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1.
Ned Tijdschr Tandheelkd ; 128(7-8): 365-370, 2021 Jul.
Artigo em Holandês | MEDLINE | ID: mdl-34242382

RESUMO

Minimally invasive dentistry is being used increasingly often, especially in paediatric dentistry. It involves replacing traditional 'drilling and filling' with treatment modalities that are tissue-saving and minimally burdensome to the patient. One of these techniques for treating carious dentine lesions is the Hall technique. A stainless-steel crown is cemented onto the primary molar without the use of anaesthesia or any form of preparation. The molar is 'sealed' under the crown and this stops the carious process in the cavity. Usually, the procedure requires 2 sessions. The Hall technique is well tolerated by children and provides the primary molar with a durable restoration. Together with this technique, the patient is also guided in an individual prevention process. The survival rates of Hall crowns are very high.


Assuntos
Cárie Dentária , Aço Inoxidável , Criança , Coroas , Cárie Dentária/terapia , Restauração Dentária Permanente , Humanos , Dente Molar , Dente Decíduo
2.
Ned Tijdschr Tandheelkd ; 128(7-8): 371-380, 2021 Jul.
Artigo em Holandês | MEDLINE | ID: mdl-34242383

RESUMO

The new KIMO guidelines 'Oral Health Care for Children' approach caries as a behavioural related disease and unequivocally assign priority to causal caries treatment, emphasising lifestyle and behavioural changes. The 5-step concept of non-restorative caries treatment (NRCT) is recommended as treatment of choice for cavitated dentine lesions in primary dentition. Communicative aspects of NRCT are supported by limited technical interventions, for the purpose of effective oral care. A balance between aetiological and symptomatic treatment is sought for each child individually, in close cooperation with the parents. Technical aspects per tooth range from limited interventions like making cavities accessible for brushing, applying fluoride varnish or SDF, covering the cavity with a layer of glass ionomer cement to emergency treatment like ART restoration or the Hall technique, in cases of necessity. Lifestyle changes lead to sustainable treatment results and enhance the quality of life of the child or young person.


Assuntos
Cárie Dentária , Qualidade de Vida , Adolescente , Criança , Cárie Dentária/terapia , Fluoretos , Cimentos de Ionômeros de Vidro , Humanos , Dente Decíduo
3.
Am J Dent ; 34(3): 143-149, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34143584

RESUMO

PURPOSE: To evaluate the clinical performance of Class II restorations made with bulk-fill or layering pure ormocer materials, as well as the time necessary to fill the preparations. METHODS: After ethics approval, a randomized controlled split-mouth clinical trial was performed. 30 subjects were selected according to the inclusion/exclusion criteria, and two restorations were randomly performed in each first or second molar that presented caries, fracture, or cosmetic needs. One restoration was done with the bulk-fill material Admira Fusion x-tra, applied with increments up to 4 mm (intervention group), while the second was performed with the regular Admira Fusion, applied by a 2 mm layering technique (control group). The universal adhesive system Futurabond U was used for both groups. The subjects and examiners were blinded, and the examiners were previously calibrated. The restorations were evaluated according to FDI criteria, after 7 days, 6, 12 and 24 months, and the outcome was success rate based on esthetic, functional and biological properties. The time necessary for application of both materials into the preparations was also measured. RESULTS: After 24 months, 26 patients attended the recall and 52 restorations were evaluated. The Fisher's statistical analysis (α= 5%) showed non-significant differences between techniques for esthetic, biological and functional properties in all evaluations (P> 0.05). After 2 years, 96% of the subjects for both groups did not show any sign of post-operative sensitivity and 100% of the teeth were vital and without secondary caries. Around 70% of the restorations received score excellent for surface luster, more than 83% for surface staining and 63% for color match. In relation to marginal adaptation and marginal staining, more than 80% for the layering material and 63% for the bulk showed excellent scores. Only three restorations of the 60 performed showed small fractures, although not affecting the esthetics or function. The time for composite application was significantly shorter for the bulk material (P= 0.0454). After 24 months of intraoral service, the restorations made with both materials presented similar and excellent clinical performance for all parameters analyzed. The bulk-fill material required significantly less chair time to apply than the layering one, simplifying and accelerating the restorative technique. CLINICAL SIGNIFICANCE: The bulk-fill ormocer-based composite was an appropriate alternative to the conventional layering material, since similar clinical performance was observed after 2 years, with the advantage of shorter chair time, due to simplified operative procedures.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Cárie Dentária/terapia , Adaptação Marginal Dentária , Humanos , Dente Molar , Cerâmicas Modificadas Organicamente
4.
J Adhes Dent ; 23(3): 243-252, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34060304

