Reabilitação oral em paciente acometido por cárie da primeira infância: relato de caso / Oral rehabilitation in a patient with severe early childhood caries: a case report

Objetivo: Apresentar as abordagens adotadas no tratamento estético reabilitador de paciente pediátrico acometido por cárie da primeira infância respeitando as individualidades e buscando a integralidade do paciente infantil. Relato do caso: O caso clínico descreve a reabilitação bucal realizada em uma criança de 4 anos e 6 meses de idade, diagnosticada com cárie da primeira infância. Após anamnese criteriosa, exames físicos e complementares e de posse do diagnóstico, estabeleceu-se um plano de tratamento obedecendo-se a todas as fases terapêuticas, nas quais a fase preparatória englobou abordagem psicológica, fluorterapia, exodontias e selamento dos dentes com cimento de ionômero de vidro. Posteriormente, procedeu-se à fase estético-re-abilitadora por meio de restaurações diretas e indireta, instalação de mantenedor de espaço estético-funcional e confecção e instalação de uma prótese total superior. Após a conclusão do tratamento odontológico, os responsáveis foram orientados quanto à necessidade e importância do tratamento multidisciplinar com o fonoaudiólogo para completa recuperação da saúde do paciente e de visitas periódicas ao cirurgião-dentista para acompanhamento. Conclusão: A reabilitação bucal da criança propiciou o restabelecimento das funções do sistema estomatognático e promoveu a recuperação da sua saúde bucal.

Aim: To present the approaches adopted in the rehabili-tative aesthetic treatment of pediatric patients affected by early childhood caries, respecting individualities and seeking the integrality of the child patient. Case report: The clinical case describes the oral rehabilitation performed in a child aged 4 years and 6 months, diagnosed with early childhood caries. After careful anamnesis, physical and complementary examinations and in possession of the diagnosis, a treatment plan was established, complying with all therapeutic phases, in which the preparatory phase included a psychological approach, fluortherapy, extractions and teeth sealing with glass ionomer cement. Subsequently, the esthetic-rehabilitation phase was carried out through direct and indirect restorations, installation of an esthetic-functional space maintainer and fabri-cation and installation of an upper total denture. After completion of the dental treatment, those responsible were instructed on the need and importance of multi-disciplinary treatment with the speech therapist for the complete recovery of the patient's health and periodic visits to the dentist for follow-up. Conclusion: The child's oral rehabilitation provided the reestablishment of the functions of the stomatognathic system and promoted the recovery of their oral health.

Caries temprana de la infancia: rehabilitación estética, funcional e integral en paciente preescolar. Caso clínico / Early childhood caries: esthetic, functional and comprehensive rehabilitation in preschool patient. A clinical case

La American Academy of Pediatric Dentistry (2020) define a la caries temprana de la infancia (CTI) como una forma severa de caries de etiología multifactorial que compromete la dentición primaria de niños pre-escolares. Afecta principalmente a los incisivos primarios superiores seguidos de los primeros molares primarios, pudiendo promover el desarrollo de hábitos parafuncionales, reducción de la eficacia masticatoria, pérdida de la dimensión vertical, alteraciones en la fonación y defectos estéticos que causan repercusiones emocionales e impacto psicosocial. La insuficiente cantidad y calidad de estructura coronaria remanente, luego de la eliminación del tejido cariado, puede comprometer la adhesión de los materiales de restauración. El objetivo de este trabajo es presentar la atención y el seguimiento a dos años de un paciente preescolar que presenta CTI, que concurrió para su atención a la Cátedra de Odontología Integral Niños de la Facultad de Odontología de la Universidad de Buenos Aires (AU)

Reabilitação estética e funcional em paciente com cárie na primeira infância: relato de caso / Aesthetic and functional rehabilitation in a patient with caries in early childhood: case report

Introdução: Cárie na Primeira Infância (CPI) é o termo utilizado para descrever a cárie dentária em crianças menores de 6 anos de idade. Objetivo: Relatar o tratamento reabilitador estético e funcional de uma criança com CPI. Relato do caso: Paciente do sexo masculino, 5 anos de idade, compareceu à clínica de Odontopediatria da Faculdade de Odontologia de Araçatuba (FOA/UNESP), acompanhado pela mãe, que relatou como queixa principal dor e presença de cárie. Ao exame clínico intrabucal, constatou-se na arcada superior lesões de cárie em todos os dentes, exceto nos dentes 55, já restaurado, e dente 65, hígido. Na arcada inferior, lesões de cárie foram observadas nos dentes 74 e 84. Após diagnóstico clínico e radiográfico, optou-se por realizar a confecção de coroa de aço para os dentes 74 e 84, exodontia dos dentes 51, 52, 61 e 64, instalação de aparelho mantenedor de espaço funcional removível e restaurações dos demais dentes afetados com compósito resinoso. Conclusão: Foi possível recuperar as funções estéticas, fonéticas e mastigatórias do paciente, colaborando para a melhora da autoestima da criança, o que gerou satisfação dos familiares. A educação em saúde bucal realizada com a criança e os responsáveis foi essencial para o sucesso do tratamento e a manutenção da saúde bucal.

