Effect of daily use of fluoridated dentifrice and bleaching gels containing calcium, fluoride, or trimetaphosphate on enamel hardness: an in vitro study.

OBJECTIVE: This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice. DESIGN: Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100 ppm) dentifrice. The bleaching gels were applied thrice (40 min/session) at the intervals of 7 days between each application. After 21 days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined. RESULTS: Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels. CONCLUSION: The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice. CLINICAL RELEVANCE: The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.

Amount of Dentifrice and Fluoride Concentration Influence Salivary Fluoride Concentrations and Fluoride Intake by Toddlers.

The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2-3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher's LSD or Student-Newman-Keuls' tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.

Periodontal Pathogen Colonization in Young Children by PCR Quantification - A Longitudinal Survey.

INTRODUCTION: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood. AIM: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers. STUDY DESIGN: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits. RESULTS: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens. CONCLUSION: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Periodontal Pathogen Colonization in Young Children by PCR Quantification - A Longitudinal Survey.

INTRODUCTION: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood. AIM: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers. STUDY DESIGN: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits. RESULTS: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens. CONCLUSION: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience.

PURPOSE: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience. MATERIALS AND METHODS: Eighty children, aged 6-8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months. RESULTS: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent. CONCLUSION: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience.

The association between prune belly syndrome and dental anomalies: a case report.

BACKGROUND: Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. CASE PRESENTATION: The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. CONCLUSION: This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Developmental disturbance of an unerupted permanent incisor due to trauma to its predecessor.

Developmental disturbances of permanent teeth can result from trauma to primary teeth because of the proximity of the root of the primary teeth to their permanent successors. We describe the case of a 14-month-old boy who was referred to the baby clinic of the School of Dentistry, Universidad Estadual Paulista, Araçatuba, Brazil, after sustaining a severe trauma that led to intrusion of the right primary central incisor. Radiographic examination 4 years after the trauma showed a developing morphological change in the germ of the permanent successor. On eruption of the permanent central incisor, a crown malformation along with enamel hypoplasia was observed. We conclude that radiographic follow-up is indicated after trauma to monitor possible sequelae in the permanent successors even before their eruption

Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service.

AIM: The purpose of this study is to evaluate the developmental disturbances in permanent teeth as a result of luxation injuries in the primary teeth predecessors. MATERIALS AND METHODS: A total of 5330 records, corresponding to 10 years attendance at the Emergency Center of Baby Clinic, Londrina State University, Brazil, were analyzed. Three hundred and eighty nine children were involved in this study, totaling 620 traumatized primary teeth. Clinical and radiographic examinations were carried out in the permanent successor teeth. RESULTS: In total, 623 permanent teeth were examined and developmental disturbances were detected in 126 teeth (20.2%). The white or yellow-brown discoloration of enamel was the clinical disturbance most observed (78.0%) and the crown alteration most detected through radiographic analysis was hypoplasia (86.0%). Root alterations were rare; root dilaceration was observed in only one case. The age of the children when their primary teeth received damage varied between 6 and 36 months (P = 0.000325). Intrusive luxation and avulsion were related with most of the cases of sequelae in the successor permanent teeth (P = 0.000001). CONCLUSION: The results of the present investigation emphasize the special attention required for children who suffered dental trauma at an early age, especially in cases of intrusive luxation and avulsion.

Molar incisor hypomineralization.

Enamel defects are common alterations that can occur in both the primary or permanent dentition. A range of etiological factors related to this pathology can be found in the literature. Molar Incisor Hypomineralization (MIH) is a kind of enamel defect alteration that requires complex treatment solutions, and for this reason, it is of great clinical interest for dental practice. This article describes the management of a clinical case of MIH in a 7-year-old child. The different treatment options depending on the extension of the defect, the degree of tooth eruption and the hygiene and diet habits of the patient are also discussed.

Immediate reimplantation of primary teeth: a histological study in dogs.

