number and type of dental procedures performed was obtained. Result: Of the 232 records analyzed, more than half of the patients (56.0%) had mental retardation, cerebral palsy or congenital abnormalities caused by infectious agents associated with mental retardation. Among the congenital abnormalities, the most prevalent was the Down syndrome (9.9%). Only 20% of patients started treatment before the age of ten and 62.0% used anticonvulsants, antipsychotics, anxiolytics, antidepressants and antiepileptics. A total of 4,506 dental procedures were performed, 37.6% were preventive procedures and 62.4% curative procedures (restorative, 28.0%; periodontal, 13.9%; endodontic, 9.7%; surgical, 9.1%, and prosthetic 1.7%). Also was observed that for most patients (63%) up to 10 sessions were required for the completion of treatment. Conclusion: Most patients with special needs who sought dental treatment at FOAr presented neurological involvement. Despite this service prioritize preventive procedures; most of the procedures carried out were curative, fact directly linked to late search for the dental treatment.

Molar-incisor hypomineralization in schoolchildren of Manaus, Brazil

To analyze the prevalence and severity of Molar Incisor Hypomineralization (MIH) and its relationship with dental caries in public school children in Manaus/AM.Material and Methods:Overall, 2,062 primary school children aged 6-10 years were examined to obtain MIH, DMFT, dmft and DDE indexes. The participation of five schools in each district of the city of Manaus was randomly determined, totaling 40 schools, and in each of them, two classes of each grade of elementary school in two shifts were selected, totaling 10 classes. Clinical examinations were conducted by two previously calibrated examiners in school environment under natural lighting. Data collected were submitted to descriptive statistical analysis by Chi-square, Fisher's Exact and Mann-Whitney tests at 5% significance level. Results:The prevalence of MIH in Manaus was 9.12% and no significant association with gender and age of schoolchildren was found. The mandibular arch was the most affected, with greaternumber of teeth being affected on the left side. The most frequently affected teeth were the mandibular permanent first molars, followed by maxillary counterparts and maxillary/mandibular central incisors. The most frequent diagnosis was mild MIH. The DMFT of children with MIH was 1.58 and dmft was 2.47, higher than those of the unaffected group. A correlation was found between DDE and MIH. Conclusion:Earlydiagnosis of MIH is imperative, since children affected show high risk for the development of dental caries...

Effect of chlorhexidine gluconate on porosity and compressive strength of a glass ionomer cement / Efeito da adição de gluconato de clorexidina na porosidade e resistência à compressão de um cimento de ionômero de vidro

Introduction: For presenting wide antibacterial activity, chlorhexidine (CHX) has been extensively used in dentistry and can be easily incorporated into the glass ionomer cement (GIC) and consequently released into the oral cavity. Aim: The aim of this study was porosity and compression strength of a GIC, that was added to different concentrations of CHX. Material and Method: Specimens were prepared with GIC (Ketac Molar Esaymix) and divided into 4 groups according to the concentration of CHX: control, 0.5% and 1% and 2% (n = 10). For analysis of pores specimens were fractured with the aid of hammer and chisel surgical, so that the fracture was performed in the center of the specimens, dividing it in half and images were obtained from a scanning electron microscope (SEM) analyzed in Image J software. The compressive strength test was conducted in a mechanical testing machine (EMIC - Equipment and Testing Systems Ltd., Joseph of the Pines, PR, Brazil). Statistical analysis was performed by ANOVA, Tukey test. Significance level of 5%. Result: No statistically significant changes between the study groups was observed both for the number of pores as well as for the compressive strength. Conclusion: The use of GIC associated with CHX gluconate 1% and 2% is the best option to be used in dental practice. .

