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1.
BMC Oral Health ; 21(1): 185, 2021 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-33845806

RESUMO

High-resolution micro-computed tomography is a powerful tool to analyze and visualize the internal morphology of human permanent teeth. It is increasingly used for investigation of epidemiological questions to provide the dentist with the necessary information required for successful endodontic treatment. The aim of the present paper was to propose an image processing method to automate parts of the work needed to fully describe the internal morphology of human permanent teeth. One hundred and four human teeth were scanned on a high-resolution micro-CT scanner using an automatic specimen changer. Python code in a Jupyter notebook was used to verify and process the scans, prepare the datasets for description of the internal morphology and to measure the apical region of the tooth. The presented method offers an easy, non-destructive, rapid and efficient approach to scan, check and preview tomographic datasets of a large number of teeth. It is a helpful tool for the detailed description and characterization of the internal morphology of human permanent teeth using automated segmentation by means of micro-CT with full reproducibility and high standardization.


Assuntos
Cavidade Pulpar , Dentição Permanente , Humanos , Processamento de Imagem Assistida por Computador , Reprodutibilidade dos Testes , Raiz Dentária , Microtomografia por Raio-X
2.
BMC Oral Health ; 21(1): 199, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33874922

RESUMO

BACKGROUND: The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. METHODS: 30 subjects (14 males, 16 females; mean age of 24.53 ± 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome "Tor Vergata" from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5-6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by "Diagnostic" OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1-T0 differences were tested with dependent sample t-test (P < 0.05). RESULTS: In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. CONCLUSIONS: The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software.


Assuntos
Aparelhos Ortodônticos Removíveis , Adolescente , Adulto , Criança , Arco Dental , Esmalte Dentário , Dentição Permanente , Feminino , Humanos , Masculino , Maxila , Dente Molar , Adulto Jovem
3.
Am J Orthod Dentofacial Orthop ; 159(4): 512-521, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33795092

RESUMO

INTRODUCTION: This study aimed to evaluate the efficiency of a newly constructed computer-based decision support system (DSS) on the basis of artificial intelligence technology and designed to plan treatment for patients with a deep overbite. METHODS: With the help of information technology, a DSS was developed specifically for treatment planning of deepbite malocclusion. The program inputs were the components and the contributing factors used commonly by the orthodontic clinicians in deepbite diagnosis. The program outputs were the treatment planning options for deepbite treatment. A total of 357 decisions made by the algorithm were evaluated for accuracy by comparing them to the actual treatment changes of 51 patients with a well-treated deepbite. RESULTS: The decisions made by the algorithm were precise, with 94.4% having a very good agreement with actual treatment changes determined using Cohen's kappa coefficient. CONCLUSIONS: The constructed DSS was shown to be an efficient tool for planning treatment of deep overbite malocclusion in the permanent dentition; thus, the artificial intelligence could be used to formulate a customized plan for orthodontic clinicians.


Assuntos
Inteligência Artificial , Má Oclusão , Algoritmos , Cefalometria , Dentição Permanente , Humanos , Má Oclusão/terapia , Mandíbula
4.
Artigo em Inglês | MEDLINE | ID: mdl-33803857

RESUMO

The nonsuppurative osteomyelitis of the mandible is a rare condition that can occur in children due to low-grade inflammatory processes, dental cavities, periodontal lesions as well as the eruption process of the teeth. We submit a case report involving the orthodontic management of a 9-year-old female patient who presented in our service in the mixed dentition period with diagnosed Garre's sclerosing osteomyelitis of the entire mandibular body. After a full work-up, the following symptoms and signs were noted: bilateral temporomandibular joint (TMJ) pain, loss of the leeway space, anterior open bite, distalization of the secondary maxillary right canine, nail biting and tongue thrust. Our orthodontic objectives were to relieve the TMJ pain, limit the eruption process of the teeth and to diminish the evolution of the osteomyelitis, reduce the growth of the inferior lower third of the face and to prevent further invasive treatment of the patient. In the first phase of treatment, we established a centric relationship using an orthopedic appliance (occlusal splint) and physiotherapy to deprogram the muscles and the TMJ. Throughout the second phase of treatment, we used orthopedic appliances to inhibit the overeruption of the secondary molars. After another year of treatment, the osteomyelitis lesions were under control with the permanent teeth in final position, good facial esthetic and as a functional result, no root resorption. We can conclude that by using low physiological forces to direct and control the growth pattern, good results could be obtained in stabilizing and controlling the sclerosing osteomyelitis of the mandible.


