What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents?

OBJECTIVE: To evaluate the performance of visual inspection alone and associated to radiographic and laser fluorescence (LF) methods in detecting non-evident caries lesions at adolescents' proximal surfaces. MATERIALS AND METHODS: Adolescents (12 to 17 years old) were assessed for the presence of caries lesions through visual inspection, radiographic examination, and LF method (DIAGNOdent pen), at non-cavitated (NC) and cavitated lesion (CAV) thresholds. Temporary separation with orthodontic rubbers followed by direct visual inspection was the reference standard method. Two examiners conducted the examinations, and the first examiner reassessed around 20% of the sample, to evaluate inter- and intra-examiner reproducibility, respectively. Sensitivity, specificity, accuracy, and utility values were calculated for the methods alone and combined with visual inspection using two different strategies: simultaneous and sequential combination. RESULTS: A total of 834 proximal surfaces (51 adolescents) were included. Visual inspection presented higher reproducibility values (higher than 0.98). Moreover, visual inspection presented higher sensitivity (around 0.51) than those obtained with other diagnostic strategies (varying from 0.09 to 0.20) at the NC threshold. For CAV, visual inspection presented higher specificity (0.996) than the sequential association with adjunct methods (around 0.97), but with lower sensitivity. Accuracy and utility values for combined strategies were similar or lower than those achieved with the visual inspection performed alone. CONCLUSION: Visual inspection alone performs better for detecting caries lesions in premolars and molars of adolescents than other diagnostic strategies. CLINICAL RELEVANCE: The best diagnostic strategy for caries detection of proximal caries lesions in adolescents is the visual inspection alone.

Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children.

BACKGROUND: To evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs. METHODS: This is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3-6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up. RESULTS: 4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias. CONCLUSIONS: Simultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice. Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014.

Prevalence of early loss of primary molar and its impact in schoolchildren's quality of life.

BACKGROUND: Evidence regarding the impact of premature loss of primary molars on oral health-related quality of life (OHRQoL) is lacking. AIM: To evaluate the prevalence of premature loss of primary molars in schoolchildren and its impact on OHRQoL. DESIGN: We randomly selected 667 children aged 8-9 years enrolled in public and private schools from Aracaju (Brazil). The presence of untreated dental caries and early loss of primary molars were recorded, and its impacts on OHRQoL evaluated using Child Perceptions Questionnaire (CPQ8-10 ). Influence of some variables on tooth loss and OHRQoL was assessed by multilevel Poisson's regression analysis (P < 0.05). RESULTS: The prevalence for early tooth loss was 65.4% (95% confidence interval 51.1%-77.3%). Children with untreated dental caries and attending public schools presented higher prevalence of early tooth loss. Moreover, early loss of primary molars provoked negative impact on OHRQoL considering total score of CPQ8-10 and domains "oral symptoms," "functional limitations" and "emotional well-being." Children presenting early teeth loss presented significantly higher scores of CPQ8-10 , as well as females and children with dental caries in other teeth. CONCLUSIONS: The prevalence of early loss of primary molars is high, and it impacts the OHRQoL of children aged 8-9 years.

Responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) is related to dental treatment complexity.

BACKGROUND: The responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children. METHODS: Preschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses. RESULTS: Of the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively). CONCLUSIONS: Parents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.

Use of artificial primary teeth for endodontic laboratory research: experiments related to canal length determination.

BACKGROUND: Due to the scarcity of exfoliated/extracted human primary teeth with complete roots, artificial teeth were developed as an alternative to be used for educational and laboratory research purposes. This study aimed to assess the feasibility of using artificial primary teeth for conducting laboratory research through an experiment related to canal length determination, comparing artificial teeth with natural teeth. METHODS: Thirty anterior and 21 posterior artificial teeth, and the same number of natural primary teeth were selected. After preparing the access cavity, the root canal length was determined by two examiners twice using three different methods: radiography and two electronic apex locators. Then, the actual root canal length was measured by inserting a K-file up to the apical foramen (reference standard). Accuracy was calculated using Bland-Altman analysis and intraclass correlation coefficient (ICC). The inter- and intra-examiner reproducibility was also calculated using the ICC. RESULTS: The methods using the electronic apex locators showed better accuracy in both artificial and natural teeth. Trends observed with artificial primary teeth were similar to those observed with natural teeth, except for the results in artificial anterior teeth. CONCLUSIONS: The model of artificial teeth might be a good alternative for educational purposes; however, improvements are necessary to employ these teeth for research purposes when considering experiments for canal length determination.

Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study.

AIM: To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood. METHODS: A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%. RESULTS: We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96). CONCLUSIONS: Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.

Evaluation of the furcation area permeability of deciduous molars treated by neodymium:yttrium-aluminum-garnet laser or adhesive.

The purpose of this in vitro study was to compare the effects of a self-etch adhesive system and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser application on the dentinal permeability of the furcation area of primary molars. After endodontic access, 39 extracted human deciduous molars were divided into three groups: control group (CG), no treatment; adhesive group (AG), self-etching adhesive was applied to the furcation area; laser group (LG), specimens were irradiated with Nd:YAG laser. To evaluate dentin permeability of the furcation area, we immersed the specimens in 0.5 % methylene blue dye for 4 h. Then, they were longitudinally sectioned into two halves and photographed. The images were analyzed by two qualified evaluators using TpsDig software to calculate the percentage of the dye penetration area in comparison with the total furcation area. Additional analyses by scanning electron microscopy (SEM) were performed. The analysis of variance (ANOVA), complemented by Student's t-test, showed that mean dye penetration in the LG was statistically significant lower than that in all the other groups (P < 0.05). The SEM analysis showed mostly dentinal tubules obliterated by smear layer in the CG; in the AG the smear layer was modified by the adhesive, and, in the LG, melted surfaces were observed. It can be concluded that the Nd:YAG laser was capable of reducing the dentinal permeability of the furcation area of deciduous molars.

Which Dental Procedures Lead to Greater Distress During Children's Dental Treatment? A Cohort Study

ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3-10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment.

Management of dental caries among children: a look at the cost-effectiveness.

INTRODUCTION: Dental caries is the most prevalent non-communicative disease worldwide. Although the etiological factors are well known for years, reducing the number of decayed and missing teeth in children still remains as a barrier. Preventive and curative options are numerous but little is known about their economical advantages. Selecting the intervention that offers the best balance of effectiveness and financial resources becomes crucial in the current situation of budget restrictions worldwide. AREAS COVERED: This expert review summarizes available evidence on cost-effectiveness analyses of preventive and curative measures to manage dental caries in children. EXPERT COMMENTARY: Preventive measures have been more extensively studied than dental caries treatment. Only water fluoridation and tooth brushing are well-established as cost-effective preventive approaches. Despite the increasing number of cost analysis treatment studies in the literature, most of them focus on the cost description, with no correlation to the intervention effectiveness. There is a current need of well-designed and well-reported cost-effectiveness regarding dental caries management.

Effect of cut-off points on performance of laser fluorescence for detecting occlusal caries.

This in vitro study aimed to evaluate the influence of cut-off points on the performance of laser fluorescence (LF) in detecting occlusal caries in permanent and primary teeth. The use of different cut-off points influenced the performance of LF device in detection of occlusal caries in both kind of teeth, but the performance in permanent teeth suffered more influence from variation of cut-off points scales than in primary group.

Papila Apical Dentaria como fuente de Células Madre: Relato del Caso / Papila Apical Dentária como Fonte de Células Tronco: Relato de Caso / Dental Apical Papila Stem Cell: Case Report

Las células madre mesenquimales (MSCs) son células madre adultas que tienen la capacidad de diferenciarse en varios tipos de células. Una rica fuente de células madre mesenquimales puede ser obtenida de tejidos dentales como la papila apical. El objetivo de este trabajo fue extraer las células madre de la papila apical de terceros molares humano para mirar su viabilidad de usarse en la práctica clínica. La de separación celular con Stro-1 y estudio de cinéticas fueron realizados. Como resultado, esas células, presentaron alta tasa de proliferación, formación de colonias y fácil acceso. Concluimos que el uso de células madre obtenidas de diente puede ser una buena alternativa por ser de fácil acceso, alta viabilidad celular y expresión positiva para marcadores celulares mesenquimales. La regeneración tisular o la formación de estructuras craneofaciales constituyen el futuro de la medicina regenerativa, ofreciendo una posibilidad para el tratamiento de malformaciones congénitas, traumas y otras enfermedades.

