Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 57
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Braz Oral Res ; 34: e045, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32401935

RESUMO

This in vitro study aimed to evaluate the effect of a silane-containing universal adhesive used with or without a silane agent on the repair bond strength between aged and new composites. Forty nanohybrid composite resin blocks were stored in distilled water for 14 d and thermo-cycled. Sandpaper ground, etched, and rinsed speciments were randomly assigned into four experimental groups: silane + two-step etch-and-rinse adhesive system, two-step etch-and-rinse adhesive system, silane + silane-containing universal adhesive system, and silane-containing universal adhesive system. Blocks were repaired using the same composite. After 24 h of water storage, the blocks were sectioned and bonded sticks were submitted to microtensile testing. Ten unaged, non-repaired composite blocks were used as a reference group to evaluate the cohesive strength of the composite. Two-way ANOVA and Tukey's tests were used to analyze average µTBS. One-way ANOVA and Dunnet post-hoc tests were used to compare the cohesive strength values and bond strength obtained in the repaired groups (α = 0.05). The µTBS values were higher for the silane-containing universal adhesive compared to the two-step etch-and-rinse adhesive system (p = 0.002). Silane application improved the repair bond strength (p = 0.03). The repair bond strength ranged from 39.3 to 65.8% of the cohesive strength of the reference group. Using universal silane-containing adhesive improved the repair bond strength of composite resin compared to two-step etch-and-rinse adhesive. However, it still required prior application of a silane agent for best direct composite resin repair outcomes.

2.
J Dent Child (Chic) ; 87(1): 12-17, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32151305

RESUMO

Purpose: To assess the survival and risk factors associated with the failure of atraumatic restorative treatment (ART) restorations placed in children with early child-hood caries (ECC).
Methods: The sample consisted of 286 restorations from the records of 137 children treated in a university dental clinic. The date of restoration placement, any reintervention (failure), and the patient's last checkup were recorded. Restoration longevity up to one year of follow-up was assessed via the Kaplan-Meier survival test. Multi-variate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P <0.05).
Results: The mean age of the children was 2.3±0.6 years, presenting a decayed, missing, and filled teeth (dmft) mean of 6.3±3.2. Mean survival time was 11.1 months (95 percent confidence interval = 10.8 to 11.4), with 85 percent of the restorations surviving after one year. Caries experience was associated with risk of restoration failure in crude analysis. ART restorations done in children with high caries experience had 2.71 times more risk of failure than those placed in children with moderate caries experience (P=0.03). However, the association lost its significance in the adjusted model (P=0.07).
Conclusion: ART is a patient-friendly approach to manage ECC that promotes satisfactory restoration survival after one year.


Assuntos
Tratamento Dentário Restaurador sem Trauma , Cárie Dentária , Criança , Pré-Escolar , Falha de Restauração Dentária , Restauração Dentária Permanente , Cimentos de Ionômeros de Vidro , Humanos , Lactente , Fatores de Risco
3.
Clin Oral Investig ; 24(1): 71-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31016542

RESUMO

OBJECTIVES: We investigated factors associated with failure of adhesive restorations in primary teeth and whether repair may increase the survival of failed restorations placed in high-caries risk children. MATERIALS AND METHODS: The sample comprised children who attended a university dental service to perform restorative treatment in primary teeth. Data were collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: "Success" (Level 1)-when any re-intervention was considered as failure; "Survival" (Level 2)-when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p < 0.05). RESULTS: A total of 584 primary teeth restorations (178 patients) were included in the analysis. The longevity of restorations up to 36 months (Level 1) was 34.8% (AFR 29.6%). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69; 95% CI 1.18, 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22; 95% CI 1.35, 3.65). There was an increase in restoration survival when repair was not considered as failure (p < 0.001). The survival of repaired restorations (Level 2) reached 43.7% (AFR 24.1%). CONCLUSIONS: Adhesive restorations placed in primary teeth of high-caries risk children showed restricted longevity; however, the repair of failed restorations has increased its survival over time. CLINICAL RELEVANCE: Repair is a more conservative and technically simple procedure that increases the survival of failed restorations in primary teeth.