Reimplantation of primary teeth has been the subject of various clinical and histological studies, but very little is known about the effect of this treatment on primary teeth. The aim of the present study was to histologically evaluate the biological response of dog primary teeth after immediate reimplantation. Twelve dogs were divided into two groups according to postoperative time: 1 week and 3 weeks. Twenty-one upper and lower intermediate incisors were extracted and submitted to endodontic treatment, reimplantation and splinting. The 21 homologous teeth not submitted to treatment served as controls. The animals were killed after the respective experimental periods, and the obtained specimens were processed for histological analysis. Most dogs of the 1-week group exhibited the following alterations: gingival epithelium was inserted in the cemento-enamel junction, with a small number of chronic inflammatory cells being observed in the gingival corium; the periodontal ligament was partially reestablished, with a more expressive chronic inflammatory infiltrate being observed in the apical third; small root resorption was observed on the palatine/lingual side in the apical third. In contrast, in 3-week animals, gingival epithelial insertion was predominantly absent on the buccal side, and a moderate chronic inflammatory infiltrate was present; the periodontal ligament generally showed no bone-cementum reinsertion especially on the palatine/lingual side, with an expressive inflammatory infiltrate in the apical region, and large root resorption was mainly observed on the palatine and lingual sides. In conclusion, reimplantation causes histological alterations in the tooth and its supporting periodontal structures that suggest the impossibility of its maintenance.

Facial and dental injuries due to dog bite in a 15-month-old child with sequelae in permanent teeth: a case report.

This article reports a longitudinal follow-up of a 15-month-old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14-year clinical and radiographic follow up of the case is presented.

Clinical approach of ankyloglossia in babies: report of two cases.

Ankyloglossia is a developmental anomaly of the tongue characterized by a short lingual frenum, resulting in restricted movement of the tongue. Its etiology is undefined and there is no gender preference. Few studies are available in the literature and the diagnosis and management of ankyloglossia in infants remains controversial. We report two cases of infants submitted to lingual frenectomy, emphasizing the management of ankyloglossia and its implications in breast-feeding.

Oral Condition of Adolescents who Participated in an Oral Health Program During the First Decade of Life

ABSTRACT Objective: To evaluate the oral health of adolescents who participated in an oral health preventive program during the first decade of life. Material and Methods: For the evaluation of dental caries and gingival condition, DMFT and Community Periodontal Index were used, both recommended by the World Health Organization. To verify the occurrence of dental fluorosis, the Dean index was used. Results: Data collection was obtained from 252 patients aged 12 to 16 years. The average DMFT index was 1.14; in relation to the gingival condition, the index of healthy gingival tissue prevailed and the average of this value was 84%, with code 0 being more registered in tooth 11, code 1, more frequently in teeth 16/17 and 36/37 and for last, code 2, in tooth 31 most frequently. Dean's index showed a percentage of 89% of patients without clinical signs of dental fluorosis. Conclusion: Adolescents participating in an oral health preventive program in the first decade of life exhibited very satisfactory results regarding the prevention of caries disease, healthy periodontal condition and reduced prevalence of dental fluorosis.

Clinical performance of glass ionomer cement and composite resin in Class II restorations in primary teeth: A systematic review and meta-analysis.

OBJECTIVES: This study compared the clinical performance of glass ionomer cement (GIC) compared to composite resin (CR) in Class II restorations in primary teeth. DATA: Literature search according to PRISMA guidelines including randomized controlled trials comparing Class II restorations performed with GIC, compared to CR, in primary teeth. SOURCES: PubMeb, Scopus, Web of Science, VHL, Cochrane Library, Clinical Trials and OpenGrey, regardless of date or language. STUDY: Ten studies were included in qualitative synthesis, and 9 in the meta-analyses (MA). Six studies were classified as low risk of bias, and 4 as "unclear". Heterogeneity ranged from null to high (0% to 73%). GIC and CR presented similar failure patterns (risk difference -0.04 [-0.11, 0.03]; p = 0.25, I2 = 51%), and the exclusion of studies with follow-up period <24 months, or grouping according to the type of GIC (conventional or resin-modified), or according to the type of isolation (cotton roll or rubber dam), or according to the evaluation criteria applied did not affect the pattern of the results obtained. GIC exhibited significantly lower values of secondary carious lesions (SCL) than CR (SCL: risk difference 0.06 [0.02, 0.10], p = 0.008, I2 = 0%). The materials presented similar performance (p > 0.05) regarding the overall effect, as well as for marginal discoloration, marginal adaptation and anatomical form. The superiority of GIC was maintained when resin-modified GIC and rubber dam isolation were analyzed separately. CONCLUSIONS: GIC and CR presented similar clinical performance for all criteria analyzed, except for secondary carious lesions, in which GIC presented superior performance, especially for the resin-modified GIC and with rubber dam isolation.