As células tronco mesenquimais (CTMs) são células-tronco adultas que têm a capacidade de diferenciar em vários tipos de células. Uma rica fonte de células tronco mesenquimais pode ser obtida de tecidos dentais como a papila apical. O objetivo deste trabalho foi extrair as células tronco da papila apical de terceiros molares humano para ver sua viabilidade de ser usado na prática clinica. Teste separação celular com Stro-1 e estudo de cinéticas foram realizados. Como resultado essas células apresentaram alta taxa de proliferação, formação de colônias e de fácil acesso. Concluímos que o uso de células tronco obtidas de dente pode ser uma boa alternativa por ser fácil acesso, alta viabilidade celular e expressão positiva para marcadores celulares mesenquimais. A regeneração tecidual ou a formação de novo de estruturas craniofaciais é o futuro da medicina regenerativa, oferecendo uma possibilidade para tratamento de malformações congênitas, traumas e outras doenças.

Mesenchymal stem cells (MSCs) are adult stem cells that have the ability to diffe-rentiate into various cell types. A rich source of mesenchymal stem cells can be obtained from dental tissues such as the apical papilla. The objective of this work was to extract stem cells from the apical papilla of third human molars to see its feasibility to be used in clinical practice. Testing of cell separation with Stro-1 and study of kinetics were performed. As a result, these cells had a high rate of pro-liferation, formation of colonies and easy access. We conclude that the use of stem cells obtained from teeth can be a good alternative because they are easy to ac-cess, high cell viability and positive ex-pression for mesenchymal cell markers. Tissue regeneration or new formation of craniofacial structures is the future of re-generative medicine, offering a possibili-ty for treatment of congenital malforma-tions, traumas and other diseases.

Selamento de lesões de cárie oclusais em metade externa de dentina em dentes decíduos: estudo clínico randomizado em crianças cearenses / Sealing dentinal caries lesion in deciduous teeth: clinical trial randomized

Objetivo: Avaliar o efeito do selamento de lesões de cárie com resina flow no controle de lesões cariosas oclusais comparado ao tratamento restaurador com resina composta. Material e Método: foram selecionadas 22 crianças na faixa etária de 4 a 9 anos que frequentam a Clínica Infantil da Universidade de Fortaleza (UNIFOR). Foi realizado um exame clínico inicial a fim de selecionar molares decíduos apresentando lesão de cárie na superfície oclusal, com envolvimento de dentina e abertura em esmalte menor ou igual a 3 mm. O exame radiográfico foi utilizado para verificar a profundidade da lesão de cárie, onde foram selecionadas as lesões que se apresentavam em metade externa de dentina. As crianças foram divididas aleatoriamente em 2 grupos, onde o primeiro foi realizado o selamento de cárie com resina flow (GRF) e o segundo grupo (GRC) restauração convencional com resina composta (remoção total do tecido cariado). Após 6 meses, 03 pacientes foram perdidos da pesquisa e, os grupos foram avaliados radiograficamente, afim de se verificar o comportamento das lesões: progressão (escore 2), paralisação (escore 1), ou regressão (escore 0) para o grupo GRF e para o Grupo GRC progressão (escore 2) e paralisação (escore 1). Uma avaliação clínica foi conduzida para verificação da integridade dos selamentos e das restaurações: retenção completa, parcial, perda total. Os dados foram comparados por meio do teste Mann-Whitney, com nível de significância de 5%. Resultados: não houve diferença estatística entre os grupos, onde 90% dos dentes do grupo GRF apresentaram retenção completa do material e em 100% dos casos houve ausência de progressão da lesão. Cem por cento dos molares pertencentes ao grupo GRC apresentaram, retenção completa do material, em 100% dos casos houve ausência da progressão da lesão. Conclusão: o selamento de lesão de cárie com resina flow constitui-se uma alternativa conservadora ao tratamento restaurador, propiciando a paralisação de lesões de cárie em metade externa de dentina.