Assuntos
Cárie Dentária/epidemiologia , Restauração Dentária Permanente , Criança , Resinas Compostas , Falha de Restauração Dentária , Humanos , Estudos Retrospectivos , Dente Decíduo , Universidades
4.
J Clin Pediatr Dent ; 43(5): 305-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560588

RESUMO

This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification after a minimum of three months to determine which one provides the best results. The literature was screened via PubMed/MEDLINE and Embase databases up to June 2017 to select observational studies that compared pulp revascularization and apexification treatments assessing clinical, radiographic and functional retention outcomes. Two reviewers independently performed screening and evaluation of articles. A total of 231 articles were retrieved from databases, wherein only four articles were selected for full-text analyses. After exclusion criteria, three studies remained in quantitative and qualitative analyses. Pooled-effect estimates were obtained comparing clinical and radiographic outcomes ('overall outcome') and functional retention rates between apexification and pulp revascularization treatment. The meta-analysis comparing apexification vs. revascularization for 'overall outcome' (Z=0.113, p=0.910, RR=1.009, 95%CI:0.869-1.171) and functional retention rates (Z=1.438, p=0.150, RR=1.069, 95%CI:0.976-1.172) showed no statistically significant differences between the treatments. All studies were classified as high quality. The current literature regarding the clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification is limited. Based on our meta-analysis, the results do not favor one treatment modality over the other.


Assuntos
Apexificação , Necrose da Polpa Dentária , Polpa Dentária , Dentição Permanente , Humanos , Estudos Observacionais como Assunto , Ápice Dentário
5.
J Am Dent Assoc ; 150(7): 582-590.e1, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31153548

RESUMO

BACKGROUND: The authors conducted a systematic review of randomized controlled trials comparing the risk of experiencing restoration failure in primary teeth after complete and selective carious tissue removal of soft dentin. METHODS: The authors searched electronic databases (PubMed [MEDLINE], Scopus, Cochrane Central Register of Controlled Trials) and the ClinicalTrials.gov Web site with manual searching and cross-referencing for trials reporting restoration failure after follow-up of 6 months or longer. Two reviewers independently selected studies, extracted data, and assessed the risk of bias and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. The authors performed intention-to-treat and per-protocol meta-analyses and calculated odds ratios (OR) as effect estimates in the random-effects model. RESULTS: From 327 potentially eligible studies, the authors selected 23 for full-text screening and included 4. Results showed increased risk of experiencing restoration failure (intention-to-treat analysis, OR [95% confidence interval] 1.74 [1.01 to 3.00], and per-protocol analysis, OR [95% confidence interval] 1.79 [1.04 to 3.09]) after selective carious tissue removal of soft dentin. The risk of bias was high, and the quality of evidence was low. CONCLUSIONS: Selective carious tissue removal of soft dentin may increase the risk of experiencing restoration failure in primary teeth. However, the evidence level is insufficient for definitive conclusions. PRACTICAL IMPLICATIONS: Patients with restorations performed after selective carious tissue removal of soft dentin should have shorter recall visit intervals to evaluate the restorations' quality and control caries disease, allowing for more conservative approaches, such as repair, in cases of defective restorations.


Assuntos
Cárie Dentária , Dente Decíduo , Dentina , Humanos , Razão de Chances , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Int J Paediatr Dent ; 29(5): 566-572, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30860303