Assuntos
Mandíbula , Osteomielite , Criança , Dentição Mista , Dentição Permanente , Feminino , Humanos , Dente Molar , Osteomielite/terapia
5.
Cochrane Database Syst Rev ; 3: CD014545, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33720395

RESUMO

BACKGROUND: The detection and diagnosis of caries at the earliest opportunity is fundamental to the preservation of tooth tissue and maintenance of oral health. Radiographs have traditionally been used to supplement the conventional visual-tactile clinical examination. Accurate, timely detection and diagnosis of early signs of disease could afford patients the opportunity of less invasive treatment with less destruction of tooth tissue, reduce the need for treatment with aerosol-generating procedures, and potentially result in a reduced cost of care to the patient and to healthcare services. OBJECTIVES: To determine the diagnostic accuracy of different dental imaging methods to inform the detection and diagnosis of non-cavitated enamel only coronal dental caries. SEARCH METHODS: Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 31 December 2018); Embase Ovid (1980 to 31 December 2018); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 31 December 2018); and the World Health Organization International Clinical Trials Registry Platform (to 31 December 2018). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA: We included diagnostic accuracy study designs that compared a dental imaging method with a reference standard (histology, excavation, enhanced visual examination), studies that evaluated the diagnostic accuracy of single index tests, and studies that directly compared two or more index tests. Studies reporting at both the patient or tooth surface level were included. In vitro and in vivo studies were eligible for inclusion. Studies that explicitly recruited participants with more advanced lesions that were obviously into dentine or frankly cavitated were excluded. We also excluded studies that artificially created carious lesions and those that used an index test during the excavation of dental caries to ascertain the optimum depth of excavation. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently and in duplicate using a standardised data extraction form and quality assessment based on QUADAS-2 specific to the clinical context. Estimates of diagnostic accuracy were determined using the bivariate hierarchical method to produce summary points of sensitivity and specificity with 95% confidence regions. Comparative accuracy of different radiograph methods was conducted based on indirect and direct comparisons between methods. Potential sources of heterogeneity were pre-specified and explored visually and more formally through meta-regression. MAIN RESULTS: We included 104 datasets from 77 studies reporting a total of 15,518 tooth sites or surfaces. The most frequently reported imaging methods were analogue radiographs (55 datasets from 51 studies) and digital radiographs (42 datasets from 40 studies) followed by cone beam computed tomography (CBCT) (7 datasets from 7 studies). Only 17 studies were of an in vivo study design, carried out in a clinical setting. No studies were considered to be at low risk of bias across all four domains but 16 studies were judged to have low concern for applicability across all domains. The patient selection domain had the largest number of studies judged to be at high risk of bias (43 studies); the index test, reference standard, and flow and timing domains were judged to be at high risk of bias in 30, 12, and 7 studies respectively. Studies were synthesised using a hierarchical bivariate method for meta-analysis. There was substantial variability in the results of the individual studies, with sensitivities that ranged from 0 to 0.96 and specificities from 0 to 1.00. For all imaging methods the estimated summary sensitivity and specificity point was 0.47 (95% confidence interval (CI) 0.40 to 0.53) and 0.88 (95% CI 0.84 to 0.92), respectively. In a cohort of 1000 tooth surfaces with a prevalence of enamel caries of 63%, this would result in 337 tooth surfaces being classified as disease free when enamel caries was truly present (false negatives), and 43 tooth surfaces being classified as diseased in the absence of enamel caries (false positives). Meta-regression indicated that measures of accuracy differed according to the imaging method (Chi2(4) = 32.44, P < 0.001), with the highest sensitivity observed for CBCT, and the highest specificity observed for analogue radiographs. None of the specified potential sources of heterogeneity were able to explain the variability in results. No studies included restored teeth in their sample or reported the inclusion of sealants. We rated the certainty of the evidence as low for sensitivity and specificity and downgraded two levels in total for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the in vitro studies, and the observed inconsistency of the results. AUTHORS' CONCLUSIONS: The design and conduct of studies to determine the diagnostic accuracy of methods to detect and diagnose caries in situ are particularly challenging. Low-certainty evidence suggests that imaging for the detection or diagnosis of early caries may have poor sensitivity but acceptable specificity, resulting in a relatively high number of false-negative results with the potential for early disease to progress. If left untreated, the opportunity to provide professional or self-care practices to arrest or reverse early caries lesions will be missed. The specificity of lesion detection is however relatively high, and one could argue that initiation of non-invasive management (such as the use of topical fluoride), is probably of low risk. CBCT showed superior sensitivity to analogue or digital radiographs but has very limited applicability to the general dental practitioner. However, given the high-radiation dose, and potential for caries-like artefacts from existing restorations, its use cannot be justified in routine caries detection. Nonetheless, if early incidental carious lesions are detected in CBCT scans taken for other purposes, these should be reported. CBCT has the potential to be used as a reference standard in diagnostic studies of this type. Despite the robust methodology applied in this comprehensive review, the results should be interpreted with some caution due to shortcomings in the design and execution of many of the included studies. Future research should evaluate the comparative accuracy of different methods, be undertaken in a clinical setting, and focus on minimising bias arising from the use of imperfect reference standards in clinical studies.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Conjuntos de Dados como Assunto , Cárie Dentária/diagnóstico por imagem , Radiografia Dentária/métodos , Adulto , Viés , Criança , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Dentição Permanente , Reações Falso-Negativas , Reações Falso-Positivas , Humanos , Radiografia Dentária/estatística & dados numéricos , Radiografia Dentária Digital/estatística & dados numéricos , Padrões de Referência , Sensibilidade e Especificidade , Dente Decíduo
6.
BMC Oral Health ; 21(1): 105, 2021 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-33750357