RESUMO

PURPOSE: To investigate the influence of the etching strategy of universal adhesives on bond degradation to sound and artificially-induced caries-affected dentin. MATERIALS AND METHODS: The universal adhesives (Scotchbond Universal Adhesive; All-Bond Universal; Prime&Bond Elect) and adhesives used as controls (Adper Single Bond 2 and Clearfil SE Bond) were applied to sound and artificially-induced caries-affected bovine dentin. Microtensile bond strength was evaluated immediately (24 h) and after one year of water storage (1 year). Representative specimens were also prepared to assess nanoleakage. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 0.05), considering each substrate separately. RESULTS: Bonding degradation was observed for all universal adhesives on caries-affected dentin, irrespective of the etching strategy. On sound dentin, bonding degradation was observed when adhesives were used on the etch-and-rinse strategy. CONCLUSION: The universal adhesives were not capable of maintaining bond stability over time on caries-affected dentin. The self-etch strategy seems better able to maintain the durability of adhesive interfaces created on sound dentin.


Assuntos
Colagem Dentária , Cárie Dentária , Animais , Bovinos , Cárie Dentária/terapia , Suscetibilidade à Cárie Dentária , Dentina , Resistência à Tração
5.
BMC Oral Health ; 21(1): 318, 2021 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-34167525

RESUMO

BACKGROUND: Decision analytic models are often used in economic evaluations to estimate long-term costs and effects of treatment which span beyond the time-frame of a clinical trial, therefore providing a better understanding of the long-term implications of decisions that conventional trial-based economic evaluations fail to provide. This is particularly relevant for considering oral health interventions in children as treatments may affect adult oral health. However, in the field of child oral health there has not been an evaluation of the quality and scope of decision analytical models which extend into adulthood. The aim of this review is to examine the scope and quality of decision modelling studies, with horizons extending into adulthood, within the field of child oral health. METHODS: The following databases were searched: NHS Economic Evaluation Database (CRD York), MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, the Cochrane Library and Econlit. Full economic evaluations, in the field of child oral health, published after 1997 which included a decision model with a horizon that extended beyond the age of 18 years old were included. Included studies were appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by calibrated reviewers. RESULTS: Four hundred studies were identified, of which nine met the inclusion criteria. Of the nine, eight were cost-effectiveness models. The majority focussed on the prevention or management of dental caries. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 82% (median = 85%, range = 54-100%). Discounting of costs and performing an incremental analysis were noted as key methodological weaknesses. The mean percentage of applicable CHEERS criteria met by each study was 82% (median = 87%, range = 32-96%). Justifying the type of model, analytical methods used, and sources of funding were most commonly unreported. CONCLUSIONS: There is a paucity of decision analytical models in the field of child oral health. Most of those that are available are of high methodological and reporting quality.


Assuntos
Cárie Dentária , Saúde Bucal , Adolescente , Adulto , Criança , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Cárie Dentária/terapia , Humanos
6.
Mater Sci Eng C Mater Biol Appl ; 124: 112062, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33947556