The objective of this study was to evaluate the effect of sealing cavities with flow resin for controlling occlusal carious lesions compared with restorative treatment using composite resin. Twenty two children between 4 to 9 years attending the Children's Clinic of the University of Fortaleza (UNIFOR) were selected. After the initial clinical examination primary molars showing caries lesions on the occlusal surface (involving dentin and enamel in the opening less than or equal to 3 mm) were selected. Radiographic examination was used to check the depth of carious lesions and the selected lesions were those that affected the outer half of dentin. Children were randomly divided into 2 groups: group GRF ­ the sealing of cavities with flowable composite was conducted, and group GRC - conventional restoration with composite resin (total removal of decayed tissue) was performed. After six months of follow-up, 03 patients were excluded from the study, the groups were evaluated radiographically (to check the behavior of the lesions: progression, paralization or regression for the group GRF and for the group GRC progression or paralization) and clinically (to verify the integrity of sealing and restorations: complete retention, partial retention and loss total). Data were compared using the Mann-Whitney test at 5% significance level. The results showed that 90% of the teeth from group GRF showed complete retention of the material and 100% did not show progression of the lesion. One hundred percent of the molars belonging to group GRC showed complete retention of the material and 100% did not show progression of the lesion. In conclusion, the sealing of carious lesions with flowable composite constitutes a conservative alternative to restorative treatment, providing the paralization of carious lesions in the outer half of dentin.

Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions.

The purpose of this study was to assess photodynamic antimicrobial chemotherapy (PACT) via irradiation, using a low power laser associated with a photosensitization dye, as an alternative to remove cariogenic microorganisms by drilling. Remaining dentinal samples in deep carious lesions on permanent molars (n = 26) were treated with 0.01% methylene blue dye and irradiated with a low power laser (InGaAIP - indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 320 Jcm(-2); 90 s; 9J). Samples of dentin from the pulpal wall region were collected with a micropunch before and immediately after PACT and kept in a transport medium for microbiological analysis. Samples were cultured in plates of Brucella blood agar, Mitis Salivarius Bacitracin agar and Rogosa SL agar to determine the total viable bacteria, mutans streptococci and Lactobacillus spp. counts, respectively. After incubation, colony-forming units were counted and microbial reduction was calculated for each group of bacteria. PACT led to statistically significant reductions in mutans streptococci (1.38 log), Lactobacillus spp. (0.93 log), and total viable bacteria (0.91 log). This therapy may be an appropriate approach for the treatment of deep carious lesions using minimally invasive procedures.

Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars - a multilevel approach.

UNLABELLED: OBJECTIVE: The aim of this in vivo study was to evaluate the association between several parameters related to children and to their teeth, and the presence of active carious lesions assessed by two different visual indices on occlusal surfaces of primary molars. METHODS: Occlusal surfaces of 757 primary molars in 139 children (3-12 years old) were classified as sound, or having inactive or active carious lesions using the Nyvad criteria (NY) and the International Caries Detection and Assessment System (ICDAS-II) and a supplemental lesion activity assessment system (ICDAS-LAA). Several parameters related to the tooth and to the child were recorded. Associations between these parameters and the presence of active carious lesions on occlusal surfaces were evaluated using logistic multilevel analysis. RESULTS: Second primary molar teeth and children with high caries experience were more frequently with active occlusal carious lesions compared to sound and inactive occlusal carious lesions classified by both visual scoring systems. Teeth with a mature dental plaque on the occlusal surface and younger children had more active caries than inactive occlusal carious lesions (excluding sound teeth in the analysis). A previous visit to a dentist was related to a lower frequency of active occlusal carious lesions classified by NY only, and upper primary molars presented with higher numbers of active occlusal carious lesions classified by ICDAS-LAA. CONCLUSIONS: Presence of mature dental plaque and tooth type are tooth-related variables associated with active carious lesions on occlusal surfaces of primary teeth, as well as anterior caries experience and age are variables related to the child.

Effect of insertion method on knoop hardness of high viscous glass ionomer cements.