Introdução: Por apresentar ampla atividade antibacteriana, a clorexidina (CHX) tem sido amplamente utilizada em odontologia, podendo ser facilmente incorporada ao cimento de ionômero de vidro (CIV) e liberada consequentemente na cavidade bucal. Objetivo: O objetivo neste estudo foi avaliar a porosidade e resistência à compressão de um CIV, ao qual foi adicionado diferentes concentrações de CHX. Material e Método: Os espécimes foram preparados com CIV (Ketac Molar Esaymix) e divididos em 4 grupos de acordo com a concentração de CHX: controle, 0,5% e 1% e 2% (n=10). Para análise dos poros os espécimes foram fraturados com auxílio de martelo e cinzel cirúrgicos, de modo que a fratura era realizada no centro do corpo de prova, dividindo-o ao meio e as imagens obtidas no microscópio eletrônico de varredura (MEV) analisadas no software Image J. O teste de resistência à compressão foi realizado na máquina de ensaios mecânicos (EMIC - Equipamentos e Sistemas de Ensaios Ltda, São José dos Pinhais, PR, Brazil). A análise estatística foi realizada por ANOVA, complementada pelo teste de Tukey. Nível de significância adotado de 5%. Resultado: Não se observou alteração estatisticamente significante entre os grupos estudados tanto para o número de poros quanto para a resistência à compressão. Conclusão: O uso de CIV associado ao gluconato de CLX a 1% e 2% é a melhor opção para ser utilizada na clínica odontológica. .

Addition of chlorhexidine gluconate to a glass ionomer cement: a study on mechanical, physical and antibacterial properties.

The objective of this work was to determine the effect of different concentrations of chlorhexidine digluconate (CHX) on setting time, surface hardness, maximum tensile bond strength and antibacterial activity of a glass ionomer cement (GIC). The material used as control was Ketac Molar Easymix GIC. CHX was incorporated into the GIC during its manipulation at concentrations of 0.5, 1.0 and 2.0%. Antimicrobial activity against S. mutans and L. acidophilus was evaluated by means of agar diffusion test. Tensile bond strength data were analyzed statistically using Analysis of variance and Tukey's test. Setting time, Vickers hardness and agar diffusion test were analyzed using Kruskal-Wallis and Mann-Whitney tests at a significance level of 5%. It was observed that adding CHX at concentrations of 1% and 2% increased significantly the setting time of the material (p=0.012 and p=0.003, respectively). There was no significant difference between control and 0.5% CHX groups regarding the setting time. Addition of 2% CHX decreased significantly the surface hardness in relation to the control group (p=0.009), followed by the 1% CHX group (p=0.009). The tensile bond strength of the material also decreased significantly after adding CHX at a concentration of 2% (p=0.001). Addition of CHX promoted formation of an inhibition halo in both bacterial strains for all concentrations. The results showed that the best option for clinical use of GIC with CHX is at 0.5% concentration, since antibacterial activity increased and the physical-mechanical properties remained unchanged.

Oral health promotion in early childhood: age of joining preventive program and behavioral aspects.

OBJECTIVE: To analyze the interference of age in the entrance into a public dental care program for infants as well as family behavioral aspects about tooth decay experience in children 0 to 4 years old. METHODS: Cross-sectional study involving 465 children who were divided into 3 groups: infants whose mothers joined the program during pregnancy (n=50); infants enrolled in the program during the first year of life (n=230); and infants enrolled in the program between 13 and 18 months old (n=185). The χ(2) and Kruskal-Walis tests (95% confidence interval) were used to assess the relationship among variables. RESULTS: There was an association between the age of entrance in the programs and dental caries (p<0.001). A lower prevalence was seen in infants whose mothers joined the program during pregnancy, and among those infants enrolled in the program during the first year of life. The same low prevalence occurred in relation to mothers' commitment to attend follow-up visits with their infants, cariogenic diet, nighttime oral care, duration of night feeding and parents' educational level (p<0.001). Unfavorable socioeconomic conditions (p>0.05) and daily oral care (p=0.214) were common variables in the groups with 99% of occurrence. Commitment to attend follow-up visits, nighttime oral care and parents' educational level (p>0.05) were considered protective factors for dental caries. Cariogenic diet and night feeding were determinant factors to the appearance of dental caries. CONCLUSION: To promote children oral health it is essential to enroll children in oral health programs and adopt healthy habits as early as possible, besides the adherence of the child to their parents' advice.