RESUMO

This work aimed to study for the first time to our knowledge the influence of the structure of the dental flosses (DF) coated by hydroxyapatite nanoparticles (HAP NPs) on the biological performance of saliva probiotic bacteria (S. salivarius), and human dermal and osteoblast-like cells. We used three types of HAP@DF composites (based on two unwaxed dental flosses - "fluffy" and "smooth", and one waxed "smooth") with different morphologies. Obtained composites were characterized from the point of view of their structure, morphological characteristics, elemental and chemical composition. We observed that HAP NPs coated "smooth" dental flosses led to an increase of viability and proliferation of oral cavity probiotic bacteria (Streptococcus salivarius) and human cells (dermal fibroblasts and osteoblast-like). In contrast, the highest viability loss of probiotic bacteria (S. salivarius), fibroblasts, and osteoblast-like cells were observed for "fluffy" unwaxed dental flosses due to high cytotoxicity. Our studies showed that HAP NPs significantly improved the biological properties of "fluffy" dental floss. Pristine "smooth" DFs (waxed and unwaxed), as well as all HAP-coated DFs, induced acceptable biocompatibility toward selected human cells.


Assuntos
Cárie Dentária , Probióticos , Cárie Dentária/terapia , Durapatita , Humanos , Boca , Saliva
7.
BMC Oral Health ; 21(1): 221, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33931037

RESUMO

BACKGROUND: Women tend to delay dental treatment due to misconceptions regarding the safety of dental procedures during pregnancy which may negatively affect their quality of life. Minimally invasive restorative techniques offer alternatives for caries treatment and can improve their oral health-related quality of life (OHRQoL) during this stage. METHODS: A randomized controlled clinical trial was conducted in 2019 and included 162 pregnant women visiting public family health centers in Alexandria, Egypt, with mild to moderate dental pain due to caries. Participants were randomly assigned into Papacarie-Duo group (n = 82) and ART group (n = 80). The outcome variable was percent change in OHRQoL (oral health impact profile, OHIP-14) after 6 months. T test/Mann Whitney U test were used to compare groups and a multivariable linear regression analysis was conducted to evaluate the factors affecting the outcome variable. RESULTS: A significant reduction (P < 0.002) was noted in OHIP-14 between baseline and 6 months indicating improvement in OHRQoL in the Papacarie-Duo and ART groups (16.26% and 18.91%, P = 0.120 in bivariate analysis). Multiple linear regression revealed significantly greater reduction in OHIP-14 scores in the Papacarie-Duo than the ART group (regression coefficient = 4.03, 95% confidence interval: 0.652, 7.409, P = 0.020). CONCLUSION: Minimally invasive restorative techniques, such as ART and chemo-mechanical caries removal using Papacarie- Duo can improve the OHRQoL of pregnant women suffering from mild to moderate pain due to dental caries. Significantly more improvement was noted in the Papacarie-Duo group after adjusting all other variables. Trial registration ID NCT04619264 ( https://clinicaltrials.gov/ ); November 6 2020, retrospective registration. ( https://clinicaltrials.gov/ct2/show/NCT04619264?term=NCT04619264&draw=2&rank=1 ).


Assuntos
Tratamento Dentário Restaurador sem Trauma , Cárie Dentária , Assistência Odontológica , Cárie Dentária/terapia , Egito , Feminino , Humanos , Saúde Bucal , Gravidez , Gestantes , Qualidade de Vida , Estudos Retrospectivos
8.
Dent Clin North Am ; 65(3): 427-445, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34051924

RESUMO

Dental caries is a dynamic, preventable, reversible, complex biofilm-mediated, multifactorial disease that involves a series of demineralization/neutrality/remineralization of dental hard tissue in primary and permanent dentition. An imbalance in the continuum with a net demineralization over time results in the initiation of caries lesions. Visual inspection and intraoral radiographs are vital in caries detection, although they are of suboptimal sensitivity for early caries lesions. Shifting toward a conservative, noninvasive approach to caries management has resulted in the development of innovative-sensitive technologies. These newer techniques may serve as adjunct for the dental practitioner in detecting earliest changes in tooth structure.


Assuntos
Cárie Dentária , Radiologia , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/terapia , Odontólogos , Humanos , Papel Profissional , Radiografia
9.
Br Dent J ; 230(8): 523-527, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33893425

RESUMO

White enamel lesions are a common presentation to the general dentist and aesthetic concerns are the most frequent presenting problem. Aetiology may be multifactorial and management of such lesions is heavily dependent on the cause. In the paediatric patient, differentiating white lesions caused by caries, fluorosis and genetic and developmental disorders is key to offering optimal long-term treatment outcomes. Early intervention allows for carefully planned management of less common disorders. Many of these disorders exist along a spectrum, and white lesions offer a useful clue to prompt intervention and referral to the relevant specialists. This article overviews common white lesions of the teeth and outlines the hierarchy of management options available.


