The Top 100 Most-Cited Articles on Permanent Teeth Avulsion: A Bibliometric Analysis.

INTRODUCTION: Knowledge of bibliometric indices on the avulsion of permanent teeth can help researchers to identify gaps in the literature. The aim of this study was to analyze the bibliometric characteristics of the 100 most-cited articles on the avulsion of permanent teeth. MATERIALS AND METHODS: Two researchers conducted an unfiltered search in the Core Collection section of the Web of Science (WoS-CC) database. The following data were extracted: position in the citation list, total number and density of citations, title, authors, institution, country, year of publication, journal, keywords, study design, tooth storage medium, and other topics of interest. Bibliometric networks were generated and analyzed using the VOSviewer software. Descriptive analysis and a Poisson regression analysis were performed (P < .05). RESULTS: The number of citations per article varied between 31 and 407. The average was 70.05, and 13 articles received more than 100 citations. J.O. Andreasen (n = 13) and M. Trope (n = 15) were the authors who contributed most often to publications. The United States was the country with the highest number of articles (n = 31). Authors associated with the University of Copenhagen, Denmark (n = 9) and University of North Carolina, USA (n = 10) showed higher productivity. In vitro/animal model studies were the most frequent study designs (n = 50), and the most-discussed topic of interest was prognosis (n = 47). There was strong clustering among 13 research groups. CONCLUSION: Observational studies, published by authors from Europe and about prognosis or treatment presented more citation ratio in WoS-CC. Clinical studies on permanent tooth avulsion are needed to increase the quality of scientific evidence and provide insights for health professionals and public policy makers.

Impact of Pulp Necrosis on Oral Health-Related Quality of Life of Children with Early Childhood Caries.

Purpose: To assess the impact of pulp necrosis on the oral health-related quality of life (OHRQoL) of children with early childhood caries and their caregivers.
Methods: A cross-sectional study was performed with a consecutive sample of children who were divided into three groups: (1) caries-free children; (2) with untreated carious lesions and without pulp necrosis; and (3) with untreated carious lesions and at least one tooth with pulp necrosis. Data were collected using a sociodemographic questionnaire, the Early Childhood Oral Health Impact Scale (ECOHIS) and a dental clinical examination using the International Caries Detection and Assessment System index. Descriptive statistics, Kruskal-Wallis tests, Mann-Whitney tests and Poisson regression were performed (P <0.05).
Results: A total of 532 children and their legal guardians participated in the study. Children with pulp necrosis had a greater negative impact on the OHRQoL versus those with untreated carious lesions without pulp necrosis (ratio of unadjusted and adjusted rates [RR] = 1.59; 95 percent confidence interval [95% CI] = 1.36 to 1.86; P <0.001), as measured by the total ECOHIS score. in Group 3, four- and five-year-old children had a greater negative impact on the OHRQoL than two- and three-year-old peers (RR = 1.36; 95% CI = 1.08 to 1.72; P <0,001).
Conclusion: The presence of pulp necrosis increased the negative impact on OHRQoL of children with untreated carious lesions and their guardians.

Fluoridated water impact on tooth decay and fluorosis in 17-20-year-olds exposed to fluoride toothpaste.

OBJECTIVE: To determine the impact of water fluoridation on the prevalence and severity of dental caries and fluorosis in individuals aged 17-20 years exposed to fluoride toothpaste. METHODS: The study population consisted of 660 students from public schools, residents of areas supplied with fluoridated water (exposed group) or not (not exposed group). Students from both groups had access to fluoride toothpaste throughout life. A questionnaire about socioeconomic demographic aspects, conditions related to access and exposure to fluoridated water, and habits related to oral health was applied. Dental caries was measured by the DMFT index and dental fluorosis by the TF index. The chi-square test, t test, and subsequently logistic regression were applied for data analysis. RESULTS: Caries experience (DMFT≠0) was significantly higher in students from areas not exposed to fluoridated water, after adjustments to clinical conditions, demographic socioeconomic profile, and hygiene habits. The DMFT mean (±SD) was significantly higher in students from areas not exposed to fluoridated water than exposed (3.83 [±3.28] and 2.48 [±2.71] respectively). The prevalence of very mild/mild and moderate fluorosis was 41.1% and 21% for students either exposed to fluoridated water or not, respectively. CONCLUSION: Exposure to fluoridated water was associated with a lower prevalence and severity of tooth decay, in spite of the use of fluoridated toothpaste. The prevalence of dental fluorosis at all levels was higher in fluoridated areas, however, in both groups, there were few cases with esthetic implications.

Hypomineralized Teeth Have a Higher Frequency of Dental Hypersensitivity.