Oral health promotion in early childhood: age of joining preventive program and behavioral aspects / Promoção da saúde oral na primeira infância: idade de ingresso em programas preventivos e aspectos comportamentais / Promoção da saúde oral na primeira infância: idade de ingresso em programas preventivos e aspectos comportamentais

Objective : To analyze the interference of age in the entrance into a public dental care program for infants as well as family behavioral aspects about tooth decay experience in children 0 to 4 years old. Methods : Cross-sectional study involving 465 children who were divided into 3 groups: infants whose mothers joined the program during pregnancy (n=50); infants enrolled in the program during the first year of life (n=230); and infants enrolled in the program between 13 and 18 months old (n=185). The χ2 and Kruskal-Walis tests (95% confidence interval) were used to assess the relationship among variables. Results : There was an association between the age of entrance in the programs and dental caries (p<0.001). A lower prevalence was seen in infants whose mothers joined the program during pregnancy, and among those infants enrolled in the program during the first year of life. The same low prevalence occurred in relation to mothers’ commitment to attend follow-up visits with their infants, cariogenic diet, nighttime oral care, duration of night feeding and parents’ educational level (p<0.001). Unfavorable socioeconomic conditions (p>0.05) and daily oral care (p=0.214) were common variables in the groups with 99% of occurrence. Commitment to attend follow-up visits, nighttime oral care and parents’ educational level (p>0.05) were considered protective factors for dental caries. Cariogenic diet and night feeding were determinant factors to the appearance of dental caries. Conclusion : To promote children oral health it is essential to enroll children in oral health programs and adopt healthy habits as early as possible, besides the adherence of the child to their parents’ advice. .

Objetivo : Analisar a interferência da idade de ingresso em programas públicos de Odontologia para crianças e dos aspectos comportamentais familiares sobre a experiência com cárie dentária em crianças de zero a 48 meses de idade. Métodos : Estudo transversal com 465 crianças divididas em 3 grupos: crianças cujas mães ingressaram no programa quando gestantes (n=50); crianças que ingressaram no programa durante o primeiro ano de vida (n=230); e crianças que ingressaram no programa entre 13 e 18 meses de idade (n=185). Os testes χ2 e Kruskal-Walis (intervalo de confiança de 95%) foram utilizados para avaliar a relação das variáveis. Resultados : Encontrou-se associação entre a idade do ingresso nos programas e cárie dentária (p<0,001), sendo menor a prevalência para crianças cuja as mães ingressaram no programa durante as gestação e para aqueles que ingressaram no programa durante o primeiro ano de vida, o mesmo ocorreu em relação a assiduidade as consultas de retorno, dieta cariogênica, higiene oral noturna, duração de aleitamento noturno e escolaridade materna/responsável (p<0,001). Desfavorável nível socioeconômico (p>0,05) e higiene oral diária (p=0,214) foram variáveis comuns nos grupos com 99% de ocorrência. Assiduidade, higiene oral noturna e escolaridade materna (p<0,05) foram consideradas fatores de proteção à cárie dentária. Dieta cariogênica e aleitamento noturno foram consideradas determinantes para o aparecimento da cárie dentária. Conclusão : Para promover saúde oral infantil é essencial o ingresso ao programa e adoção de hábitos saudáveis de maneira precoce, além da adesão às orientações por seus responsáveis. .

Influence of the addition of chlorhexidine diacetate on bond strength of a high-viscosity glass ionomer cement to sound and artificial caries-affected dentin / Influência da adição do diacetato de clorexidina na resistência de união de um cimento de ionômero de vidro de alta viscosidade à dentina sadia e afetada por cárie artificial

Introduction: The aim of adding chlorhexidine (CHX) to glass ionomer cements (GIC) is to improve their antibacterial property, but it may interfere with their bond to dentin. Objective: To evaluate the influence of adding chlorhexidine diacetate at different concentrations to a high-viscosity GIC on its bond to sound and artificial caries-affected dentin. Material and Method: Eighty human third molars were used, on which an area of dentin was exposed on the occlusal surface. Half of the specimens were kept sound and the other half were subjected to artificially induced caries. CHX was mixed with GIC powder at 0.5%, 1% and 2% (w/w). GIC without CHX was used as control. On each dentin surface a specimen measuring 1 mm in diameter and 1 mm high was made. The samples were kept at 37 °C and 100% humidity for 24 hours and subject to microshear testing. The results were analyzed using Kruskal-Wallis and Mann Whitney tests (α=0.05). Result: There was no significant difference between bond strength of sound and caries-affected dentin (p>0.05). For both substrate conditions, groups GIC, GIC+0.5% CHX and GIC+1% CHX showed statistically similar bond strength (p>0.05), and higher than that of GIC+2% CHX (p≤0.025). Cohesive and mixed failures were predominant in all groups. Conclusion: The addition of 0.5% and 1% chlorhexidine did not result in negative changes in the bond strength of GIC to caries-affected and sound dentin. .