Assuntos
Cárie Dentária , Fluorose Dentária , Criança , Cárie Dentária/etiologia , Cárie Dentária/terapia , Suscetibilidade à Cárie Dentária , Esmalte Dentário , Estética Dentária , Humanos
10.
Stomatologiia (Mosk) ; 100(2): 40-43, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33874659

RESUMO

AIM: The analysis of the criteria for predicting the effectiveness and safety of the use of periodontal anesthesia methods in the treatment of dental caries was carried out. MATERIALS AND METHODS: The study involved 78 patients: 41 women and 37 men aged from 25 to 56 years without severe somatic pathology, who needed treatment for dental caries. Intraligamental and modified periodontal anesthesia using a 4% articaine solution with different concentrations of vasoconstrictor were used as methods of anesthesia. The «method of the local injection anesthesia of the tooth pulp evaluating¼ was used during the modified periodontal and intraligmental anesthesia which determines the criteria for predicting the effectiveness and safety of the planned anesthesia and which is based on determining the functional parameters of the tooth pulp such as electrical excitability and microcirculation. RESULTS: The obtained results demonstrated the high efficiency and safety of the modified periodontal anesthesia with 4% articaine with epinephrine 1:200 000, which is easier to use and does not require specialized equipment. CONCLUSION: Modified periodontal anesthesia is safe and effective for the treatment of dental caries.


Assuntos
Anestesia Dentária , Cárie Dentária , Adulto , Anestesia Local , Anestésicos Locais , Carticaína , Cárie Dentária/terapia , Método Duplo-Cego , Epinefrina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
J Dent Child (Chic) ; 88(1): 23-28, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33875048

RESUMO

Purpose: To describe and evaluate the oral health status and dental treatment needs of children with intellectual disabilities attending Special Olympics in Australia from 2010 to 2018.
Methods: This was a retrospective observational study. Children aged 18 years and younger with intellectual disabilities attending Special Olympics with their caregivers were screened between 2010 and 2018. Trained volunteer dentists performed the screening using the standardized Special Olympics Special Smiles protocol. Reported findings included presence or absence of untreated decay, filled teeth, missing teeth, trauma, fluorosis, and gingivitis as well as treatment urgency.
Results: A total of 155 children with a mean age of 15 years participated in the dental screening in 2010, 2014, and 2018. Twelve percent reported oral pain, 15 percent needed urgent care, 21 percent had untreated caries, 39 percent had filled teeth, 39 percent had missing teeth, 59 percent had signs of gingival disease, 8.4 percent had fluorosis, and 13 percent had dental trauma. Mouthguards were recommended for 17 percent of child athletes. Missing teeth and filled teeth were significantly lower in 2014 compared to 2010 and 2018 (P <0.001).
Conclusion: The burden of the untreated caries was not high in athletes attending the Special Olympics in Australia.


Assuntos
Cárie Dentária , Deficiência Intelectual , Esportes , Adolescente , Austrália/epidemiologia , Criança , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Humanos , Deficiência Intelectual/epidemiologia , Saúde Bucal
12.
Oper Dent ; 46(1): E60-E67, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33882138