RESUMO

BACKGROUND: Ethnic background has been claimed to affect arch form. The purpose of this study was to describe and elucidate the maxillary and mandibular arch forms in Jordanian population and to develop a classification method for these forms which could be employed to construct orthodontic archwires accordingly. METHODS: The sample was comprised of study casts of five hundred and twenty subjects (231 males and 289 females with a mean age of 15.4 ± 1.02 years). All subjects had permanent dentition with normal occlusion. A mathematical method associated with a polynomial function of 6th degree was employed to assess the dental arch forms. The resultant arch forms were classified into 5 groups for both the maxilla and mandible utilizing a computer software with special code designed for this study. Each group was subdivided into 3 subgroup sizes namely: small, medium, and large. RESULTS: Catenary arch form was found in 47% and 41.2% (p Ë‚ 0.01) of maxilla and mandible arch forms, respectively. Form 2 (which is halfway between ellipse and U-shaped arch form) was found in 27.7% and 26.7%. Medium size arch form was found in 55.4% of the maxillary and 65.6% of the mandibular arch forms. CONCLUSION: Catenary arch form was the most prevalent arch form, followed by wide elliptical form. The other forms, which included tudor arch, tapered equilateral and quadrangular forms were less frequent. Regarding size, the medium size was the most prevalent among the studied samples.