The aim of this study was to assess the Knoop hardness of three high viscous glass ionomer cements: G1 - Ketac Molar; G2 - Ketac Molar Easymix (3M ESPE) and G3 - Magic Glass ART (Vigodent). As a parallel goal, three different methods for insertion of Ketac Molar Easymix were tested: G4 - conventional spatula; G5 - commercial syringe (Centrix) and G6 - low-cost syringe. Ten specimens of each group were prepared and the Knoop hardness was determined 5 times on each specimen with a HM-124 hardness machine (25 g/30 s dwell time) after 24 h, 1 and 2 weeks. During the entire test period, the specimens were stored in liquid paraffin at 37ºC. Significant differences were found between G3 and G1/G2 (two-way ANOVA and Tukey's post hoc test; p<0.01). There was no significant difference in the results among the multiple ways of insertion. The glass ionomer cement Magic Glass ART showed the lowest hardness, while the insertion technique had no significant influence on hardness.

Glass ionomer cement hardness after different materials for surface protection.

The aim of the present study was to evaluate the Knoop hardness of high viscous glass ionomer cement (GIC) Ketac Molar Easy Mix (3M ESPE, Saint Paul, USA) submitted to different types of compounds for surface protection. Sixty specimens of GIC were made in PVC molds with 7.5 mm diameter and 2.5 mm thickness. Divided in 6 groups: G1, Control (no protection); G2, Cavitine (Copal varnish); G3, Magic bond (Adhesive); G4, Adper Single Bond 2 (Single bottle adhesive); G5, Solid Petroleum Jelly; G6, Nail Varnish. The surface protection was applied after initial setting reaction. The specimens were immersed in deionized water, at 37 degrees C, for 24 h. The surfaces were polished in a rotation machine (Aropol 2V). The hardness test was accomplished in a Digital Microhardness tester HVS-100. In each specimen five indentations were done and repeated after 30 days and 4 months, under the same conditions. The results were submitted to Two-way ANOVA and Tukey Test. The only material that differed from the control group was the nail varnish (p < 0.001), with the other materials showing no significant difference from the control group. It was concluded that the best material for surface protection of GIC was the nail varnish, but because of possible harmful effects, petroleum jelly could be a better option.

Impacto dos problemas bucais na qualidade de vida em pré-escolares / Impact of Oral Problems on the Quality of Life of Preschool Children

Objetivo: Avaliar o impacto das condições clínicas bucais e fatores socioeconômicos na qualidade de vida relacionada à saúde bucal (QVRSB) de pré-escolares. Metodologia: A amostra consistiu de todas as crianças de seis a 72 meses de idade e pais residentes em Venda Branca, Casa Branca/SP. Foram aplicados dois questionários sobre QVREB (ECOHIS) e condições socioeconômicas. Um examinador calibrado avaliou a presença da doença cárie, maloclusões e lesões traumáticas. Utilizou-se análise de regressão de Poisson. Resultados: As prevalências observadas para o trauma dentário, mordida aberta anterior, selamento labial inadequado e doença cárie foram respectivamente 1,63%; 27,97%; 4,92% e 54,10%. A análise univariada mostrou associação entre a criança ter casa própria e melhor qualidade de vida. A mordida aberta anterior e a doença cárie foram associadas à pior qualidade de vida. A análise múltipla confirmou a análise univariada, na qual as variáveis casa própria, mordida aberta anterior e doença cárie foram associadas à melhoria da qualidade de vida relacionada à saúde bucal nas crianças. Conclusão: Fatores socioeconômicos e clínicos causam impacto negativo na qualidade de vida dos pré-escolares.

Objective: To evaluate the impact of oral clinical conditions and socioeconomic factors on the quality of life related to oral health (QLROH) of preschool children.Method: The sample included all children aged 6 to 72 months and their parents living in Venda Branca, in the city of Casa Branca, SP, Brazil. Two questionnaires on QLROH (ECOHIS) and socioeconomicconditions were applied. A calibrated examiner evaluated the presence of caries disease, malocclusions and traumatic injuries. Poisson?s regression analysis was used.Results: Prevalence of dental trauma, open anterior bite, inadequate lip seal and caries disease was respectively 1.63%, 27.97%, 4.92% and 54.10%. Univariate analysis showed association between living in an own house and having better quality of life. Open anterior bite and caries disease were associated with worse quality of life. Multiple analyses corroborated the univariate analysis, as the variables ownhouse, open anterior bite and caries disease were associated withimproved QLROH in the children.Conclusion: Socioeconomic and clinical factors were shown to have a negative impact on the preschool children?s quality of life.