RESUMO

CLINICAL RELEVANCE: The clinical performance of both conventional and flowable giomer restorative materials was particularly good in Class I restorations after three years of service. SUMMARY: This study evaluated and compared the clinical performance of a flowable and a conventional giomer restorative material after three years. Forty-four pairs of restorations (total n=88) were placed in Class I cavities with either a flowable giomer (Beautifil Flow Plus F00; Shofu Inc, Kyoto, Japan) or a conventional giomer restorative material (Beautifil II; Shofu Inc) after the application of a dentin adhesive (FL-Bond II; Shofu Inc) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 3 years, 39 pairs of restorations were evaluated with the modified United States Public Health Service criteria, and digital color photographs of restorations were taken at each patient visit. The evaluation parameters were as follows: color match, marginal integrity, marginal discoloration, retention, secondary caries formation, anatomic form, surface texture, and postoperative sensitivity. Evaluations were recorded as a clinically ideal situation (Alpha), a clinically acceptable situation (Bravo), or a clinically unacceptable situation (Charlie). Data were analyzed with Fisher's exact and McNemar tests (α=0.05).None of the restorations showed retention loss, postoperative sensitivity, secondary caries, or color change. The performance of Beautifil II in terms of marginal integrity, marginal discoloration, and surface anatomic form was significantly lower at the 36-month follow-up than at baseline (p=0.007). There were no significant differences between the baseline and 36-month follow-up scores for the other criteria for Beautifil II (p>0.05). No differences were found between the baseline and the 36-month follow-up scores for any of the criteria for Beautifil Flow Plus F00 (p>0.05). No statistically significant difference in overall clinical performance was found between the 2 materials after 36 months (p>0.05).The three-year clinical performance of both restorative materials (Beautifil Flow Plus F00 and Beautifil II) was very good and not significantly different for any of the parameters evaluated.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Cor , Resinas Compostas , Cárie Dentária/terapia , Adaptação Marginal Dentária , Materiais Dentários , Seguimentos , Humanos , Japão , Propriedades de Superfície
13.
Oper Dent ; 46(1): 87-99, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33882139

RESUMO

CLINICAL RELEVANCE: Effective methods to control incipient caries lesions are needed. In this investigation, several methods provide encouraging results. SUMMARY: This study aimed to evaluate in situ the inhibition of incipient caries lesion progression using different treatment protocols and to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, DIAGNOdent pen, and VistaProof fluorescence camera [FC]) in monitoring this process. The research was conducted in four phases: (1) at baseline, (2) after a first cariogenic challenge, (3) after treatment modalities, and (4) after a second cariogenic challenge. Sixteen volunteers used intraoral acrylic palatal appliances, each containing six enamel blocks (n=96). The cariogenic challenge was performed using a 20% sucrose solution over a 14-day period. The appliances were removed eight times a day and, upon removal, two drops of the solution were placed onto each enamel block. The enamel blocks were randomly assigned to three treatment groups: fluoride varnish ([FV] Duraphat; n=32), resin infiltrant ([RI] Icon; n=32), and adhesive system ([AS] Scotchbond; n=32). At the end of each phase, the surface microhardness (SMH) was measured, and two trained examiners evaluated the specimens using fluorescence-based methods. In addition, integrated mineral loss (ΔΔZ; vol%.min x µm) and lesion depth (ΔLD; µm) were evaluated using transverse microradiography. A two-way analysis of variance and a Tukey post hoc test were calculated (α=5%). Significant differences in SMH were observed according to the treatment, phases, and interaction of factors (p<0.001). Treatment with FV resulted in significantly higher SMH values in phases 3 and 4 compared to RI and AS, with the last two treatments resulting in similar values (p>0.05). The ΔΔZ value was similar for FV and AS but significantly higher for RI (p=0.016). ΔLD was not significantly different among the groups (p=0.126). Significant differences in the measurement of fluorescence for each fluorescence-based method were observed between each phase of the study (p<0.05). It can be concluded that all treatments were effective in inhibiting the in situ progression of incipient lesions, although to different degrees, with minor mineral loss changes observed for the AS and FV. Besides, all fluorescence-based methods tested, except for that using the FC device, were effective in monitoring caries lesion progression.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Cariostáticos , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Esmalte Dentário , Fluorescência , Humanos , Microrradiografia
14.
J Dent Child (Chic) ; 88(1): 52-57, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33875053