Assuntos
Arco Dental , Maxila , Adolescente , Cefalometria , Modelos Dentários , Dentição Permanente , Feminino , Humanos , Masculino , Mandíbula , Aparelhos Ortodônticos
7.
J Am Dent Assoc ; 152(4): 269-276.e2, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33775286

RESUMO

BACKGROUND: Untreated caries (UC), although highly prevalent, is largely preventable. Information on the contribution of different teeth to UC prevalence and severity could be helpful in evaluating UC surveillance protocols and the relative benefits of caries prevention interventions. METHODS: The authors combined data from 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey for participants aged 6 through 11 years, 12 through 19 years, 20 through 34 years, 35 through 49 years, 50 through 64 years, 65 through 74 years, and 75 years and older. For each age group the authors calculated the contribution of successive permanent tooth types (for example, first molars and second molars) to UC prevalence and severity. RESULTS: UC prevalence and the percentage of prevalence detected by means of screening molars were, respectively, 5% and 95% among participants aged 6 through 11 years; 16% and 92% among participants aged 12 through 19 years; 29% and 86% among participants aged 20 through 34 years; 26% and 70% among participants aged 35 through 49 years; 21% and 48% among participants aged 50 through 64 years; 16% and 36% among participants aged 65 through 74 years; and 17% and 25% among participants 75 years and older. Among adults aged 50 years and older, no teeth appeared to capture a disproportionate share of UC prevalence. Molars accounted for 87%, 79%, and 56% of severity among participants aged 6 through 11 years, 12 through 19 years, and 20 through 34 years, respectively. After age 34 years, molars accounted for less than 50% of severity. CONCLUSIONS: Molars are the tooth type most susceptible to UC well into adulthood. PRACTICAL IMPLICATIONS: Molars could be used as sentinel teeth for surveillance of UC and adults could benefit from caries prevention that targets molars.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Adulto , Idoso , Criança , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Dentição Permanente , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Vigilância em Saúde Pública , Adulto Jovem
9.
Eur J Paediatr Dent ; 22(1): 55-60, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33719484

RESUMO

AIM: In the literature, no single therapeutic approach is preferred for treating dental pulp responses such as pulp canal obliteration (PCO). Some authors still recommend preventive endodontic treatment, whereas others choose not to intervene, to avoid causing possible iatrogenic complications. This review was conducted to explore, in the current scientific literature, the degree of knowledge concerning the onset and development of PCO and pulp necrosis (PN) following dental trauma (i.e. extrusive luxation and lateral luxation) in children and young adults (6-20 years). The authors also evaluated whether and to what extent the stage of dental root development at the time of traumatic dental injury (TDI) influences these pulp responses, and whether PN can arise in teeth already affected by PCO. MATERIALS AND METHODS The literature search was carried out during the period October 2019 to January 2020, using the following databases: PubMed/MEDLINE, SCOPUS and Web of Science. Articles in English reporting on young patients with PCO or PN in permanent teeth affected by trauma were included. Theresearch, whose questions were summarised according to the PICO method, considered the following aspects: patient age, type of TDI, stage of root development, initial treatment, presence of calcification or necrosis, time to onset of the two outcomes (PCO and PN), and duration of follow-up. The articles found were evaluated by two reviewers; in the event of disagreement regarding the inclusion of an article, a third reviewer was called upon to decide. RESULTS: The initial screening of the databases, using the selected search keywords, yielded a total of 343 articles. After exclusion of duplicates and articles not meeting the inclusion criteria, 11 articles remained. Of these, only four completely met the inclusion criteria. Closer analysis of these four publications revealed that they would not easily yield standardised sets of clinical data that might be homogenised in order to produce clear meta-analytical data. Hence the need to limit the data collected to the following seven items: number and type of injuries, type of initial intervention, duration of follow-up, main pulp responses, number and type of pulp responses. CONCLUSIONS: PCO is a physiological pulp response associated with a traumatic event, usually a luxation injury. It is diagnosed on the basis of combined radiographic and clinical-anamnesticdata. Signs of PCO start to appear at around one year after the traumatic event, and its development reaches completion by about five years post-trauma. PN, on the other hand, is clearly apparent within the first year. Endodontic treatment, be it carried out as a preventive measure or following detection of PCO, is inappropriate and can cause serious iatrogenic damage. Treatment is indicated only in cases of definite PN.