Introdução: A adição da clorexidina (CLX) ao cimento de ionômero de vidro (CIV) visa melhorar a sua propriedade antibacteriana, podendo contudo interferir na adesão à dentina. Objetivo: Avaliar a influência da adição de diacetato de CLX em diferentes concentrações a um CIV de alta viscosidade, na sua adesão à dentina sadia e afetada por cárie artificial. Material e Método: Foram utilizados 80 terceiros molares, que tiveram a superfície de dentina exposta na face oclusal. Metade dos dentes foram mantidos hígidos e a outra metade foi submetida à indução artificial de cárie. A CLX foi misturada ao pó do CIV nas concentrações de 0,5%, 1% e 2%. O CIV sem CLX foi usado como controle. Em cada superfície dentinária foi confeccionado um espécime com 1 mm de diâmetro e 1 mm de altura. Estes foram mantidos a 37 °C com 100% de umidade por 24 horas, e, submetidos ao teste de microcisalhamento. Os resultados foram analisados pelos testes de Kruskal-Wallis e Mann Whitney (α=0.05). Resultado: Não houve diferença estatística entre os valores de resistência de união para dentina hígida e afetada (p>0,05). Para as duas condições do substrato, os grupos CIV, CIV+CLX 0,5% e CIV+CLX 1% apresentaram resistência de união estatisticamente semelhante (p>0,05), e superior ao CIV+CLX 2% (p≤0.025). Houve predominância de fraturas mistas e coesivas do material para todos os grupos. Conclusão: A adição de CLX nas concentrações de 0,5% e 1% não influenciou negativamente na resistência de união de um CIV de alta viscosidade à dentina sadia e afetada por cárie. .

Addition of Chlorhexidine Gluconate to a Glass Ionomer Cement: A Study on Mechanical, Physical and Antibacterial Properties

The objective of this work was to determine the effect of different concentrations of chlorhexidine digluconate (CHX) on setting time, surface hardness, maximum tensile bond strength and antibacterial activity of a glass ionomer cement (GIC). The material used as control was Ketac Molar Easymix GIC. CHX was incorporated into the GIC during its manipulation at concentrations of 0.5, 1.0 and 2.0%. Antimicrobial activity against S. mutans and L. acidophilus was evaluated by means of agar diffusion test. Tensile bond strength data were analyzed statistically using Analysis of variance and Tukey's test. Setting time, Vickers hardness and agar diffusion test were analyzed using Kruskal-Wallis and Mann-Whitney tests at a significance level of 5%. It was observed that adding CHX at concentrations of 1% and 2% increased significantly the setting time of the material (p=0.012 and p=0.003, respectively). There was no significant difference between control and 0.5% CHX groups regarding the setting time. Addition of 2% CHX decreased significantly the surface hardness in relation to the control group (p=0.009), followed by the 1% CHX group (p=0.009). The tensile bond strength of the material also decreased significantly after adding CHX at a concentration of 2% (p=0.001). Addition of CHX promoted formation of an inhibition halo in both bacterial strains for all concentrations. The results showed that the best option for clinical use of GIC with CHX is at 0.5% concentration, since antibacterial activity increased and the physical-mechanical properties remained unchanged.