Dureza knoop de três cimentos de ionômeros de vidro / Knoop hardness of three glass ionomer cements

Objetivo: Avaliar a dureza Knoop de três cimentos de ionômero de vidro (CIV) nacionais após 24 horas e 7 dias. Método: Os materiais foram dosados e manipulados de acordo com as instruções dos fabricantes e divididos em grupos (n=10): G1: Vidrion R® - SS White (convencional), G2: Vitro Molar® - DFL (alta viscosidade) e G3: Maxxion R® - FGM (alta viscosidade). A seguir os corpos de prova foram confeccionados em moldes de PVC. Após 10 minutos imersos em solução oleosa (Vaselina Líquida), a 37ºC por 24 horas, as superfícies foram polidas com lixa de granulação 600 (Buehler), em máquina politriz Aropol 2V (Arotec). O teste de dureza foi realizado em durômetro Pantec (digital microhardness Tester HVS-1000) com 25g de carga e 30s, com penetrador tipo Knoop. Em cada amostra foram realizadas três indentações e repetidas após uma semana, mantidas as mesmas condições. Resultados: As médias da dureza Knoop (e desvios-padrão) foram: após 24 horas G1:47,65 (20,1), G2:52,06 (10,6) e G3: 72,43 (17,4); após uma semana G1: 74,25 (16,5), G2: 87,55 (12,1) e G3: 132,17 (39,7). Após análise de Variância e complementação pelo teste de Tukey, foi constatada diferença estatística significante para os valores de dureza do G3 em relação ao G1 e G2 (p<0,05) e também nas leituras da dureza após 24 horas e uma semana. Conclusão: O cimento de ionômero de vidro de alta viscosidade Maxxion R apresenta propriedade mecânica superior quando comparado aos cimentos Vidrion R e Vitro Molar. O tempo aumenta a dureza desses três cimentos de ionômero de vidro nacionais.

Objective: To evaluate the Knoop microhardness of three national glass ionomer cements (GIC) after 24 hours and 7 days. Methods: The materials were dispensed and mixed according to the manufacturers' instructions and divided in groups (n=10): G1: Vidrion R© - SS White (conventional), G2: Vitro Molar© - DFL (high viscosity) and G3: Maxxion R© - FGM (high viscosity). The specimens were fabricated using PVC molds. After 10 minutes, they were immersed in an oily solution (liquid petroleum jell) at 37oC during 24 hours and the surfaces were polished with 600-grit silicon carbide paper (Buehler) in a polishing machine (Aropol 2V, Arotec). Microhardness test was performed in a digital microhardness tester (Pantec HVS-1000) using a Knoop indenter with 25 g load during 30 seconds. Three indentations were made in each specimen and repeated after 1 week, under the same conditions. Results: Knoop microhardness means (and standard deviations) were: after 24 hours - G1: 47.65 (20.1). G2:52.06 (10.6) and G3: 72.43 (17.4); after 1 week - G1: 74.25 (16.5). G2: 87.55 (12.1) and G3: 132.17 (39.7). Statistical analysis by ANOVA and Tukey's test revealed significant difference (p<0.05) between G3 and groups G1 and G2 as well as between the microhardness readings obtained after 24 hours and after 1 week. Conclusion: The high-viscosity GIC Maxxion R presented higher mechanical property than the GICs Vidrion R and Vitro Molar. The microhardness of these three national GICs increased with time.