Assuntos
Avulsão Dentária , Criança , Cavidade Pulpar , Necrose da Polpa Dentária/etiologia , Dentição Permanente , Humanos , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-33528463

RESUMO

This study aimed to characterize extraction sockets based on indirect digital root analysis. The outcomes of interest were estimated socket volume and dimensions of the socket orifice. A total of 420 extracted teeth, constituting 15 complete sets of permanent teeth (except third molars), were selected. Teeth were scanned to obtain STL files of the root complex for digital analysis. After digitally sectioning each root 2.0 mm apical to the cementoenamel junction (CEJ), root volume was measured in mm3 and converted to cc. Subsequently, a horizontal section plane was drawn at the most zenithal level of the buccal CEJ, and the surface area (in mm2) and buccolingual and mesiodistal linear measurements of the socket orifice (in mm) were computed. Maxillary first molars exhibited the largest mean root volume (0.451 ± 0.096 cc) and mandibular central incisors the smallest (0.106 ± 0.02 cc). Surface area analysis demonstrated that mandibular first molars presented the largest socket orifice area (78.56 ± 10.44 mm2), with mandibular central incisors presenting the smallest area (17.45 ± 1.82 mm2). Maxillary first molars showed the largest mean socket orifice buccolingual dimension (11.08 ± 0.60 mm), and mandibular first molars showed the largest mean mesiodistal dimension (9.73 ± 0.84 mm). Mandibular central incisors exhibited the smallest mean buccolingual (5.87 ± 0.26 mm) and mesiodistal (3.52 ± 0.24 mm) linear dimensions. Findings from this study can be used by clinicians to efficiently plan extraction-site management procedures (such as alveolar ridge preservation via socket grafting and sealing) and implant provisionalization therapy, and by the industry to design products that facilitate site-specific execution of these interventions.


Assuntos
Processo Alveolar , Extração Dentária , Dentição Permanente , Humanos , Dente Molar/cirurgia , Dente Serotino , Alvéolo Dental/cirurgia
11.
Am J Orthod Dentofacial Orthop ; 159(5): 682-692, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33495060

RESUMO

The first molar has been reported to be the most caries prone tooth in the permanent dentition. Orthodontists are treating more adult patients who are more likely to have missing and severely decayed first molars. This article will show the various orthodontic and restorative options for first molars that are already extracted or have to be extracted. The following clinical situations will be addressed: molar uprighting and its advantages for the future restoration vs orthodontic space closure, strategic extraction of salvable first molars, impacted molars, and early extraction of compromised permanent first molars in young children.


Assuntos
Dente Molar , Dente Impactado , Adulto , Criança , Pré-Escolar , Arco Dental , Dentição Permanente , Humanos , Fechamento de Espaço Ortodôntico , Extração Dentária , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
12.
BMC Oral Health ; 21(1): 13, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413327

RESUMO

BACKGROUND: Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. METHODS: Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. RESULTS: In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15-0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18-0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20-0.45; permanent dentition: OR = 0.20, 95% CI 0.14-0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.17, 95% CI 0.10-0.29; and high risk: OR = 0.14, 95% CI 0.07-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.20, 95% CI 0.10-0.39; and high risk: OR = 0.14, 95% CI 0.05-0.37). CONCLUSION: Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Bases de Dados Factuais , Cárie Dentária/prevenção & controle , Dentição Permanente , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Dente Decíduo
13.
Br Dent J ; 230(2): 77-82, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33483661

RESUMO

This is the first article in a series reviewing the current literature surrounding the management of deep caries in permanent teeth. Approaches to caries management are continuing to evolve, with more conservative management increasingly favoured. This philosophy has never been more important than in managing the deep carious lesion. Evidence is emerging that the use of selective caries removal to reduce the risk of pulp exposure, in conjunction with calcium silicate cements, can be successful in maintaining pulp vitality, delaying the restorative cycle and prolonging the lifespan of the tooth.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Assistência Odontológica , Cárie Dentária/terapia , Polpa Dentária , Restauração Dentária Permanente , Dentição Permanente , Humanos
14.
PLoS One ; 16(1): e0244927, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33507984