RESUMO

AIM: This retrospective study investigated the prevalence of defective restorations in a public dental service and factors associated with re-intervention in primary teeth. DESIGN: The sample consisted of all clinical records (census) of children presenting restorations in primary teeth, who had undergone dental treatment in a public set during 1-year period. For analysis, only restorations presenting defects related to esthetic, functional, or biological reasons at first clinical examination were included. The outcome 'Success' was set when the restoration received no treatment (monitored), refurbishing, sealing of margins, or was repaired. Otherwise, 'Failure' was set whenever the restoration was either replaced or if another treatment affecting the restoration was necessary (endodontic treatment or tooth extraction). Poisson regression model was used to assess the prevalence of patient- and tooth-related factors that may influence the re-intervention decision (repair or replacement). RESULTS: From a total of 302 restorations placed in 114 children, 37.7% presented some type of defect. Restorations with recurrent caries were more frequently present in caries-active patients (P = 0.03) and were frequently replaced (95% CI, 1.05-3.22, RR = 1.84, P = 0.03). CONCLUSION: Presence of recurrent caries influences the re-intervention decision, leading to restoration replacement in most cases.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Criança , Resinas Compostas , Falha de Restauração Dentária , Humanos , Prevalência , Estudos Retrospectivos , Dente Decíduo , Universidades
7.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 3902, 01 Fevereiro 2019. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-997921

RESUMO

Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.


Assuntos
Humanos , Criança , Adolescente , Pulpectomia/métodos , Obturação do Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Dente Decíduo , Registros Médicos , Serviços de Saúde Bucal , Brasil , Análise de Sobrevida , Estudos Retrospectivos , Estatísticas não Paramétricas
8.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4067, 01 Fevereiro 2019. ilus, tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-997984

RESUMO

Objective: To compare the teaching of the pulpectomy in primary teeth among graduate and undergraduate Brazilian dental schools. Material and Methods: From August 2015 to July 2016, an 11-question survey was sent to 44 graduate and 207 undergraduate dental schools. Data obtained were summarized using descriptive statistics. Results: The response rate was higher from graduate (56.8%) than undergraduate (41.1%) courses. Pulpectomy was taught by all participating schools. More than 90% of the undergraduate and graduate courses recommend the use of hand instruments for canals debridement, but the widening of root canals was advised in 69.4% of undergraduate and in 84% of graduate schools. Regarding the irrigatings, 1% sodium hypochlorite as a single irrigating solution was the most taught for both biopulpectomy and necropulpectomy. The iodoform-based Guedes-Pinto paste as the single indication was the preferred root canal filling material in undergraduate schools (30.6%), while the zinc oxidethickened calcium hydroxide paste as the single option was the most recommended in graduate courses (36%). Endodontic hand file associated with lentulo drill for filling root canals was recommended by most courses. Overall, biopulpectomy was performed in one session, while necropulpectomy led two sessions. Periapical radiograph for diagnosis and final obturation was the most adopted conduct by undergraduate (68.2%) and graduate (72%) schools. Gutta-percha and glass ionomer cement were preferred materials to seal the entrance of the pulp chamber. Conclusion: There was variability in the techniques and materials taught to perform pulpectomy in primary teeth among Brazilian graduate and undergraduate dental schools. Calcium hydroxide paste has been used in similar proportion to iodoform-based paste.


Assuntos
Pulpectomia/métodos , Dente Decíduo/diagnóstico por imagem , Brasil , Hidróxido de Cálcio/análise , Educação em Odontologia , Inquéritos e Questionários
9.
Clin Oral Investig ; 23(1): 199-207, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29626259

RESUMO

OBJECTIVES: Cultivation under hypoxia promotes different responses in the mesenchymal stem cells and it has been producing promising results for clinical applications. Pulp tissue from deciduous teeth is a source of stem cells which has a high proliferative potential but this is usually discarded. This study has evaluated the effects of hypoxia on proliferation, apoptosis, and the expression of the pluripotency-related genes of the stem cells from human exfoliated deciduous teeth (SHED). MATERIALS AND METHODS: The cells were isolated from dental pulp (n = 5) and characterized as mesenchymal stem cells, in accordance with the International Society for Cell Therapy. The cells were cultivated under hypoxia (3% oxygen) and compared to the normoxia cells (21% oxygen). The proliferation rate was evaluated by the Ki67 antibody for up to 7 days, while the metabolic activity was measured by the wst-8 assay for up to 14 days. The apoptotic cells were analyzed by Annexin V and propidium iodide staining at 24 h and 4 and 7 days. The expression of the pluripotent genes (OCT4, SOX2, and NANOG) was quantified by qPCR after 24 h, or 7 days, when cultivated under hypoxia or normoxia. RESULTS: No differences in the metabolic activity, the proliferation rate, and the apoptosis of SHED when cultivated under hypoxia or normoxia (p > 0.05) were observed. The expression of the pluripotent genes was significantly higher after 24 h and 7 days of the cells that were exposed to hypoxia (p < 0.01). CONCLUSION: These findings have indicated an increase of the pluripotency-related genes within 7 days as being the main advantage of SHED culture under hypoxia. CLINICAL RELEVANCE: Hypoxia culture may help maintain the quiescent state of the SHED, which could be advantageous for their future clinical applications.