Purpose: The purposes of this study were to: (1) compare dental hypersensitivity (DH) between hypomineralized permanent first molars and unaffected controls molars in patients with molar-incisor hypomineralization (MIH); and (2) assess the influence of opacity, color, and subject age on DH. Methods: This cross-sectional study identified 40 children/adolescents, who were attending a children's dental clinic and had one to three first permanent molars hypomineralized (demarcated opacities). The severity and color of the hypomineralized lesions were also evaluated. The assessment of DH was made using evaporative stimulus using a jet of compressed air applied by a dental syringe for one second, perpendicular to the occlusal surface employing the visual analogue scale (VAS) and the Schiff cold air sensitivity scale (SCASS). To verify the association between the presence or absence of DH and MIH, Pearson's chi-square and Fisher's exact test (P<0.05) were performed. Results: The frequency of DH was 28.0 percent in hypomineralized teeth and 9.4 percent in normal controls (by VAS; P=0.002). A higher frequency of opacities was observed (P<0.001). Older individuals had DH more frequently (P<0.05). Conclusions: Hypomineralized molars presented a higher frequency of dental hypersensitivity than control teeth, and dental hypersensitivity was associated with darker opacities of the lesion and older-aged subjects.

Molar-incisor hypomineralization in quilombola children and adolescents: A study of prevalence and associated factors.

OBJECTIVES: This cross-sectional observational study determined the prevalence and factors associated with molar-incisive hypomineralization (MIH) in quilombola children and adolescents in north-eastern Brazil. METHODS: The sample consisted of 251 children and adolescents (8 to 14 years old) living in the rural quilombola community Lagoas in São Raimundo Nonato, Piauí (census population). Sociodemographic and health-related data were collected from pre-, peri- and post-natal health records and a clinical examination for MIH diagnosis was performed by four previously trained and calibrated examiners. Descriptive data analysis and Poisson regression were performed. The magnitude of the association was determined by adjusted prevalence ratio (PR) and confidence intervals (95% CI). RESULTS: The prevalence of MIH was 46.6%. The presence of MIH was associated with gestational diabetes (PR = 2.49, 95% CI 2.08-2.99; p <0.001) and acute foetal distress (PR = 1.39; 95% CI 1.04-1.86; p = 0.025). CONCLUSION: It was concluded that the prevalence of MIH in the quilombola community was high and associated with gestational diabetes and acute foetal distress.

Enamel of Premolars whose Predecessors Presented Rupture of the Follicle Bone Crypt from Periapical Infections.

OBJECTIVE: To observe if dental alterations in premolars are associated with the rupture of the follicle bone crypt caused by a periapical lesion in the predecessor molars. STUDY DESIGN: This is a cross-sectional study. Data collection consisted of the analysis of medical records, a socioeconomic questionnaire, and dental clinical examination. Records from patients with a history of a radiographically visible periapical lesion in lower primary molars submitted to pulp therapy or extraction from a university dental clinic were selected. Successor premolars were clinically evaluated for the presence of enamel development defects, shape alterations, and eruption deviations. The descriptive analysis of data was performed, and Fisher's exact tests, linear trend chi-square, and the Student's t-test were applied. RESULTS: Forty-eight permanent teeth were from 36 patients were evaluated in this study, and 20 (41.7%) of the 48 examined premolars showed a radiographic image suggestive of the rupture of the bone crypt. Rupture of the follicle bone crypt was not associated with the occurrence of enamel alterations in premolars (p = 0.418). An association between dental alterations and age over six years at the time of intervention was observed (p = 0.043). CONCLUSION: The presence of enamel alterations of premolars was not associated with the rupture of the follicle bone crypt caused by a periapical lesion in predecessor molars.

Association Between Duration of Breastfeeding and Malocclusion in Primary Dentition in Brazil.

Purpose: To evaluate the relationship between type and duration of breastfeeding and the development of malocclusion in primary dentition.
Methods: A cross-sectional observational study was conducted with children of both sexes, aged 30 to 48 months, who attended to a dental program for maternal and child care. The mothers completed a questionnaire about the form (exclusive breast-feeding or not) and duration of breastfeeding, their children's non-nutritive sucking habits, and their sociodemographic information. The clinical examination was done by a calibrated examiner in the knee-to-knee position and under indirect light to evaluate the primary occlusion. Pearson's chi-square test or Fisher's exact test and Poisson regression were performed for statistical analysis.
Results: Over 45 percent of 252 children who were evaluated had malocclusion, such as anterior open bite (13.6 percent), posterior crossbite (3.6 percent), anterior crossbite (2.8 percent), midline shift (21.5 percent), overbite (19.8 percent), and overjet (32.9 percent). Children who were exclusively breastfed for less than six months had a 50 percent higher prevalence of anterior open bite (P =0.009) compared to those who had exclusive breastfeeding for more than six months.
Conclusion: Exclusive breastfeeding for less than six months was associated with anterior open bite. The other malocclusion types were not associated with the time and type of feeding the children received in the early phase of the primary dentition. (J Dent Child 2019;86(1):17-23)
Received August 29, 2018; Last Revision November 20, 2018; Accepted January 3, 2019.