RESUMO

We tested the effect of an annual caries preventive intervention, delivered by a fly-in/fly-out oral health professional team, with Indigenous children residing in a remote Australian community. Around 600 Indigenous children aged 5 to 17 years were invited to participate at baseline, of who 408 had caregiver consent. One hundred and ninety-six consented to the epidemiological examination and intervention (Intervention group) and 212 consented to the epidemiological examination only (Comparison group). The intervention, which occurred annually, comprised placement of fissure sealants on suitable teeth, and application of povidone-iodine and fluoride varnish to the whole dentition, following completion of any necessary restorative dental treatment. Standard diet and oral hygiene advice were provided. Caries increment (number of tooth surfaces with new dental caries) in both deciduous and permanent dentitions was measured at the 2-year follow-up. Comparison group children had significantly higher number of new surfaces with advanced caries in the permanent dentition than the Intervention group (IRR = 1.61; 95% CI: 1.02-2.54; p = 0.04); with a preventive fraction of 43%. The effect of intervention remained significant with children in the Comparison group developing significantly more advanced caries lesions in the permanent dentition than the Intervention group children in the adjusted multivariable analysis (IRR = 2.21; 95% CI: 1.03-4.71). Indigenous children exposed to the intervention had less increment in advanced dental caries in the permanent dentition than those not exposed to the intervention.


Assuntos
Cárie Dentária/epidemiologia , Dentição Permanente , Povos Indígenas/estatística & dados numéricos , Austrália/epidemiologia , Austrália/etnologia , Criança , Feminino , Humanos , Masculino
15.
Nutrients ; 13(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33430295

RESUMO

Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (<30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children's demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d1-6mft/D1-6MFT > 0), and advanced caries (d3-6mft/D3-6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children's vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ≤7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.


Assuntos
Cárie Dentária/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Dentição Permanente , Feminino , Humanos , Modelos Logísticos , Masculino , Portugal/epidemiologia , Prevalência , Saúde Pública , Fatores de Risco , Inquéritos e Questionários , Vitamina D/análogos & derivados , Deficiência de Vitamina D/epidemiologia
16.
Monogr Oral Sci ; 29: 53-64, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427220

RESUMO

Caries is a complex microbial disease characterized by a multifactorial etiology. The disease is driven by cariogenic microbiota that metabolize dietary carbohydrates into acids, creating prolonged periods of low pH on the biofilm surrounding the teeth, which will result in loss of calcium from the teeth leading to carious lesions. Caries remains a major public health problem globally, ranking first for the decay of permanent teeth (2.3 billion people) and 12th for deciduous teeth (560 million children) according to the Global Burden of Disease study by the WHO in 2015. Different factors play a role in the development of the disease: (i) individual factors such as tooth morphology, saliva, and the oral microbiome, (ii) behavioral factors such as frequency and amount of fermentable carbohydrates in the host's diet and overall oral hygiene, and (iii) socioeconomic status and host genetics as well as modifying factors such as fluoride. Various models exist which explain the transition from a health-compatible oral microbiota to a cariogenic microbiota. Longitudinal studies may increase our knowledge of the oral microbial compositions in different age groups by analyzing the temporal sequence leading to carious lesions. Understanding the factors which control microbial colonization early in life as well as the keystone species that should be present or absent may provide us with strategies for the acquisition and maintenance of a health-promoting oral microbiome. Thus, the importance lies in understanding caries etiology to improve strategies for diagnosis, risk assessment, prevention, and (operative) treatment.