RESUMO

Purpose: To evaluate the effect of caries management on the periodontal status of preschool and school-age children.
Methods: Twenty-six four- to eight-year-old children with at least one primary molar with a deep carious lesion were selected to undergo a periodontal evaluation before and six months after dental treatment. Two examiners conducted the periodontal exams using the visible plaque index (VPI) and gingival bleeding index (GBI). Longitudinal changes were compared using paired t-test and Fisher's test. Poisson regression models were used to investigate the variables influencing GBI (α =five percent).
Results: There were no significant differences in the mean percentage of VPI-positive sites (55.8±26.9 percent to 54.5±29.8 percent; P =0.829) and GBI-positive sites (37.2±22.2 percent to 32.1±22.8 percent; P =0.222) before and after treatment. In contrast, the mean number of GBI sites decreased from 8.5±5.03 to 6.3±4.39 (P =0.026), while the percentage of patients presenting GBI of no more than 10 percent increased from 11.5 percent to 26.9 percent over time (P =0.013). Similar analyses for VPI did not show a statistical significance. Boys (P =0.037) and six- to eight-year-old children ( P =0.029) had lower reductions on GBI.
Conclusion: Caries management has a positive impact on the periodontal condition of children, especially on gingival bleeding.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Criança , Pré-Escolar , Cárie Dentária/terapia , Índice de Placa Dentária , Humanos , Masculino , Índice Periodontal , Instituições Acadêmicas
15.
BMC Oral Health ; 21(1): 167, 2021 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789643

RESUMO

BACKGROUND: Studies have questioned the necessity of restoring cavitated carious lesion on primary teeth, once the control of biofilm is the most important factor to arrest these lesions. This randomized clinical trial aimed to compare the survival of teeth treated with a non-restorative cavity control (NRCC) compared to resin composite restorations (RCR) on proximal carious lesion in anterior primary teeth, as well as the impact of these treatments on patient-centered outcomes. METHODS: A randomized clinical trial with two parallels arms (1:1) will be conducted. Children between 3 and 6 years old will be selected from the Center of Clinic Research of Pediatric Dentistry of Ibirapuera University (UNIB), a dental trailer (FOUSP) located on Educational Complex Professor Carlos Osmarinho de Lima, the Pediatric Dentistry Clinic of Santa Cecília University and from the Pediatric Dentistry Clinic of University Center UNINOVAFAPI. One hundred and forty-eight teeth will be randomly distributed in two experimental groups: (1) Selective removal of carious tissue and RCR; or (2) NRCC through cavity enlargement using a metallic sandpaper. The primary outcome will be tooth survival after 6, 12, 18 and 24 months. The duration and the cost of dental treatments will be considered for the estimation of the cost-effectiveness of the evaluated treatments. The discomfort reported by the participants will be measured after each treatment using the FIS scale. The participants' satisfaction and perception of the parents/legal guardians will be evaluated through questionnaires. For the primary outcome, Kaplan-Meier's survival and Long-Rank test will be used for comparison between the two groups. All the variables will be modeled by Cox regression with shared fragility. Significance will be considered at 5%. DISCUSSION: The NRCC could be an option to manage carious lesions on proximal surfaces of primary teeth, and the approach could be well accepted by the children and parents/legal guardians. Trial registration Clinicaltrials.gov registration: NCT03785730, Registered on December 18th 2018, first participant recruited 30/04/2019, https://clinicaltrials.gov/ct2/show/NCT03785730 . Ethics Reference No: 91569118.8.0000.5597. Trial Sponsor: Universidade Ibirapuera. The Trial was prospectively registered.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Criança , Pré-Escolar , Resinas Compostas , Cárie Dentária/terapia , Humanos , Assistência Centrada no Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Dente Decíduo
16.
Niger J Clin Pract ; 24(4): 584-594, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33851682