Fractura radicular en los incisivos centrales maxilares permanentes: reporte de un caso de 10 años de seguimiento / Fratura radicular nos incisivos centrais superiores permanentes. Relato de caso de 10 anos de acompanhamento longitudinal / Root fracture in the permanent maxillary central incisors: a case report of 10 years follow-up

El objetivo de este trabajo es referir, a través de un reporte de caso clínico, a una paciente de sexo femenino de 9 años que sufrió una caída de su propia altura en el colegio. Inicialmente, la paciente acudió a urgencias en su ciudad natal, en la que al examen clínico se objetivó un traumatismo dentario en los dientes 11 y 21 y el diente 11 sufrió una luxación extrusiva leve, siendo reposicionada por el odontólogo que le brindó la primera atención. El examen radiográfico reveló una fractura radicular horizontal en el tercio medio de los dos incisivos centrales superiores. Los dientes fueron ferulizados con resina compuesta en los dientes proximales involucrados en el trauma. Posteriormente, la paciente fue remitida a la consulta de odontopediatría de la FOA-Unesp, donde recibió atención clínica y radiográfica por un período de diez años. No fue necesaria la intervención endodóntica en ambos dientes incisivos centrales, y los procesos de cicatrización se dieron de dos maneras diferentes. Cicatrización del diente 11 por interposición de hueso y tejido conectivo, y cicatrización del diente 21 por interposición de tejido conectivo. Después de diez años, los dientes se presentaban sin signos o síntomas significativos que requirieran una intervención invasiva. Se concluye que en un mismo paciente ocurren diferentes procesos de cicatrización en dientes muy próximos entre sí y que la cooperación del paciente en cuanto a cuidados, higiene bucal y asistencia a las citas de retorno, puede ser determinante para el éxito del tratamiento

The objective of this case report is to present a 9-year-old female patient who suffered horizontal root fracture in the middle third of the two upper central permanent incisors. The teeth were splinted with composite resin in the proximal teeth involved in the trauma. After, the patient was referred to the pediatric dentistry clinic, where she received clinical and radiographic care for a period of ten years. Endodontic intervention was not necessary on both central incisors teeth. Tooth 11 healing by interposition of bone and connective tissue, and teeth 21 healing by interposition of connective tissue. After ten years, the teeth presented without any significant signs or symptoms requiring an invasive intervention. It is concluded that the patient's cooperation regarding care, oral hygiene and attendance at the return appointments, can be decisive for the success of the treatment

O objetivo deste trabalho é referir-se, por meio de um relato de caso clínico, sobre um paciente de 9 anos de idade, sexo feminino, que sofreu queda da própria altura na escola. A paciente recebeu atendimento em sua cidade de origem, em que ao exame clínico foi observado traumatismo dentário sobre os dentes 11 e 21 e o dente 11 sofreu suave luxação extrusiva sendo reposicionado pelo cirurgião dentista que prestou os primeiros atendimentos. Ao exame radiográfico foi constatada fratura radicular horizontal de terço médio nos dois elementos dentários. Foi realizada a contenção dos dentes com resina composta nas proximais dos dentes envolvidos no trauma. A paciente foi encaminhada para a clínica de Odontopediatria da FOA-Unesp onde recebeu atendimento clínico e radiográfico por um período de dez anos, sem que a mesma apresentasse sinais ou sintomas significativos que necessitasse de uma intervenção invasiva. Dessa forma, infere-se que uma correta atuação no primeiro atendimento e a proservação do caso, pode ser determinante para o sucesso do tratamento, assim como a colaboração do paciente quanto aos cuidados, higienização bucal e comparecimento nas consultas de retorno

Dentigerous cysts in primary dentition: report of 2 cases.