Assuntos
Cárie Dentária , Microbiota , Biofilmes , Criança , Dentição Permanente , Humanos , Saliva
17.
J Dent Child (Chic) ; 87(3): 159-165, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33349300

RESUMO

Purpose: To investigate the extent to which parents can distinguish between their children's primary and permanent teeth in mixed dentition.
Methods: One hundred and fifty parents (107 mothers, 43 fathers) and their children (n=150; mean age=7.6±1.13 years old) were included in this study. All the children were examined, and their decayed, missing, and filled primary and permanent values and decayed, missing, and filled primary surface and permanent surface values were recorded. Parents were asked whether each of their children's 12 teeth on the maxillary and mandibular right side was a primary or permanent tooth. Each of their answers was recorded as zero (incorrect answer) or one point (correct answer), and the total score was calculated.
Results: One-third (33 percent) of the parents stated that the permanent first molar (PFM) was a permanent tooth, 59.3 percent said it was a primary tooth, and 7.3 percent said they had no idea. The median value of the total correct answer for the 12 teeth was 10. There were no statistically significant differences among the parents' total correct scores according to the sociodemographic status (P >0.05).
Conclusion: Parents do not have sufficient knowledge about their children's teeth, especially about PMFs. Parents' education on the subject is important for children's dental health.


Assuntos
Cárie Dentária , Dentição Permanente , Criança , Humanos , Maxila , Dente Molar , Pais , Dente Decíduo
18.
Pediatr Dent ; 42(6): 418-426, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-33369551

RESUMO

Purpose: This study evaluated the evidence for associations between malnutrition and dental caries among children and adolescents in primary and permanent dentition. Methods: A search was conducted in Medline, Cochrane, Google Scholar, Scopus, and Web of Science databases for studies comparing malnourishment and dental caries among children and adolescents. PRISMA guidelines were followed for the meta-analysis. Participants included well-nourished and malnourished children and adolescents ranging in age from six months to 19 years. The primary out-come was the prevalence of dental caries in primary and permanent dentition and early childhood caries (ECC) for children younger than six years. Quality was evaluated using the risk of bias assessment tool. Random-effects model was used to assess the odds ratio of the association between malnutrition and dental caries. Results: Eleven studies met the inclusion criteria. There were 1,851 and 1,395 malnourished and well-nourished children available for analysis. Analysis of the longitudinal studies indicated that malnourished children were associated with a higher presence of caries (odds ratio equals 2.69, 95 percent confidence interval [CI] equals 2.05 to 3.53, P<0.001). Malnourished children were associated with a higher presence of dental caries in permanent dentition (odds ratio equals 3.56, 95 percent CI equals 2.21 to 5.74, P<0.001). Conclusion: Meta-analysis suggests that malnutrition is associated with dental caries in permanent dentition. However, no such association was observed between malnutrition with dental and ECC in the primary dentition.


Assuntos
Cárie Dentária , Desnutrição , Adolescente , Criança , Pré-Escolar , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Dentição Permanente , Humanos , Desnutrição/complicações , Desnutrição/epidemiologia , Dente Decíduo
19.
J Clin Pediatr Dent ; 44(6): 423-428, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378468

RESUMO

OBJECTIVE: To determine the maximum occlusal bite force (MOBF) of the complete spectrum of dental caries in first permanent molars (FPMs) in children aged 7-9 years. STUDY DESIGN: A cross-sectional study was conducted on 123 children. The evaluation of the caries spectrum of FPMs was carried out using the Caries Assessment Spectrum and Treatment index (CAST). The MOBF was measured in the FPM region using the portable occlusal force gauze. Independent sample t-test and one-way analysis of variance test were performed to compare MOBF with CAST scores of FPMs. Based on the CAST scores, FPMs were categorized into three groups, group 1: healthy (score 0, 1, 2), group 2: premorbid (score 3), group 3: morbid (score 4, 5). RESULTS: A significantly lower MOBF was observed (167.56 N ± 49.77) in the morbid stage (group 3) than in the premorbid stage (group 2: 291.57 N ± 56.64), and healthy (group 1; 320.93 N ± 54.23). Intergroup comparison also revealed that FPMs in the healthy stage was associated with a higher bite force compared to those in the premorbid and morbid stages (p<0.001). CONCLUSIONS: The mean MOBF decreased with the progression of the caries spectrum of FPMs in early permanent dentition.