Assuntos
Hipóxia , Células-Tronco Pluripotentes/citologia , Dente Decíduo/citologia , Apoptose , Proliferação de Células , Células Cultivadas , Criança , Expressão Gênica , Humanos , Reação em Cadeia da Polimerase , Regulação para Cima
10.
Am J Dent ; 31(5): 261-266, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30346673

RESUMO

PURPOSE: To evaluate the longevity and factors associated with failure of primary teeth restorations placed in high caries-risk children. METHODS: The sample was comprised of children treated in a University Dental Service. Patients' records were screened retrospectively to determine whether they had received restorative treatment in primary teeth presenting cavitated caries lesions. Kaplan-Meier estimator and Multivariate Cox regression analysis with shared frailty were used to assess restorations' survival and factors associated with failure, respectively. RESULTS: 123 high caries-risk children (10.3±4 DMF-T) with 316 restorations were analyzed. The 3-year survival reached 53.4% (AFR=18.8%). Restorations placed without rubber dam (P= 0.04), over selective caries removal (P= 0.03), with calcium hydroxide liner (P< 0.01) and glass-ionomer cement (P= 0.04) presented lower survival rates. Caries-controlled patients presented significantly (P= 0.03) higher rates of restoration survival (77.7%) than caries-active patients (49.9%). The adjusted model showed that restorations placed in teeth after selective caries removal showed 3.41 times higher risk of failure compared with restorations over complete caries removal (95%CI:1.37-8.46). CLINICAL SIGNIFICANCE: Adhesive restorations placed in high-caries experience patients have limited survival rates. Some treatment-related factors may influence the performance of these restorations. A strict preventive regimen to control dental caries activity must be followed in order to increase the restoration survival.


Assuntos
Resinas Compostas , Cárie Dentária , Restauração Dentária Permanente , Criança , Falha de Restauração Dentária , Cimentos de Ionômeros de Vidro , Humanos , Estudos Retrospectivos , Dente Decíduo
11.
Caries Res ; 51(5): 466-474, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28848160

RESUMO

OBJECTIVE: The aim of this retrospective study was to analyze the survival probability of selective caries removal (SCR) treatments in the primary teeth of children with high caries experience and factors potentially associated with treatment failure. METHODS: The sample included SCR treatments conducted in anterior and posterior teeth without sedation or general anesthesia among children attending a university dental service. Kaplan-Meier survival analysis was used to estimate the longevity of restorations and multivariate Cox regression with shared frailty was used to assess risk factors. RESULTS: A total of 284 SCR treatments in 88 children (aged 5.2 ± 1.91 years) with high caries experience (mean dmft/DMFT = 11.1 ± 5.04) were analyzed. The 3-year survival reached 48.8%, with an annual failure rate of 21.2%. Restorative failures (n = 60) were found more frequently compared to pulp complications (n = 12). SCR performed in anterior primary teeth were more prone to failure (hazard ratio = 3.6, 95% CI: 1.94; 6.71). Patients with a higher amount of visible plaque experienced more failures in SCR treatments (hazard ratio 3.0, 95% CI:1.27; 7.07). CONCLUSIONS: In this retrospective study, SCR showed restricted survival when compared to other prospective clinical trials. Patient-related factors, especially the young age and high caries experience of the children, may represent a challenge for restoration survival. Regardless of the caries removal technique or restorative material, cariogenic biofilm has a negative effect on the survival of restorations, probably by acting directly on material deterioration and, particularly, on the development of new caries lesions of rapid progression.