Dentigerous cysts are benign odontogenic cysts associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. The purpose of this case report was to describe the management of 2 dentigerous cysts in children. The treatments instituted were the extraction of the deciduous tooth involved followed by marsupialization in the first case and enucleation in the second one. Both treatments allowed rapid healing of the lesion and eruption of the permanent teeth without the need for orthodontic treatment.

Profile of Breastfeeding Practice among Mothers of Brazilian Children Attended in a Dentistry Preventive Program

ABSTRACT Objective: To evaluate the breastfeeding practice of mothers of children assisted in the educational and preventive dentistry program to create actions to promote, protect and support breastfeeding. Material and Methods: This is a cross-sectional study with a quantitative approach carried out in a dental clinic for babies. A questionnaire was applied to the mothers containing 10 multiple choice questions about breastfeeding practices and attitudes. Data were stored in a Microsoft Excel database for descriptive statistical analysis. Results: 614 mothers answered the questionnaire. It was found that 96.4% of mothers considered breastfeeding the best way to feed a baby and the child's health benefits stood out as the main reason (98.7%) for breastfeeding. According to 82.9% of mothers, the ideal time to breastfeed the baby is up to 2 years of age; 81.8% breastfed or intended to breastfeed their children up to this age, finding it perfectly natural to breastfeed in public (72.1%). The greatest fear of mothers was not being able to breastfeed their child long enough (61.4%), feeling guilty about it (77%). On the other hand, breastfeeding in public was considered a fantastic attitude (56.8%). Conclusion: Mothers in this sample have information about the recommendations of the health agencies regarding breastfeeding; however, there was a large weaning index among them.

Influence of the Amount of Dentifrice and Fluoride Concentrations on Salivary Fluoride Levels in Children.

PURPOSE: This study evaluated fluoride (F) concentrations in saliva of children after brushing with dentifrices containing different F concentrations (zero, 550, and 1,100 ppm F) in different quantities (full bristles, transversal technique, and pea-sized). METHODS: Eight- to 10-year-old volunteers (N=24) were randomly assigned into nine experimental groups (dentifrice type versus amounts) following a double-blind, crossover protocol. After a one-week washout period (use of placebo toothpaste), stimulated saliva was collected prior to toothbrushing (baseline) and at five, 15, 30, 60, and 120 minutes after toothbrushing with one of the possible combinations. Centrifuged saliva was used for F analysis after buffering with TISAB III. Data were submitted to repeated-measures ANOVA followed by Student-Newman-Keuls' test (P<0.05). RESULTS: Salivary F peaked at five minutes after brushing, decreasing exponentially afterward. A clear dose-response relationship was seen between F concentration/amount of dentifrice applied and the mean area under the curve (AUC) of salivary F concentrations (P<0.001). The low-fluoride toothpaste applied using transversal technique or full bristles led to a significantly higher AUC than the conventional toothpaste using a pea-sized amount. CONCLUSIONS: Brushing with a low-fluoride toothpaste applied using the transversal technique delivers more fluoride to saliva compared to a conventional toothpaste in a pea-sized amount.

Odontomas in pediatric dentistry: report of two cases.

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

Molar incisor hypomineralization: considerations about treatment in a controlled longitudinal case.

Molar incisor hypomineralization (MIH) is a defect in the tooth enamel of systemic origin and may affect one or all four first permanent molars frequently associated with the permanent incisors. This case reports a 7-year-old child with severe MIH in the permanent molars associated with tooth decay and intense pain. In the first stage of treatment, therapy was performed with fluoride varnish and restoration with glass ionomer cement (GIC). After 6 years of clinical and radiographic follow-up, the restorations presented wear and fractures on the margins, indicating their replacement with composite resin. Severe cases of MIH in the early permanent molars can be treated with varnish and GIC to restore the patient's comfort and strengthen the hypomineralized dental structures. The clinical and radiographic monitoring frequently indicated when the restoration with composite resin should be performed.