RESUMO

Background: Dental caries is a multifactorial disease that causes reversible decalcification and cavitation of susceptible teeth exposed to sugary substrates over a period of time in the oral cavity. It gives clinical and social burdens to the child patients and their parents/carers. Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars. Aims: The Hall technique is a biologic method of managing primary teeth by sealing in the caries with preformed metal crowns (SSCs). The objectives of this study were to assess and compare the primary and secondary treatment outcomes of stainless steel crown restorations using the conventional method and the Hall technique in primary molars immediately after placement and over a 12-month period using both clinical and radiological parameters. Methods: The study was a randomized control clinical trial using a split mouth approach. A total of 25 stainless steel crown restorations using the conventional method and 25 stainless steel crown restorations using the Hall technique were placed in 25 subjects aged 3-8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch, and extent of caries. All subjects were monitored and reviewed every 3 months for 12 months. Results: Twenty three subjects returned for follow-up. There was no statistically significant difference (P-value > 0.05) between the conventional SSC restoration and the Hall technique for both the primary outcomes/major failures (irreversible pulpitis, dental abscess, peri-radicular radiolucency, and crown loss with tooth unrestorable) and secondary outcomes/minor failures (crown loss and tooth restorable, crown perforation, secondary/marginal caries, and reversible pulpitis). But, there was a statistical significant difference in the average time taken for the placement of the restorations between the two groups (P-value 0.001). Conclusion: Both the conventional SSC restorations and the Hall technique can be provided for all the subjects in this study. The Hall Technique compared favorably well with the conventional SSC restoration in clinical and radiological outcomes. The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and treatment under general aaesthesia can sometimes be a problem.


Assuntos
Cárie Dentária , Aço Inoxidável , Criança , Pré-Escolar , Coroas , Cárie Dentária/terapia , Falha de Restauração Dentária , Restauração Dentária Permanente , Humanos , Dente Molar/diagnóstico por imagem , Dente Decíduo , Resultado do Tratamento
17.
Pediatr Dent ; 43(1): 44-49, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33662250

RESUMO

Purpose: To determine the effect of a dental curing light on the penetration depth of silver diamine fluoride (SDF), dentin hardness, and silver and fluoride ion precipitation into cavitated carious lesions. Methods: SDF was applied on 16 primary incisors extracted due to caries extending into dentin. Teeth were divided into two groups: (1) control group, was not light-cured; and (2) test group, was light-cured. A scanning electron microscope, and OmniMet software were used to measure penetration depth, dentin hardness, and ion precipitation. Wilcoxon's ranksum test was used for statistical analysis. Results: All samples in both groups showed SDF penetration beyond the carious lesion and into sound dentin. The penetration depth into sound dentin was 70 µm further without the dental curing light it (P<0.001). Silver precipitation in infected dentin with the dental curing light was approximately 2.6 times greater than without it (P=0.02). Dentin hardness of infected dentin was 26 percent more with the dental curing light (P=0.04). Conclusions: Applying a dental curing light during silver diamine fluoride treatment of carious lesions induces more silver ion precipitation in infected dentin, increases its hardness, and, perhaps because more silver stays in the infected dentin, less SDF penetrates into sound dentin.


Assuntos
Luzes de Cura Dentária , Cárie Dentária , Cárie Dentária/terapia , Dentina , Fluoretos Tópicos , Humanos , Incisivo , Cura Luminosa de Adesivos Dentários , Compostos de Amônio Quaternário , Compostos de Prata
18.
Niger J Clin Pract ; 24(3): 425-434, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33723119

RESUMO

Objective: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars. Materials and Methods: This clinical study observed 35 children (aged 4-8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05). Results: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05). Conclusion: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.


Assuntos
Cárie Dentária , Aço Inoxidável , Criança , Pré-Escolar , Coroas , Cárie Dentária/terapia , Suscetibilidade à Cárie Dentária , Restauração Dentária Permanente , Humanos , Dente Molar , Dente Decíduo
19.
Evid Based Dent ; 22(1): 20-21, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33772125