Assuntos
Força de Mordida , Cárie Dentária , Criança , Estudos Transversais , Dentição Permanente , Humanos , Dente Molar
20.
Int. j. odontostomatol. (Print) ; 14(4): 670-677, dic. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1134556

RESUMO

RESUMEN: El tratamiento de dientes inmaduros necróticos es hoy un gran desafío clínico. La ausencia de cierre del ápice y el reducido grosor de las paredes de la dentina hacen que el tratamiento endodóntico del diente sea difícil e impredecible. Tradicionalmente, estos dientes han sido tratados con apexificación y obturación del canal radicular, sin embargo, con este tratamiento el diente permanece desvitalizado y con paredes de dentina frágiles y cortas, lo que compromete su pronóstico. La endodoncia regenerativa, por el contrario, busca revitalizar el diente e inducir una maduración de la raíz, y se basa en la utilización de las células madre mesenquimales presentes en la región periapical, los factores de crecimiento presentes en la dentina y un andamio que permite el crecimiento de tejido nuevo al interior del canal. Los resultados clínicos son alentadores, ya que en general existe maduración de la raíz y revascularización del diente, sin embargo, el tejido neoformado es tejido de tipo reparativo y, a excepción de estudios ocasionales, no se ha observado regeneración de dentina y pulpa. La endodoncia regenerativa se originó para tratar dientes inmaduros necróticos. Sin embargo, recientemente, estudios preliminares han expandido la aplicación de la endodoncia regenerativa a dientes maduros necróticos, es decir, en pacientes adultos. Los resultados clínicos son positivos y similares a los del diente inmaduro, si n embargo, la investigación referente a la revitalización de dientes maduros se encuentra en etapas tempranas y requiere de un mayor nivel de evidencia antes de ser ofrecida sistemáticamente como terapia a pacientes adultos. Los beneficios potenciales justifican mayor investigación al respecto. Este artículo resume la evidencia científica disponible con respecto a la revitalización de dientes inmaduros y maduros necróticos, sus fundamentos biológicos, los resultados esperados y limitaciones, así como el protocolo clínico.


ABSTRACT: Nowadays, the treatment of immature necrotic teeth is an important clinical challenge. The absence of apex closure and low thickness of the dentin walls, make endodontic treatment unpredictable and difficult. Traditionally, these teeth have been treated with apexification and obturation of the root canal. As a result of this treatment, the tooth remains devitalized and with fragile and short dentin walls, which compromises its prognosis. Regenerative endodontics, on the other hand, seeks to revitalize the tooth and induce root maturation, and is based on the use of mesenchymal stem cells present in the periapical tissues, growth factors present in the dentin and a scaffold that allows growth of new tissue in the root ca- nal. The clinical results are encouraging, since generally, there is root maturation and revascularization of the tooth. However, the newly formed tissue is reparative tissue and with the exception of some studies, no regeneration of dentin and pulp has been reported. Regenerative endodontics emerged to treat necrotic immature teeth. However, recently, preliminary studies have applied regenerative endodontics in mature necrotic teeth, in adult patients. Preliminary results are positive and are similar to those of immature teeth. Nevertheless, research regarding the revitalization of mature teeth is in the early stages and requires further evidence before being systematically administered as therapy in adult patients. However, the potential benefits justify further research in this regard. This article summarizes the available scientific evidence regarding the revitalization of immature and mature necrotic teeth, their biological basis, the expected results and limitations, as well as the clinical protocols for each case.


Assuntos
Humanos , Adulto , Necrose da Polpa Dentária/terapia , Dentição Permanente , Endodontia Regenerativa/métodos , Protocolos Clínicos/normas , Resultado do Tratamento , Neovascularização Fisiológica , Necrose da Polpa Dentária/tratamento farmacológico , Transplante de Células-Tronco Mesenquimais , Tecidos Suporte
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