O objetivo deste trabalho foi determinar o efeito de diferentes concentrações de gluconato de clorexidina (CLX) sobre o tempo de presa, dureza superficial, resistência máxima a tração e atividade antibacteriana de um cimento de ionômero de vidro (CIV). O material utilizado como controle foi o CIV Ketac Molar Easymix. O gluconato de CHX foi incorporado no CIV durante a sua manipulação, em concentrações de 0,5, 1,0 e 2,0%. Atividade antimicrobiana contra S. mutans e L. acidophilus foi avaliada por meio de teste de difusão em ágar. Análise de variância (ANOVA) e teste de Tukey foram usadas para avaliar a resistência a tração do material. Para avaliar tempo de presa, dureza Vickers e teste de difusão em ágar foram usados os testes de Mann-Whitney e Kruskal-Wallis ao nível de significância de 5%. Observou-se que a adição de CHX, em concentrações de 1% e 2%, aumentou significativamente o tempo de presa do material (p = 0,012 e p = 0,003, respectivamente). Não houve diferença significativa entre os grupos controle e CHX 0,5% em relação ao tempo de presa. A adição de 2% de CHX diminuiu significativamente a dureza superficial, em relação ao grupo controle (p = 0,009), seguido pelo grupo 1% de CHX (p = 0,009). A resistência à tração do material também diminuiu significativamente após a adição de CHX a uma concentração de 2% (p = 0,001). A adição de CHX promoveu formação de halo de inibição em ambas as linhagens bacterianas para todas as concentrações. Os resultados mostraram que a melhor opção para o uso clínico de CIV com CHX está numa concentração de 0,5%, uma vez que a atividade antibacteriana aumentada e as propriedades físico-mecânicas permaneceram inalteradas.

Incorporation of chlorhexidine gluconate or diacetate into a glass-ionomer cement: porosity, surface roughness, and anti-biofilm activity.

PURPOSE: To evaluate the porosity, surface roughness and anti-biofilm activity of a glass-ionomer cement (GIC) after incorporation of different concentrations of chlorhexidine (CHX) gluconate or diacetate. METHODS: For the porosity and surface roughness tests, 10 test specimens were fabricated of the GIC Ketac Molar EasyMix (KM) and divided into the following groups: Control, GIC and 0.5% CHX diacetate; GIC and 1.0% CHX diacetate; GIC and 2.0% CHX diacetate; GIC and 0.5% CHX gluconate; GIC and 1.0% CHX gluconate; GIC and 2.0% CHX gluconate. To evaluate porosity, the test specimens were fractured. The fragments were photographed by scanning electron microscopy (SEM), and the images analyzed with the aid of the software program Image J. The surface roughness (Ra) was obtained by the mean value of three readouts performed on the surface of each specimen, always through the center. To analyze the anti-biofilm activity, strains of S. mutans ATCC 35688 were used, and the groups control and GIC +CHX diacetate 1% were divided as follows: GIC (1 day); GIC (7 days), GIC (14 days), GIC (21 days); GIC+CHX (1 day), GIC+CHX (7 days), GIC+CHX (14 days), GIC+CHX (21 days); GIC+ CHX (1 day), GIC+ CHX (7 days), GIC+ CHX (14 days) and GIC+ CHX (21 days) using 10 test specimens per group. For biofilm growth, the specimens were placed in a vertical position in 24-well plates and incubated overnight 10 times. The culture medium was renewed every 24 hours. The suspension was diluted and seeded on BHI agar for quantification of the bacteria present. For evaluation of all the tests the two-way ANOVA was used, and if necessary, the Tukey test was applied, with a level of significance of 5%. RESULTS: Regarding GIC porosity, the ANOVA showed that the presence of CHX increased the porosity (P < 0.001) proportionally to the increase in concentrations (P = 0.001), without however, presenting interaction between material and concentration (P = 0.705). Regarding the number of pores, a significant increase in pores was observed with the increase in CHX concentration (P = 0.003). The surface roughness test demonstrated no statistically significant effect as to increase or reduction in roughness at any of the CHX concentrations used (P > 0.05). Anti-biofilm activity analysis pointed out a significant effect of the factors material (P = 0.006) and time (P < 0.001), with CHX diacetate CHX presenting greater effectiveness in reducing microorganisms.

Non-nutritive sucking associated with self-mutilating behavior / Hábito de sucção não-nutritiva associada à automutilação

Although sucking activity has been considered an essential behavior of early childhood to satisfy nutritive and non-nutritive needs, digit andpacifier sucking are deleterious oral habits that may interfere with child development. Furthermore, this clinical picture may be compounded by other concerning habits, such as self-mutilating behavior. This article reports 4-year follow-up of a child in whom non-nutritive sucking was associated with an unusual self-mutilating behavior; namely, the child would pull out her own hair after wrapping it around her finger every time she sucked on the pacifier. This occurred specially at bedtime, while she was watching TV, or when she was somewhat anxious, and remitted and recurred throughout the follow-up period. In an attempt to address this behavior, pacifier use was discontinued and the child?s head was shaved. Ultimately, the case was only solved through combined efforts involving the child, her family, and health professionals. Based on the parents? reports and clinical examination and follow-up findings, we emphasize the importance of investigating the origin of the problem and considering emotional aspects and its association with other habits in such cases.