Assuntos
Cárie Dentária/terapia , Dente Decíduo , Biofilmes , Criança , Pré-Escolar , Restauração Dentária Permanente/métodos , Progressão da Doença , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Falha de Tratamento , Resultado do Tratamento
12.
J Dent ; 64: 30-36, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28602850

RESUMO

OBJECTIVES: To investigate repairs of direct restorations by a group of Dutch general dental practitioners (GDPs) and its consequences on longevity of restorations. METHODS: Data set was based on dental records of patients attending 11 general dental practices (24 Dentists) in the Netherlands. Patients that received Class II Amalgam or Composite restorations were included in the study. The outcomes were considered in two levels: "Success" - When no intervention was necessary on the original restoration, it was considered clinically acceptable. "Survival" - Repaired restorations were considered clinically acceptable. Kaplan-Meier statistics and Multivariate Cox regression were used to assess restorations longevity and factors associated with failures (p<0.05). RESULTS: 59,722 restorations placed in 21,988 patients were analyzed. There was a wide variation in the amount of repairs among GDPs when a restoration had failed (Level 1). Repairs of multi-surface restorations were more frequent (p<0.001). A total of 9253 restorations (Level 1) or 6897 restorations (Level 2) had failed in a 12-year observation time. "Success" and "Survival" of the restorations reached 65.92% (AFR=4.08%) and 74.61% (AFR=2.88%) at 10 years, respectively. Patient (age, removable denture) and tooth/treatment-related factors (molars, >2 restored surfaces, endodontic treatment, Amalgam) were identified as risk factors for failure (p<0.001). CONCLUSION: Overall, the GDPs showed satisfactory rates of restoration longevity over 10 years. Repair can increase the survival of restorations although, substantial differences exist among practitioners in repair frequency and AFRs. Molars, multi-surface restorations, presence of an endodontic treatment and a removable denture were identified as risk factors for failure. CLINICAL SIGNIFICANCE: Repair, instead of total replacement of a defective restoration, is a Minimally Invasive procedure which can increase the survival of the original filling, reducing the risk for pulp complications and treatment costs.


Assuntos
Falha de Restauração Dentária/estatística & dados numéricos , Reparação de Restauração Dentária/estatística & dados numéricos , Restauração Dentária Permanente/métodos , Restauração Dentária Permanente/estatística & dados numéricos , Adulto , Resinas Compostas , Amálgama Dentário , Feminino , Odontologia Geral , Humanos , Estimativa de Kaplan-Meier , Longevidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Países Baixos , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
Braz Dent J ; 28(1): 121-128, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28301009

RESUMO

Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.


Assuntos
Pulpectomia , Estudantes de Odontologia , Dente Decíduo/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Radiografia Dentária
14.
Braz. dent. j ; 28(1): 121-128, Jan.-Feb. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-839122

RESUMO

Abstract Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.