Introduction: Early Childhood Caries (ECC) is the term used to describe dental caries in children under 6 years of age. Objective: Report the aesthetic and functional rehabilitation treatment of a child with ECC. Case report: A 5-year-old male patient was attended at the to the Pediatric Dentistry Clinic of the Araçatuba Dental School (FOA/UNESP), accompanied by his mother, who reported pain and dental caries as the main complaint. On intraoral clinical examination, caries lesions were found in all upper teeth, except for tooth 55, already restored, and tooth 65, healthy. In the lower arch, caries lesions were observed in teeth 74 and 84. After clinical and radiographic diagnosis, it was decided for the manufacture of steel crown for teeth 74 and 84, extraction of teeth 51, 52, 61 and 64, installation of removable functional space maintenance device and restorations of the other affected teeth with composite resin. Conclusion: In view of the treatment performed, it was possible to recover the aesthetic, phonetic and masticatory functions, contributing to the improvement of the child's self-esteem as well assatisfaction of family members. Oral health education carried out with the child and his parents was essential for the success of the treatment and the maintenance of oral health.

Impact of different restorative treatments for deep caries lesion in primary teeth (CEPECO 1) - study protocol for a noninferiority randomized clinical trial.

BACKGROUND: Due to the lack of evidence to determine the best treatment for deep cavitated caries lesions in primary molars, the search for an effective restorative technique, which results in a minimal discomfort to patients, and reduce the time needed for the treatment, becomes relevant. The objective of this randomized clinical trial was to evaluate if high-viscosity glass ionomer cement (HVGIC) restorations is noninferior to restoration with calcium hydroxide cement associated with HVGIC for treatment of deep lesions in primary molars, as well as the impact of the treatments on cost and discomfort of the patient. METHODS: A non-inferiority randomized clinical trial with two parallels arms (1:1) will be conducted. Children with 4 to 8 years will be selected at Clinic of Pediatric Dentistry at Ibirapuera University. 108 teeth will be randomized into two groups: (1) Calcium hydroxide cement associated with HVGIC and (2) HVGIC restoration. Primary outcome will be considered the pulp vitality and to be evaluated after 6, 12, 18 and 24 months by two calibrated examiners. Survival of restorations will also be evaluated in the equal intervals. The duration of dentals treatment and the cost of all materials used will be considered for estimating of cost-efficacy of each treatment. Individual discomfort will be measured after each dental procedure using the Wong-Baker's Facial Scale. For the primary outcome, Kaplan-Meier survival and the long-rank test will be used to comparison between the groups. Cox regression will be performed to assess the influence of variables on the outcome. For all analyzes, the significance level is set at 5%. DISCUSSION: Based on the philosophy of ART, our hypothesis is that the HVGIC restoration is a possible approach to restore the deep caries lesion with pulp vitality without the use of rubber dam and anesthesia. TRIAL REGISTRATION: Clinicaltrials.gov registration NCT02903979 . Registered on June 9th 2016.

Rehabilitation of severely worn teeth: A systematic review.

OBJECTIVES: The aim of this systematic review was to evaluate the treatment performance/longevity of dental materials/techniques indicated to restore teeth with severe wear. MATERIALS AND METHODS: A systematic literature search was conducted to select retrospective studies (cohort and case series) and prospective studies that evaluated or compared techniques/materials to restore teeth with severe wear. A search was conducted in Medline (via Pubmed - June 2015) with no limits for publication year or language to identify clinical studies. Two reviewers independently selected studies, extracted data and assessed the risk of bias of randomized controlled trials included. The annual failure rate (AFR%) of restorations was calculated for each study. RESULTS: A total of 511 articles were found and 23 studies were eligible for full-text analysis; hand search included 7 more papers. From the 30 studies, 12 were eligible for the review. Most of these studies presented good performance of the restorations in teeth with severe wear. AFR ranged from 0.4% (microhybrid) to 26.3% (microfilled) for direct resin composite, 0% to 14.9% for indirect resin composite and 2.7% for porcelain veneers. CONCLUSION: There is no strong evidence to suggest that any material is better than another. Direct or indirect materials may be feasible options to restore severely worn teeth.