Apesar de a atividade de sucção ser considerada um comportamento essencial da primeira infância por satisfazer as necessidades nutritivase não-nutritivas, a sucção do dedo e chupeta são hábitos deletérios ao desenvolvimento da criança. Além disso, esse quadro clínico podeser ainda mais preocupante se houver associação com outros hábitos, como o da automutilação. Neste contexto, no presente artigo sãorelatados 4 anos de acompanhamento de uma criança que costumava arrancar seus cabelos depois de enrolá-los nos dedos enquanto estavacom a chupeta na boca, sem demonstrar sinal algum de sintomatologia dolorosa. Tal fato ocorria especialmente próximo a períodos de sono, ansiedade ou quando assistia à televisão, havendo períodos de remissão e exacerbação. Na tentativa de solucionar o caso foi proposta, além da interrupção do uso da chupeta, a raspagem de todo o cabelo da criança. Contudo, a solução definitiva só foi possível quando houve o envolvimento coletivo, abrangendo criança, família e profissionais da saúde. Baseando-se no relato dos pais, no exame clínico e no acompanhamento do caso, enfatiza-se a importância de se investigar a origem do problema, considerando os aspectos emocionais e sua associação com outros hábitos.

Resistência à tração diametral de cimentos de ionômero de vidro submetidos à aplicação de ondas de ultrassom / Diametral tensile strength of glass ionomer cements subjected to of ultrasound waves

Introdução: O cimento de ionômero de vidro é um material odontológico que apresenta limitações de uso devido às suas propriedades mecânicas, como baixa resistência ao desgaste, microdureza, compressão e tração diametral. Com base nisso, este estudo investigou o efeito da excitação ultrassônica sobre o CIV, em diferentes tempos de aplicação, por meio da resistência à tração diametral. Material e Método: Os materiais utilizados foram o Ketac Molar Easymix (KME) e o Ketac Cem Easymix (KCE). Foram confeccionados 10 corpos de prova para cada condição estudada: grupo controle, e os grupos que receberam aplicação de ultrassom por 15s, 30s e 45s, para ambos materiais. A excitação ultrassônica foi aplicada durante a reação de presa inicial do CIV, logo após sua inserção na matriz de silicone. Os valores de resistência à tração diametral foram analisados pelo teste Shapiro Wilk e Anova (α = 0.05). Resultado: A aplicação de excitação ultrassônica não apresentou efeito estatisticamente significante na resistência à tração diametral dos materiais testados, independente do tempo de aplicação (p > 0,05). O KME apresentou resistência estatisticamente maior que o KCE (p = 0,023). Conclusão: A utilização das ondas ultrassônicas não influenciou na resistência à tração diametral dos CIV testados independentemente do seu tempo de aplicação.

Introduction: The glass ionomer cement is a dental material that has limitations of use due to its mechanical properties, such as low wear resistance, hardness, tensile and compressive diametral. Based on this, this study investigated the effect of ultrasonic excitation on the GIC in different application times, through the diametral tensile strength. Material and Method: The materials used were Ketac Molar EasyMix (KME) and Ketac Cem EasyMix (KCE). Were made 10 specimens for each condition studied: control group, and the groups that received application of ultrasound for 15s, 30s and 45s, for both materials. The ultrasonic excitation was applied during the initial setting reaction of GIC, soon after its insertion into the silicone matrix. The values of the diametral tensile strength were analyzed by Shapiro Wilk test and ANOVA (α = 0.05). Result: The application of ultrasonic excitation showed no statistically significant effect on diametral tensile strength of the materials tested, regardless of the time of application (p > 0.05). The KME resistance showed statistically greater than the KCE (p = 0.023). Conclusion: The use of ultrasound waves did not influence the diametral tensile strength of CIV tested regardless of their time of application.