Nível de satisfação dos pais/responsáveis de crianças atendidas em programa odontológico de atenção materno-infantil / Satisfaction level of parents of children in a dental program of maternal child attention

Objetivo: avaliar o nível de satisfação dos pais e/ou responsáveis de crianças atendidas em programa odontológico deatenção materno-infantil e implantar um sistema permanente de avaliação simplificada das ações desenvolvidas.Metodologia: estudo transversal quantitativo, desenvolvido no Instituto de Perinatologia Social do Piauí onde funciona oPrograma Preventivo para Gestantes e Bebês (PPGB). Os dados foram coletados através de um questionário estruturadoauto administrado e uma escala visual simplificada que continha questões relativas à percepção dos mesmos logo após oatendimento. Foram aplicados 569 questionários no período de março a outubro de 2014. Foi realizada a análisedescritiva das variáveis categóricas. Resultados: os itens acolhimento, ambiente, atendimento, importância doatendimento e localização do programa tiveram aprovação “ótimo” e “bom” entre 91% e 97,7% no questionário, enquantona escala visual os valores ficaram entre 76,6% e 98,8% de satisfação. A localização obteve o menor índice de satisfaçãotanto no questionário como na escala visual. Conclusão: o Programa Preventivo para Gestantes e Bebês foi bem avaliadopor pais e/ou responsáveis pelas crianças atendidas e a implantação de um sistema permanente de avaliação simplificadadas ações desenvolvidas é viável e de fácil aplicação.

Objective: evaluating the level of satisfaction of the parents and/or caregivers of children attending a dental program formaternal and child care and establishing a permanent system of simplified evaluation of the actions developed.Methodology: a quantitative cross-sectional study, developed at the Institute of Social Perinatology of Piauí where thePreventive Program for Pregnant Women and Babies (PPGB) works. The data were collected through a structured selfadministeredquestionnaire and a simplified visual scale that contained questions regarding their perception soon after thecare. A total of 569 questionnaires were applied from March to October 2014. A descriptive analysis of the categoricalvariables was performed. Results: the items welcoming, ambience, attendance, importance of attendance and location ofthe program had "excellent" and "good" approval between 91% and 97.7% in the questionnaire, whereas in the visual scalethe values were between 76.6% and 98.8% satisfaction. The location obtained the lowest index of satisfaction in both thequestionnaire and the visual scale. Conclusion: the Preventive Program for Pregnant Women and Babies was wellevaluated by parents and/or caregivers of children and the implementation of a permanent system of simplifiedevaluation of actions developed is feasible and easy to apply.

Caries, Toothbrushing Habits, and Fluoride Intake From Toothpaste by Brazilian Children According to Socioeconomic Status.

PURPOSE: The purpose of this study was to evaluate the prevalence of dental caries, toothbrushing habits, fluoride intake, and factors associated with the use of toothpaste in Brazilian children according to socioeconomic status (SES). METHODS: A cross-sectional observational study was conducted with 148 three- to four-year-olds of both low and high socioeconomic status. Data collection consisted of administering a questionnaire to guardians, brushing to determine fluoride intake, and examining the children's teeth to evaluate dental caries. RESULTS: In this study, 42 percent of children from high SES and 2.7 percent of children from low SES used toothpaste without fluoride or with a concentration below 1,000 ppm F. Fluoride intake was associated with SES, frequency of brushing, the amount of toothpaste used, and the concentration of fluoride present in toothpastes (P<0.05). Low SES children had a higher fluoride intake during brushing (0.045 mg F/kg body weight/day), compared to high SES children (0.023 mg F/kg body weight/day). Unlike low SES children (68.9 percent), all high SES children were caries free. CONCLUSIONS: A lower socioeconomic status was associated with a higher prevalence of dental caries and a higher intake of fluoride from toothpaste.

Endodontic Treatment of Primary Molars with Antibiotic Paste: A Report of 38 Cases.

OBJECTIVE: This study presents 38 cases of primary molars with necrotic pulps treated with antibiotics-based paste. CASE REPORT: The technique consisted of necrotic tissue removal of the pulp chamber, using spoons excavators and low speed drills. Pulp cavity was washed with saline solution and dried with sterile cotton balls. Then an antibiotic paste composed of chloramphenicol, tetracycline, zinc oxide and eugenol - CTZ paste - was inserted at the entrance of root canals. Patients were evaluated clinically and radiographically at different times. The criteria that defined clinical success were the lack of periapical abscess and mobility compatible with chronological age. Radiographic assessments consisted in absence of radiolucency in the region of root bifurcation and pathological bone resorption. CONCLUSION: There were 100% and 93% of clinical and radiographic success, respectively. The results suggest that the CTZ paste is an optional therapy for pulp of primary molars.