Reabilitacão estética e funcional em, paciente com cárie severa da infância: relato de caso / Esthetic and functional rehabilitation in patient with severe childhood caries: case report

A Cárie Precoce da Infância (CPI) é uma doença de etiologia multifatorial que acomete crianças na fase pré-escolar, sendo sua forma mais agressiva denominada como Cárie Severa da Infância (CSI). O presente trabalho teve como objetivo descrever o caso clínico de reabilitação estética e funcional de paciente do gênero feminino, 3 anos e 6 meses de idade, acometida por CSI. Uma etapa inicial de adequação do meio bucal envolveu drenagem de abscesso periapical no elemento 61, tratamento endodôntico dos incisivos superiores, vedamento das cavidades e realização de selantes com cimento de ionômero de vidro (CIV) de alta viscosidade, além de orientações acerca da importância de bons hábitos alimentares e é de higienização na paralisação da doença cárie, utilizando-se de abordagens motivacionais e buscando a conscientização do núcleo familiar quanto a sua responsabilidade no controle da mesma. A reconstrução cá estética dos incisivos superiores se deu por meio do uso de retentores intrarradiculares e resina composta, com o auxílio de matrizes anatômicas de celuloide, tendo sido utilizada também a resina para a restauração dos molares inferiores. O tratamento proposto permitiu restabelecer a função mastigatória e a estética do sorriso, bem como ocasionou na satisfação com o resultado obtido, demonstrada pela criança e por seus familiares. O tratamento reabilitador em crianças acometidas pela doença CSI pode ser realizado em ambiente ambulatorial e com o uso de técnicas restauradoras diretas, sendo possível obter resultado estético satisfatório e promover a saúde e o bem-estar geral para o paciente e seu núcleo familiar.

The Early Childhood Caries (ECC) is a multifactorial disease that affects preschool children, being its most aggressive form known as Severe Childhood Caries (SCC). The present work aimed to describe the c1inical case of aesthetic and functional rehabilitation of a female patient, 3 years and 6 months of age, affected by SCC An initial step of adequacy of oral environment involved the draining of periapical abscess on the element 61, endodontic treatment of upper incisors, sealing ofthe cavities and realization of sealants with glass ionomer cement (GIC) of high viscosity, as well as guidelines about the importance of good eating habits and sanitation in the stoppage of caries across motivational approaches and seeking family's awareness about their responsibility in the management of dental cáries Aesthetic reconstruction of upper incisors came de through the usage of intra-radicular posts and composite resin, with the aid of strip crowns. It was used the same resin for the restoration of lower molars. The proposed treatment allowed to re-establishment of the masticatory function and smile's aesthetics, thus promoting the satisfaction with the result obtained, demonstrated by the child and her family Rehabilitation treatment in children affected by SCC can be perfomed in dental office and with the use of direct restorative techniques. being possible to obtain satisfactory aesthetic result and promote the general health and well-being to the patient and the family.

Overdenture for total rehabilitation in a child with early childhood caries.

The purpose of this case report was to present a clinical case of overdenture in a 3-year-old patient with early loss of his primary maxillary teeth, which were extracted due to the presence of early childhood caries. The treatment of choice was an overdenture using the Dalla Bona retention system, and the upper right canine was used as the retainer. The overdenture was placed to help maintain a normal daily diet that was satisfactory for the child and to re-establish masticatory function, speech, and facial aesthetics in the patient.

Tooth supported prosthetic rehabilitation in a 5-year-old child with early childhood caries.

This paper reports the case of a 5-year-old patient with early childhood caries (ECC) and presents an alternative prosthetic treatment with a tooth-supported overdenture. Primary canines were endodontically treated and received intraradicular posts with ball-type attachments to attach a tooth-supported overdenture. The patient was followed for 18 months both clinically and radiographically. In addition to esthetic and functional oral rehabilitation, the prosthetic treatment had an important psychological impact on recovery of patient's self-esteem.

An alternative aesthetic restoration for extensive coronal destruction in primary molars: indirect restorative technique with composite resin.

The indirect restorative technique with composite resin has presented efficient results when used in primary teeth. This technique enables the oral rehabilitation. Based on the results presented in the literature concerning clinical performance, this technique is presented as an alternative treatment to the primary teeth with extensive decay by showing a case of rehabilitation of primary molars. The oral rehabilitation using indirect resin composite restoration showed an important concept to be applied in primary dentition due to feasible, low cost, and lower chairside time.

Intracanal reinforcement fiber in pediatric dentistry: a case report.