Resumo Embora o tratamento endodôntico seja amplamente recomendado para polpa dentária comprometida, não há informações sobre os fatores associados ás falhas nos dentes decíduos. O objetivo do trabalho foi avaliar a sobrevida e os fatores associados à falha de pulpectomias realizadas em dentes decíduos por estudantes de odontologia. A amostra foi constituída por pacientes atendidos em um Serviço Odontológico Universitário e necessitaram de tratamento endodôntico em dentes decíduos. O estudo investigou variáveis relacionadas ao tratamento e fatores do paciente potencialmente associados à falha do tratamento. A sobrevivência das pulpectomias foi analisada pelas curvas de Kaplan-Meier seguido do teste de log-rank (p<0,05). A análise incluiu 81 pulpectomias realizadas em 62 crianças (5,6 ± 1,5 anos). A sobrevida atingiu 62,9% em até 12 meses de seguimento. A maioria das falhas ocorreu nos primeiros 3 meses (p<0,001). Os dentes com lesões cariosas no início do tratamento apresentaram mais falhas do que aqueles com restaurações ou história de trauma (p = 0,002). A sobrevida de dentes endodonticamente tratados restaurados com compósito foi maior do que os preenchidos com cimento de ionômero de vidro (p = 0,006). Pulpectomias realizadas em duas ou mais sessões apresentaram mais falhas (p = 0,028). Os pacientes com gengivite apresentaram mais falhas no tratamento endodôntico (p = 0,022). As falhas do tratamento do canal radicular em dentes decíduos foram mais propensas a ocorrer em um curto período de tempo e quando o tratamento foi realizado em dentes com lesões cariosas. O uso de compósito em vez de cimento de ionômero de vidro aumentou a sobrevivência pulpectomias. Sessões repetidas para o tratamento endodôntico e a falta de hábitos de higiene bucal tiveram um efeito negativo sobre os resultados.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Pulpectomia , Estudantes de Odontologia , Dente Decíduo/cirurgia , Radiografia Dentária
15.
Int J Paediatr Dent ; 27(3): 217-227, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27529749

RESUMO

BACKGROUND: Dental trauma and deep caries are frequent findings in children and adolescents that may lead to pulp necrosis in young permanent teeth. As a consequence, the root stops its development, and managing these immature teeth becomes challenging due to the presence of open apexes and fragile dentinal walls. AIM: We aimed to carry out a systematic review including a meta-analysis to compare the endodontic treatments available in the management of immature necrotic permanent teeth and determine which one provides the best clinical and radiographic outcomes. DESIGN: The literature was screened via PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials databases until August 2015 to select randomized clinical trials that compared at least two different treatments regarding immature necrotic permanent teeth comprising clinical and radiographic success as outcome. Two reviewers independently performed the screening and evaluation of the articles. A total of 648 studies were retrieved from the databases, in which only 14 were selected to full-text analysis by the appliance of inclusion criteria. After the exclusion criteria, the remaining seven studies had their data extracted and assessed for bias risk. Pooled-effect estimates were obtained comparing clinical and radiographic success rates among MTA Versus other treatments. RESULTS: Evaluation of clinical (Z = 2.32, P = 0.02, OR = 5.37, 95% CI: 1.29-22.23, I = 0%) and radiographic (Z = 2.45, P = 0.01, OR = 4.31, 95% CI: 1.34-13.82, I = 0%) outcomes favored the MTA (control group) when compared to other endodontic treatments (P < 0.05). No evidence of heterogeneity was detected among the studies (I < 50%), whereas a moderate risk of bias was identified in five of them. CONCLUSIONS: Although almost all of the identified studies presented moderate risk of bias, MTA apexification seems to produce overall better clinical and radiographic success rates among the endodontic treatment available in immature necrotic permanent teeth.


Assuntos
Necrose da Polpa Dentária/diagnóstico por imagem , Necrose da Polpa Dentária/terapia , Dentição Permanente , Radiografia Dentária , Dente não Vital , Adolescente , Criança , Humanos
16.
Clin Oral Investig ; 21(3): 847-855, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27103587