Does Leishmaniasis disease alter the parenchyma and protein expression in salivary glands?

Leishmaniasis is considered a serious public health problem in several regions in Brazil and worldwide. This research aimed to perform a histopathological and proteomic study of parotid, submandibular and sublingual glands of BALB/c mice infected by Leishmania (L) infantum chagasi using histological, immunohistochemical and epifluorescence techniques. Twelve isogenic BALB/c male mice, around six- to eight-weeks old, were separated into two groups: the animals of the control group were injected with 0.15 ml of NaCl, while those in the experimental group were inoculated with 5 × 10(6) amastigote forms of Leishmania (L) infantum chagasi by the ip route. After 50 days, animals were euthanized and major salivary glands were collected to perform histological, immunohistochemical and epifluorescence techniques using anti-Caspase-2, anti-Ki-67 and anti-ß-catenin antibodies, respectively. The histological and morphometric evaluation showed clusters of mononuclear inflammatory cells and a higher area and perimeter of the parotid gland. However, none of the salivary glands had morphophysiological impairment. There was no immunoreactivity to the anti-caspase-2 antibody and Ki67 expression in acinar and ductal cells in both groups. According to the immunofluorescence staining, the ß-catenin antibodies did not show nuclear expression, suggesting no uncontrolled proliferation. The data obtained in this study showed population and morphological stability of major salivary glands after 50 days post-infection by Leishmania (L) infantum chagasi.

Restorative management of severely ankylosed primary molars.

Severe dentoalveolar ankylosis is an etiological factor for malocclusion. When infraocclusion occurs early, it progresses with time, leading to severe consequences in young children because of compensatory supra-eruption of the antagonist tooth and mesialization of adjacent teeth. Early diagnosis allows for interception of the problem and may prevent orthodontic treatment. The purpose of this manuscript is to report two cases of infraocclusion of primary mandibular second molars that were diagnosed early and were treated with composite resin crowns. The use of indirect composite restorations for ankylosed teeth is a good option for primary teeth with a moderate/ severe degree of ankylosis.

Epidemiologic Study of Molar-incisor Hypomineralization in Schoolchildren in North-eastern Brazil.

PURPOSE: To determine the prevalence of molar-incisor hypomineralization (MIH) in children and possible factors associated with this disorder. METHODS: This was a cross-sectional observational study of 594 11- to 14-year-olds from Teresina, Piauí, Brazil. The diagnosis of MIH was made based on criteria set by the European Academy of Pediatric Dentistry. To investigate possible associated factors, mothers completed a questionnaire. A descriptive analysis of the data, chi-square, Mann-Whitney, and Fisher tests and Poisson regression (PR) were performed. RESULTS: The prevalence of MIH was 18.4 percent (95 percent confidence interval [CI] equals 15.20 to 21.50). The maxillary molars were the teeth most affected by MIH (36.1 percent). MIH patients showed a higher number of mean DMF-T (PR equals 2.18; 95 percent CI equals 1.46 to 2.85) than those not affected by the condition. There was an association between MIH and preterm birth (PR equals 1.76; 95 percent CI equals 1.22 to 2.12) and between MIH and respiratory distress at birth (PR equals 1.83; 95 percent CI equals 1.25 to 2.18). CONCLUSIONS: The prevalence of MIH in schoolchildren was 18.4 percent. Those with MIH had a greater mean DMF-T than those without MIH. Preterm birth and respiratory distress were associated with MIH.

The impact of a dental program for maternal and infant health on the prevalence of dental fluorosis.

PURPOSE: This study's purpose was to investigate the prevalence of dental fluorosis in children, whose parents had participated in an oral health program when the children were between zero and three years old, residing in a city with fluoridated water. METHODS: Group 1 consisted of 128 eight- to 12-year-olds whose parents had visited a program on at least five occasions when the children were zero to three years old and received education about tooth-brushing and the proper use of fluoridated toothpaste in this young age group. The prevalence of dental fluorosis in the permanent maxillary incisors, using the Thylstrup-Fejerskov index, in Group 1 was compared to that of an age-matched group of children (n=128) whose parents had not participated in the program (Group 2). RESULTS: Group 1 mothers reported higher education levels (P<.05). Group 1 children had a significantly lower prevalence (∼42 percent) and severity (P<.05) of dental fluorosis than those in the control group (∼61 percent). CONCLUSION: Children whose parents participated in a dental program that included counselling on the proper amount of fluoridated toothpaste when their children were between zero and three years old presented less frequently with dental fluorosis than a control group when examined at eight to 12 years old.