RESUMO

Aim This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to compare the efficacy of different caries removal techniques: complete caries removal (CCR), selective caries removal (SCR) and stepwise caries removal (SWR) for deep carious lesions in vital primary teeth.Data sources The design of this review followed the PRISMA guidance ( http://www.prisma-statement.org/ ). Relevant studies were identified using electronic databases (PubMed [Medline], Cochrane Library, EMBASE) and finally reference lists were screened. The US National Institutes of Health Trials Register (NIHTR; http://clinicaltrials.gov ) and World Health Organisation International Clinical Trials Registry Platform (WHO ICTRP; http://apps.who.int/trialsearch ) were used to help assess publication bias, as it was not possible to test funnel plot asymmetry. Duplicates were located and eliminated using EndNote X7 programme.Study selection To be included, studies had to be published RCTs comparing SCR or SWR with CCR as caries removal strategies for deep carious lesions in vital primary teeth. The outcomes were pulp exposure, pulpo-periodontal complications (clinical and radiological failures) and/or restorative failures. RCTs applying these caries removal techniques were excluded if one of the other trial arms did not involve caries removal (that is, Hall Technique, therapeutic sealing of cavity lesions). Initially, 1,374 potentially eligible articles were identified, out of which 15 (English or French language only) were selected for full-text screening, which included ten relevant references corresponding to eight studies.Data extraction and synthesis Two authors independently extracted data using a piloted data extraction sheet, with a third reviewer resolving any disagreements. The authors performed conventional intention-to-treat and per-protocol meta-analyses, and calculated odds ratios (ORs) as effect estimates in the random-effects model, using Revman5.Results The eight included RCTs were conducted between 1977 and 2018. They include 669 patients and 824 teeth, with follow-up ranging from four weeks to 24 months. Collective results showed reduced risk of pulp exposure after SCR (OR: 0.10, 95% CI [0.04, 0.25]) or SWR (OR: 0.20, 95% CI [0.09, 0.44]), compared with CCR. There was a higher risk of composite restorative failure (OR: 2.61, 95% CI [1.05, 6.49]) using United States Public Health Service (USPHS) criteria, after SCR was compared with CCR only in intention-to-treat analysis. However, when comparing the risk of clinical or radiographic failure of pulpo-periodontal complications, no difference was found between SCR, CCR or SWR.Conclusion The conclusions of the paper are that there is a significant decrease in pulp exposure risk with SCR and SWR in comparison with CCR. However, there is a need for further studies with less risk of bias powered to report on the long-term outcomes of pulpo-periodontal health and restoration longevity.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Gerenciamento de Dados , Cárie Dentária/terapia , Humanos , Dente Molar , Dente Decíduo , Estados Unidos
20.
Evid Based Dent ; 22(1): 32-33, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33772131

RESUMO

Design Randomised controlled trial study.Case selection Ninety-nine subjects were chosen from 219 potential subjects. The 99 who met the inclusion criteria were randomly allocated to two treatment groups: atraumatic restorative treatment (ART) and conventional treatment (CT). To be selected, patients needed to be 65 years or over, follow oral hygiene guidance and have one or more painless dentinal carious lesions. To establish suitability, a full dental examination was performed by two calibrated dentists. Prior to receiving ART or CT, all participants received standard dental care (including extractions, non-surgical treatment and oral hygiene instructions). Following ART or CT, a dental nurse collected data regarding patient treatment preferences and a calibrated independent dentist, blind to the treatment allocation, reviewed restorations six months, one year, two years and five years after treatment.Data analysis The Cox proportional-hazards (PH) model was used to assess the cumulative survival of the variables ART and CT between the intervals. Bootstrapping was employed to estimate standard errors since the multiple restorations required by many patients were not necessarily independent of each other.Results Of the 99 subjects included, only 28 (ART: 15, CT: 13) remained after five years. After five years, of the 300 restorations undertaken, 15 ART restorations and 16 CT restorations failed. The cumulative probability of restoration survival was 85% and 79% (p = 0.8095) for ART and CT, respectively, with the Cox PH model showing the treatment used had no effect on the restorations' survival.Conclusions No significant difference was noted between the treatment methods used in terms of survival of the restorations. However, it is worth noting that 64.5% of participants preferred to have dental treatment without local anaesthesia and 71.1% without the use of a dental drill. Therefore, ART was a favourable treatment option in older patients, particularly those unable to attend the dental surgery.


Assuntos
Tratamento Dentário Restaurador sem Trauma , Cárie Dentária , Idoso , Cárie Dentária/terapia , Falha de Restauração Dentária , Humanos , Modelos de Riscos Proporcionais
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