A technique for the restoration of carious primary maxillary incisors using indirect resin composite crowns and intracanal reinforcement fiber is described. Endodontic treatment was previously performed on each tooth. The advantages of using an intracanal reinforcement fiber include resin composite crown reinforcement, translucency, and relative manipulation facility. In addition, the use of indirect resin composite crowns provides good shape and esthetics, as well as reduced chair time for the child. The technique is illustrated in a case report in which indirect resin composite crowns and an intracanal reinforcement fiber are placed in a 3-year-old girl.

Rehabilitación en bebés: relato de un caso / Rehabilitation in babies: report of a case

La rehabilitación en bebés debe ser realizada para garantizar el buen desarrollo del lenguaje, deglución, masticación y la remoción de focos de infección causados por caries. En el presente trabajo se describe el tratamiento realizado en un niño de 2,5 años que presentaba una gran destrucción de los incisivos superiores, cavidades de caries en primeros molares y pigmentación de los incisivos inferiores por lesiones de caries paralizada. El objetivo del presente artículo es mostrar una alternativa para el tratamiento de caries precoz en la infancia. El tratamiento realizado consistió en la aplicación de flúor, la reconstrucción de los dientes anteriores con la utilización de postes intrarradiculares de resinas y fundas de celuloide, la obturación de las cavidades de caries en molares y microabrasión en los dientes inferiores para eliminar las pigmentaciones (AU)

Restauraçöes biológicas: alternativas para a reabilitaçäo de dentes decíduos - caso clínico / Biologic restorations: alternative for rehabilitation of great destruction on deciduous teeth - clinical report

Os autores relatam um caso clínico de reabilitaçäo dentária através da realizaçäo de colagens de fragmentos dentários provenientes do Banco de Dentes Humanos na FOUSP. Após acompanhamento clínico e radiográfico de dois anos, observou-se excelente desempenho das restauraçöes, surgerindo que a técnica da colagem de fragmento dentário ou restauraçäo biológica consiste numa alternativa restauradora eficiente para a clínica ododontopediátrica

Prótese dento-mucoso-suportada: uma alternativa para reabilitação em crianças portadoras de cárie rampante / Dento-mucous-suported prosthesis: an alternative for rehabilitation in children with rampant caries

A utilização de próteses dento-mucoso-suportadas em Odontopediatria possibilita o rápido restabelecimento dos requisitos funcionais e estéticos perdidos, geralmente por doenças agudas como a cárie rampante e traumatismos. São apresentados dois casos clínicos de crianças de tenra idade portadoras de grande destruição e perdas dentárias por cárie rampante, que foram tratadas por meio de próteses dento-mucoso-suportadas. Considera-se o sucesso da terapêutica nos aspectos educativo, preventivo e reabilitador

Nova filosofia de ação na prática restauradora / The new action philosophy in dentistry practice

Os autores revisam a literatura sobre a nova filosofia de ação da prática restauradora, baseada em atitudes que asseguram o controle da cárie dentária e maior longevidade do tratamento restaurador

Avaliaçäo de dois materiais utilizados como selante oclusal: ionômero x compósito / Evaluation, after one year, of two sealant materials: glass ionomer cement and composite sealant

Os autores verificaram o desempenho de dois materiais utilizados para selamento dental. Apesar de um deles, o cimento de ionômero de vidro, ter sido mais estável que o outro, o selante resinoso, ambos se apresentaram eficientes na prevençäo de cáries oclusais. A técnica de selamento empregada foi a invasiva, e o tempo de controle foi de 12 meses

Avaliaçäo clínica de uma técnica restauradora preventiva, nas regiöes de cicatrículas e fissuras com cáries incipientes, empregando três tipos de materiais restauradores / Clinical evaluation of a preventive restorative technic, in the pit and fissure regions with incipient caries, using three types of restorative materials

Com o objetivo de testar clinicamente uma técnica restauradora preventiva, foram realizadas 207 cavidades conservadoras na regiäo de cicatrículas e fissuras de molares e pré-molares superiores e/ou inferiores, empregando três tipos de materiais restauradores, sendo selecionados 51 pacientes com idades entre 10 e 15 anos, com 3 ou múltiplos de 3 dentes, nas condiçöes clínicas exigidas pela pesquisa, ou seja, cáries incipientes na regiäo oclusal de cicatrículas e fissuras e faces proximais sem processo de cárie, para que os materiais testados pudessem ser utilizados nas mesmas condiçöes. Foram realizados 69 preparos conservadores para cada material restaurador, procurando remover apenas o tecido cariado previamente marcado pelo corante (fucsina básica a 0,5 por cento em propileno glicol), empregando uma broca esférica carbide n§ 1/4, girando em alta rotaçäo, estendendo o preparo até o limite amelo-dentinário, ficando a cavidade totalmente em esmalte...