RESUMO

OBJECTIVE: The aim of this retrospective university-based study has been to evaluate the longevity and factors associated with failures of adhesive restorations performed in deep carious lesions of permanent molars after complete (CCR) and selective caries removal (SCR). MATERIALS AND METHODS: The sample was composed of composite resin and resin-modified glass ionomer cement (RMGIC) restorations placed in permanent molars of children attending a university dental service who were followed up for up to 36 months. Information collected retrospectively from clinical records was used for analyzing data. The following factors were investigated: gender, caries experience, visible plaque and gingival bleeding indexes, operator's experiences, number of restored surfaces, and type of capping and restorative materials. The Kaplan-Meier survival test was used to analyze the longevity of the restorations. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05). RESULTS: Four hundred seventy-seven restorations carried out in 297 children (9.1 ± 1.7 years) were included in the analysis. The survival of the restorations reached 57.9 % up to 36 months follow-up with an overall annual failure rate of 16.7 %. There was no difference in restoration longevity when CCR or SCR was performed (p = 0.163); however, CCR presented more pulp exposure (p < 0.001). Multi-surface restorations showed more failures than single-surface (HR 3.22, 95 % CI 1.49; 6.97), and teeth restored with RMGIC had a lower survival rate than those restored with composite resin (HR 4.11, 95 % CI 1.91; 8.81). Patients with evidence of gingivitis had more risk of failure in their restorations (HR 2.88, 95 % CI 1.33; 6.24). CONCLUSION: Overall, adhesive restorations performed in young permanent molars of high caries risk children presented limited survival, regardless of the caries removal technique. Risk factors for failure were identified as multi-surface fillings, RMGIC restorative material, and poor oral hygiene, reflected by gingival bleeding. CLINICAL RELEVANCE: Composite fillings associated with a strict caries preventive regimen may play an important role in the survival of restorations placed in high caries risk children.


Assuntos
Cárie Dentária/terapia , Falha de Restauração Dentária , Restauração Dentária Permanente , Criança , Resinas Compostas , Dentição Permanente , Feminino , Cimentos de Ionômeros de Vidro , Humanos , Estimativa de Kaplan-Meier , Masculino , Dente Molar , Estudos Retrospectivos , Fatores de Risco
17.
Arch Oral Biol ; 68: 13-20, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27045351

RESUMO

The culture of cells under hypoxia is considered one of the hot topics of tissue engineering, especially when exploring the proliferation capacity, a critical step for cellular-based therapies. The use of in vitro hypoxic environment aims to simulate the oxygen concentrations found in stem cell niches. Dental tissues are attractive sources of stem cells, as they are obtained from discarded tissue, after third molar extraction and exfoliation deciduous teeth, respectively. However, small amounts of cells are obtained from these sources. Thus, optimizing the in vitro conditions for proliferation and differentiation of these cells is essential for future regenerative strategies. This review presents a summary of the results regarding the effect of hypoxia on dental-derived stem cells after an electronic search on PubMed databases. The studies show increased differentiation potential and paracrine action of dental-derived stem cells under hypoxic environment. There are controversies related to proliferation of dental-derived stem cells under induced hypoxia. The lack of standardization in cell culture techniques contributes to these biases and future studies should describe in more detail the protocols used. The knowledge regarding the effect of hypoxia on dental-derived stem cells needs further clarification for assisting the clinical application of these cells.


Assuntos
Hipóxia Celular/fisiologia , Polpa Dentária/citologia , Dente Serotino/citologia , Células-Tronco/citologia , Células-Tronco/metabolismo , Dente Decíduo/citologia , Animais , Células Cultivadas , Polpa Dentária/metabolismo , Humanos , Células-Tronco Mesenquimais/citologia , Oxigênio/administração & dosagem , Oxigênio/metabolismo , Engenharia Tecidual/métodos
18.
Pesqui. bras. odontopediatria clín. integr ; 16(1): 167-175, jan.-dez. 2016. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-911333

RESUMO

Objective: To determine anxiety in children undergoing dental treatment and to evaluate associated factors. Material and Methods: The sample consisted of 48 children during dental appointment in dental clinics of the Franciscano University Center, 48 caregivers, and 46 dentistry students. The modified Venham Picture Test was used to determine anxiety of children during dental appointment, before and after treatment. For determining anxiety related to dental care among caregivers, the modified Corah's dental anxiety scale was used. The Lipp`s stress symptoms inventory for adults was applied to determine the stress level of dentistry students. In addition, the individual characteristics of participants were recorded to determine their association with the presence of anxiety. Results: Anxiety was observed in 60.4% of children, and it was related to invasive dental procedures (p = 0.021), history of dental pain (p = 0.002), presence of bruxism (p = 0.028), anxious caregivers (p = 0.023), and stress of the dental student that conducted the appointment (p = 0.005). Conclusion: Overall, the majority of pediatric patients showed anxiety, which was directly related to misbehavior during dental care. Moreover, anxiety was related to individual characteristics of children and was influenced by the anxiety level of caregivers, as well as the emotional state of dentistry students during the dental appointment.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Criança , Comportamento Infantil/psicologia , Ansiedade ao Tratamento Odontológico/prevenção & controle , Ansiedade ao Tratamento Odontológico/psicologia , Consultórios Odontológicos , Odontopediatria/métodos , Ansiedade/psicologia , Brasil , Relações Dentista-Paciente , Medo/psicologia , Estudo Observacional , Dor/psicologia , Fatores Socioeconômicos
19.
Pesqui. bras. odontopediatria clín. integr ; 16(1): 229-234, jan.-dez. 2016. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-912431