Effect of insertion method on knoop hardness of high viscous glass ionomer cements

The aim of this study was to assess the Knoop hardness of three high viscous glass ionomer cements: G1 - Ketac Molar; G2 - Ketac Molar Easymix (3M ESPE) and G3 - Magic Glass ART (Vigodent). As a parallel goal, three different methods for insertion of Ketac Molar Easymix were tested: G4 - conventional spatula; G5 - commercial syringe (Centrix) and G6 - low-cost syringe. Ten specimens of each group were prepared and the Knoop hardness was determined 5 times on each specimen with a HM-124 hardness machine (25 g/30 s dwell time) after 24 h, 1 and 2 weeks. During the entire test period, the specimens were stored in liquid paraffin at 37ºC. Significant differences were found between G3 and G1/G2 (two-way ANOVA and Tukey's post hoc test; p<0.01). There was no significant difference in the results among the multiple ways of insertion. The glass ionomer cement Magic Glass ART showed the lowest hardness, while the insertion technique had no significant influence on hardness.

O objetivo deste estudo foi avaliar a microdureza Knoop de três cimentos de ionômero de vidro de alta viscosidade: G1 - Ketac Molar; G2 - Ketac Molar Easymix (3M ESPE) and G3 - Magic Glass ART (Vigodent). Adicionalmente, como um co-objetivo, três diferentes formas de inserção do Ketac Molar Easymix foram avaliadas: G4 - espátula conventional; G5 - seringa comercial (Centrix) e G6 - seringa de baixo custo. Dez corpos de prova de cada grupo foram preparados e a microdureza Knoop foi determinada com 5 indentações por espécime com o aparelho HM-124 (25 g/30 s tempo de identação) após 24 h, 1 e 2 semanas. Durante todo o período de teste, os espécimes foram mantidos em parafina líquida a 37ºC. Diferenças estatísticas significantes foram encontradas entre G3 e G1 / G2 (ANOVA a 2 critérios e teste de Tukey post hoc; p<0,01). Não houve diferença nos resultados no que se refere às diferentes formas de inserção. O cimento de ionômero de vidro Magic Glass ART apresenta os valores mais baixos de dureza enquanto o método de inserção não influencia nos resultados de dureza.

Automedicação em crianças atendidas em centro de especialidades odontológicas na Amazônia / Children’s self-medication attended at an Amazon Dental Specialist Center

O objetivo deste trabalho foi avaliar e caracterizar alguns aspectos relacionados a automedicação em pacientes atendidos em urgência odontológica infantil em um centro de especialidades médicas e odontológicas. Os pais ou responsáveis por crianças com idade entre 2 e 9 anos que procuraram atendimento odontológico no período entre outubro e novembro de 2012, responderam a um questionário aplicado de forma randomizada. Apesar dos pais/responsáveis revelaram que a receita deve ser inalterada e intransferível (73,2%; p<0,05), a maioria dos entrevistados (67,2%) é favorável à automedicação e a reutilização de receitas antigas foi a forma mais utilizada para praticá-la (27,9%). Houve associação coerente entre o tipo de medicamento utilizado com os problemas de urgência odontológica, como emprego de analgésicos em casos de dor (65,3%; p<0,05), antitérmico para febre (67,0%; p<0,05) e anti-inflamatório em caso de edema (57,6%; p<0,05) e a maioria dos responsáveis que exerce a automedicação é do gênero feminino. O estudo mostrou que a automedicação é exercida em larga escala pelos usuários do serviço, podendo levar à utilização de doses inadequadas ou a resistência aos antibióticos pelos pacientes...

This paper aims to evaluate and characterize some aspects of patients self-medication. The study was conducted at children’s dental emergency sector in a center of medical and dental specialties. A randomized questionnaire was applied for parents or guardians of children aged 2 to 9 years who sought dental care in the period between October and November 2012. Although the parents/guardians claim that prescription should be unchanged and nontransferable (73.2%; p <0.05), most of the surveyed people (67.2%) are in favor of self-medication. The reuse of old prescription was the most used way to practice it (27.9%). There was consistent association between the type of drug used with emergency dental problems such as use of analgesics in case of pain (65.3%; p <0.05), antipyretic for fever (67.0%; p <0, 05) and anti-inflammatory in cases of edema (57.6%; p <0.05) and the women practice self-medication more often. The study showed that self-medication is exercised largely by service users, which may lead to the use of inadequate doses or resistance to antibiotics by patients...