RESUMO

Objective: To analyze the pattern of self-medication in cases of dental infection for children and pre-teens at University Dental Service. Material and Methods: It was performed a structured survey interview with the parents/caregivers of the patients. The survey consisted in seventeen questions about tooth infection episodes experienced by the children during their lives, and which medication was used, as well as information about demographic characteristics of the patient and parents/caregivers. Statistical analysis was performed with the Software SPSS for Windows, version 15.0. Descriptive analysis was performed (mean and standard deviation [SD] or median and percentis). The association between the self-medication and the variables (child age, mother age, mother educational level) was measured by chi-squared test. Results: One hundred and fifty questionnaires were analyzed. In episodes of dental infection, the most common medicaments were amoxicillin (34.8%) and acetaminophen (32.6%). The practice of self-medication was observed in 21.7% of cases. There was no association between the self-medication and the variables as child age, mother age and mother educational level (P>.05; chi-squared test). Conclusion: Children treated at University Dental Service were exposed to frequent previous use of medicines without prescription, and the data revealed a non-rational use of medications.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adolescente , Brasil , Criança , Assistência Odontológica , Automedicação , Amoxicilina/administração & dosagem , Distribuição de Qui-Quadrado , Odontopediatria , Inquéritos e Questionários
20.
Clin Oral Investig ; 20(1): 75-81, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25898896

RESUMO

OBJECTIVE: The objectives of this study are to isolate, cultivate, and characterize stem cells from the pulp of carious deciduous teeth (SCCD) and compare them to those retrieved from sound deciduous teeth (SHED--stem cells from human exfoliated deciduous teeth). MATERIAL AND METHODS: Cells were obtained of dental pulp collected from sound (n = 10) and carious (n = 10) deciduous human teeth. Rate of isolation, proliferation assay (0, 1, 3, 5, and 7 days), STRO-1, mesenchymal (CD29, CD73, and CD90) and hematopoietic surface marker expression (CD14, CD34, CD45, HLA-DR), and differentiation capacity were evaluated. RESULTS: Isolation success rates were 70 and 80 % from the carious and sound groups, respectively. SCCD and SHED presented similar proliferation rate. There were no statistical differences between the groups for the tested surface markers. The cells from sound and carious deciduous teeth were positive for CD29, CD73, and CD90 and negative for CD14, CD34, CD45, and HLA-DR and were capable of differentiating into osteogenic, chondrogenic, and adipogenic lineages. CONCLUSION: SCCD demonstrated a similar pattern of proliferation, immunophenotypical characteristics, and differentiation ability as those obtained from sound deciduous teeth. These SCCD represent a feasible source of stem cells. CLINICAL RELEVANCE: Decayed deciduous teeth have been usually discarded once the pulp tissue could be damaged and the activity of stem cells compromised. These findings show that stem cells from carious deciduous teeth can be applicable source for cell-based therapies in tissue regeneration.


Assuntos
Cárie Dentária , Polpa Dentária/citologia , Células-Tronco/citologia , Dente Decíduo/citologia , Adipogenia , Antígenos CD/análise , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Condrogênese , Citometria de Fluxo , Humanos , Imunofenotipagem , Osteogênese
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA