Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials.

AIMS: The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry. BACKGROUND: The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols. REVIEW RESULTS: Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials. CONCLUSION: The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice. CLINICAL SIGNIFICANCE: Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, et al. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.

Impact of the intermediary layer on sealant retention: a randomized 24-month clinical trial.

OBJECTIVES: The aims of this study were to assess long-term impact of tooth eruption stages (ES) on sealant retention on occlusal surfaces previously coated with intermediary bonding layer and to determine caries prevention. MATERIALS AND METHODS: Sixty-five school children were selected (aged 6-10 years), with four non-carious permanent first molar in different ES (OP (operculum present), ME (marginal edge), CE (completely erupted)). Split-mouth and single-blind study design was used. The teeth (260) were randomly selected according to treatment (sealant/technique): F (Fluroshield), H (Helioseal Clear Chroma), SF (Single Bond + F), EH (Excite + H). Sealant retention, marginal integrity, discoloration, and caries prevention were assessed after 6, 12, 18, and 24 months by calibrated examiner (Spearman = 0.91) using visual inspection. Data were submitted to the Cox proportional hazard model (survival analysis) and Likelihood ratio χ 2 test (correlation), p ≤ 0.05. RESULTS: At baseline, ES was 20 % in OP, 54 % in ME, and 26 % in CE. There was no significant difference on sealant retention between the treatments (p = 0.2774). However, significant differences were found regarding the ES on sealant retention (p = 0.0041). The CE stage showed the highest retention survival rate during the 24 months. The overall sealant prevention average was found to be about 99.4 % and showed no difference between the groups. CONCLUSIONS: Eruption stages affect sealant retention irregardless of the intermediate layer and type of sealant. However, there was caries prevention on tooth occlusal surfaces after 24 months, regardless of treatment. CLINICAL RELEVANCE: Sealing is recommended to prevent occlusal caries of newly erupted teeth in high-caries-risk patients. However, its application is critical on moisture limited control surfaces independently of sealer material and technique.

Supraperiosteal technique protocol for forehead filling with a mixture of calcium hydroxyapatite and hyaluronic acid: Double-blind, randomized controlled clinical trial.

OBJECTIVE: The current study aims to investigate the safety and efficacy of using calcium hydroxyapatite (CaHA) versus CaHA associated with hyaluronic acid (HA) for forehead volume replacement and contour restoration without forehead irregularities. METHODS: This interventional study involved 132 participants in a two-arm, parallel, double-blind trial for forehead treatment using the supraperiosteal technique. Group A received CaHA, and Group B received a combination of CaHA and HA as filler materials. Follow-up assessments occurred at 30 and 180 days, incorporating the 5-point Global Aesthetic Improvement Scale (GAIS) and photographic analysis for forehead volume replacement, contour restoration, and without forehead irregularities. Safety assessments included monitoring adverse events, particularly nodules. RESULTS: The study included all 132 enrolled patients who completed the trial. Applying CaHA in combination with HA resulted in a statistically significant improvement in both GAIS scale scores and the reduction of forehead irregularities. The total incidence of nodules was 3.7%. Group A had four times more occurrences of nodules than Group B. Furthermore, Group B exhibited lower rates of forehead irregularities following the treatment compared to Group A. CONCLUSION: The supraperiosteal application of CaHA and HA for forehead treatment demonstrates superior efficacy in addressing signs of aging compared to the isolated use of CaHA.

Selective Caries Removal: A Case Report with 21-Year Follow-Up.

Dental caries remains the most prevalent chronic disease globally, and its management should adhere to the principles of minimal intervention dentistry. This study reports a series of successful cases involving the selective removal of carious tissue in permanent molars, with follow-up periods of up to 21 years. Six permanent molars with severe and deep carious lesions were treated with selective caries removal and restored with high-viscosity glass ionomer cement. Clinical examination revealed that the teeth were free from pain and sensitivity. Follow-up assessments were conducted at 7 and 21 years posttreatment. Treatment success was defined by the absence of clinical and radiographic signs, symptoms of pulp alterations, and lesion arrest. Successful minimally invasive approaches were observed with selective removal of carious tissue and maintenance of pulp vitality for up to 21 years.

Root Resorption of the Permanent Central Incisor through Ectopic Eruption of the Maxillary Canine.

Although ectopic eruption of the maxillary canine has a low prevalence, a late diagnosis can have serious consequences. A careful clinical examination, assisted with radiographic examination, ensures early diagnosis, facilitates planning, and minimizes possible adverse consequences. This study reports a case of ectopic eruption of the permanent maxillary canine, with complete root resorption of the central permanent incisor, the consequences of which caused functional, aesthetic, and psychological harms to the patient. The procedures used included canine ectopic remodeling of the ectopic canine in the central incisor and orthodontic correction, which treated the anomaly and rebuilt the patient's self-esteem.

Orthodontic bracket bonding techniques and adhesion failures: A systematic review and meta-analysis.

Background: This systematic review compared the bonding failures of orthodontic brackets bonded by indirect or direct techniques. Data sources: The searched databases were Cochrane Library, LILACS, BBO, PubMed, Scopus, Web of Science. Material and Methods: A search for randomized clinical trials comparing the two techniques was carried out to answer the research question: When considering orthodontic bracket bonding on permanent teeth, does the indirect technique reduce the number of bonding failures compared to the direct one over time? The quality of the included papers was assessed with Cochrane risk of bias tool and the quality of evidence with GRADE. Results: From 3096 articles identified, seven were included in the systematic review (five at unclear; two at low risk of bias). Meta-analysis was carried out according to the follow-up periods (0-6 months and 12-15 months). Results: In the first period, bonding techniques were similar with regard to adhesion failures (RR = 0.59; 95% CI 0.10-3.62; p = 0.00001; I2 = 92%); in the 12-to-15-month period, the direct bonding technique proved to be superior (RR = 1.44; 95% CI 1.05 - 1.99; p = 0.41; I2 = 0%). The quality of evidence was classified as low for the 0-6 months follow-up and high for the 12 months. Conclusions: Based on the absence of heterogeneity and the high quality of evidence, it is concluded that the direct bracket bonding technique has a lower failure rate than the indirect technique in the long term (12-15 months). Key words:Orthodontic brackets, fixed orthodontics, systematic review.

TiO2 nanotubes improve physico-mechanical properties of glass ionomer cement.

OBJECTIVES: The aim of this study was to determine the physico-mechanical properties of a high viscosity glass ionomer cement (GIC) reinforced with TiO2 nanotubes (TiO2-nt). METHODS: TiO2-nt was incorporated into the GIC powder components (Ketac Molar EasyMix™) in concentrations of 0% (control group), 3%, 5%, 7% by weight. Compressive strength (n = 10/group), three point bending for flexural strength (n = 18/group), microshear bond strength to dentin and failure mode (n = 20/group), and surface roughness and weight loss before and after brushing simulation (30,000 cycles) (n = 8/group) were evaluated. Data were submitted to Shapiro-Wilk, ANOVA, Tukey and Chi-square tests (α ≤ 0.05). RESULTS: Addition of 5% of TiO2-nt into GIC presented the highest values for compressive strength and differed from the control, 3% and 7% groups (p = 0.023). There were no significant differences in flexural strength (p = 0.107) and surface roughness before and after the dental brushing (p = 0.287) among the groups. GIC added with 5% TiO2-nt showed the lowest weight loss values (p = 0.01), whereas the control, 3% or 5% TiO2-nt groups presented similar microshear bond strength values (p ≥ 0.05). The 5% TiO2-nt group featured higher microshear bond strength than the 7% TiO2-nt group (p = 0.034). Cohesive in material was the most representative failure mode for all groups. SIGNIFICANCE: The incorporation of TiO2-nt did not affect GIC's adhesiveness to dentin, but improved its compressive strength at 5%. Furthermore, TiO2-nt decreased the percentage of weight loss after GIC's surface wear.

Addition of hydrogen peroxide to methylene blue conjugated to ß-cyclodextrin in photodynamic antimicrobial chemotherapy in S. mutans biofilm.

OBJECTIVE: This study evaluated the effect of hydrogen peroxide addition on ß-cyclodextrin-conjugated methylene blue in antimicrobial photodynamic therapy(a-PDT) in S. mutans biofilm model using laser or light emitting diode (LED) (λ = 660 nm). METHODS: A preliminary assay was performed to evaluate the cytotoxicity of hydrogen peroxide in oral fibroblasts by the colorimetric method (MTT). Afterwards, groups were divided into (n = 3, in triplicate): C (negative control), CX - chlorhexidine 0.2% (positive control), P (methylene blue/ß-cyclodextrin), H (Hydrogen Peroxide at 40 µM), PH, L (Laser), LP, LH (Laser+Hydrogen Peroxide), LPH, LED, LEDP, LEDH, and LEDPH. The biofilm was formed in 24 h with BHI + 1% sucrose (w/v). Light irradiations were conducted with laser, 9 J, 323 J/cm2, 113 s or with LED, 8.1 J, 8.1 J/cm2 for 90 s. Microbial reduction was evaluated by counting the viable microorganisms of the biofilm after the respective treatments, in a selective culture medium, and laser confocal microscopy evaluation. RESULTS: LP, LH, LPH, LEDP, LEDH, and LEDPH groups statistically reduced the counts of S.mutans compared with the C group and the log reductions were of 1.87, 1.94, 2.19, 0.91, 0.92, and 1.33, respectively; the addition of hydrogen peroxide did not potentiate the microbial reductions (LPH and LEDPH) compared with the LP and LEDP groups. CONCLUSION: The association of hydrogen peroxide with the conjugated ß-cyclodextrin nanoparticle as photosensitizer did not result in an enhanced effect of a-PDT; hydrogen peroxide behaved as a photosensitizer, since it reduced the number of S. mutans when associated with laser light.

Relationship Between Celiac Disease and Dental Caries in Children and Adolescents: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To assess the relationship between celiac disease and the prevalence of dental caries in children and adolescents and also evaluate if dental enamel defects in celiac children predispose to dental caries. Material and Methods: Searches were performed in the following databases: PubMed, Scopus, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, and OpenGrey. The risk of bias was assessed using the Newcastle-Ottawa Scale. DMFT/dmft and DMFS/dmfs data of observational studies that compared the prevalence of caries between children and adolescents with celiac disease and healthy individuals. Meta-analysis was performed using a random effects model. Heterogeneity between studies was estimated using Cochran's Q test, and inconsistency was measured using I2 statistics. Results: Of the 121 studies retrieved, 17 were selected, and 12 were included in the meta-analysis. The prevalence of caries in the primary dentition (dmft) did not differ between celiac patients and controls [SMD = -0.35; 95% CI (-0.83; 0.13); p = 0,15; I2 = 89%]. There was also no difference in the prevalence of caries in permanent teeth (DMFT) between groups [SMD = -0.44; 95% CI (-1.02; 0.14); p = 0.14; I2 = 95%]. Conclusion: Celiac disease is not a determinant factor in the development of dental caries in children and adolescents compared to the control group.

Primary tooth restoration with colored compomer: case report / Restauração de dente decíduo com compômero colorido: relato de caso

ABSTRACT In pediatric dentistry, restorative treatment requires a material with good mechanical properties, ease of handling, and usability. For the restoration of deciduous teeth, colored compomers are an alternative material for motivating children in dental treatment and, consequently, behavior management. This study aimed to provide information about colored compomers by presenting a case of restoration in a deciduous molar with a five-year follow-up. Additionally, the study highlights the child's motivation toward dental treatment and oral care, thus offering an alternative to other restorative materials for clinicians to consider. The treatment plan for tooth 75 was selective removal of decayed tissue and restoration with compomer blue- colored Twinkly Star. The restoration was performed without anesthesia under relative isolation following the clinical protocol recommended by the manufacturer. As a result, it was observed that the restoration in colored Twinky Star compomer remained aesthetically and functionally satisfactory after five years. In addition, it was favorable for the child's collaboration in dental treatment. It is concluded that colored Twinky Star compomer can be a viable alternative for restoring deciduous teeth, contributing to children's dental treatment and oral care motivation.

RESUMO Em Odontopediatria, o tratamento restaurador exige um material que tenha boas propriedades mecânicas, facilidade de manipulação e de uso. Para a restauração de dentes decíduos, os compômeros coloridos são uma alternativa de material para a motivação de crianças no tratamento odontológico e consequentemente manejo de comportamento. Sabendo da necessidade de conhecer melhor os compômeros coloridos, o objetivo deste estudo foi relatar um caso de restauração com compômero colorido em molar decíduo com acompanhamento de cinco anos, bem como a motivação da criança perante o tratamento odontológico e cuidados bucais a fim de apresentar ao clínico uma alternativa a outros materiais restauradores. O plano de tratamento para este dente 75 foi remoção seletiva de tecido cariado e restauração com compômero colorido twinky star na cor azul. A restauração foi feita sem anestesia sob isolamento relativo seguindo o protocolo clínico preconizado pelo fabricante. Como resultado observou-se que a restauração em compômero Twinky Star colorido manteve-se satisfatória tanto estética quanto funcionalmente após cinco anos. Além disso, mostrou-se favorável para a colaboração da criança no tratamento odontológico. Conclui-se que o uso do compômero Twinky Star colorido pode ser uma alternativa viável para restauração de dente decíduo, contribuindo para a motivação de crianças no tratamento odontológico e cuidados bucais.

Extraction of supernumerary teeth in a hospital setting: case report in pediatric dentistry / Exodontia de dentes supranumerários em ambiente hospitalar: relato de caso na Odontopediatria

ABSTRACT The diagnosis and treatment of supernumerary teeth pose a challenge for dental clinicians and pediatric dentists. These teeth are asymptomatic and may cause the delayed eruption of the permanent dentition, altered bone growth and ectopic positioning. This paper reports a case of the surgical removal of supernumerary teeth in the anterior region of the maxilla of a child under general anesthesia in a hospital setting. A six-year-old female patient visited a private dental office in the city of Garanhuns, Brazil, accompanied by her mother, who reported a tooth with a "strange shape" in the anterior region as the main complaint and also reported that her daughter's first dental experience was negative. The clinical examination and imaging tests were performed under general anesthesia to confirm the diagnosis. In view of the patient's dental and behavioral history, surgical treatment was performed in a hospital setting and assisted by a multidisciplinary team. Care in the hospital setting was found to be feasible, providing greater comfort for uncooperative patients.

RESUMO Os dentes supranumerários representam um desafio para clínicos e odontopediatras quanto ao diagnóstico e tratamento. São assintomáticos, podendo gerar atraso na dentição permanente, alteração do crescimento ósseo e posicionamento ectópico. Assim, o presente trabalho teve como objetivo apresentar um relato de caso de remoção cirúrgica de dentes supranumerários na região anterior da maxila de um paciente infantil, em ambiente hospitalar sob anestesia geral. O paciente do sexo feminino, 6 anos, compareceu ao consultório apresentando como queixa a presença de um dente "estranho" na região anterior. Foram realizados o exame clínico e exames de imagem com a confirmação do diagnóstico de dentes supranumerários na região do incisivo central superior direito (11) e do incisivo central superior esquerdo (21). Tendo em vista o histórico odontológico e comportamental da paciente, optou-se em realizar o tratamento cirúrgico em ambiente hospitalar, auxiliado por equipe multidisciplinar. Dessa forma, ao final dos procedimentos foi verificado que o atendimento em ambiente hospitalar é viável para maior conforto do paciente não colaborador.

Penetration of Filled and Unfilled Resin Sealants on Different Enamel Substrates.

PURPOSE: To evaluate the penetration ratio of filled and unfilled resin-based sealants on different enamel substrates and pit and fissure morphologies. METHODS: Forty-eight occlusal enamel blocks obtained from impacted human third molars were randomly divided (n equals eight) according to enamel substrates (sound; caries-like lesion; caries-like lesion plus topical fluoride application) and sealant material (FluroShield; Helioseal Clear Chroma). Sealants were applied on the enamel surface. The specimens were stored in 100 percent humidity for 24 hours at 37 degrees Celsius, sectioned in a buccal-lingual direction (at approximately 50 µm), and examined to determine the sealant penetration ratio (b x 100/a; a equals total fissure length and b equals sealant penetration length) and pit and fissure morphology (V-, U-, or Y-shaped). Statistical analysis was performed using Friedman and Kruskal-Wallis tests (P<0.05). RESULTS: Enamel substrate and sealant material did not affect the sealant penetration ratio, with no interactions between these factors. Moreover, the morphology significantly affected the sealant penetration, with the "Y"-shaped fissures presenting the lowest sealant penetration ratio compared to "U-"shaped (P=0.0001) and "V-" shaped fissures (P=0.0018). CONCLUSIONS: Pit and fissure morphology was a critical factor on sealant's penetration capacity; however, enamel substrate and sealant type did not affect sealant's penetration ratio.

Severe trauma in young permanent tooth: a case report / Trauma severo em dente permanente jovem: relato de caso

ABSTRACT Dentoalveolar trauma is a severe traumatic injury involving alveolar bone and dental structures. Like any trauma, it can leave irreparable sequelae and even cause tooth loss. The aim of this study is to report on the case of a dentoalveolar trauma in a 10-year-old male patient and the treatment performed with 12-month follow-up. The child had lateral luxation and displacement of teeth 11 and 21 in labial direction after a fall from his own height. The patient was examined at a hospital, received medication and was referred to a dental clinic. At the dental office, the teeth were repositioned, as well as received endodontic treatment and dental reanatomization. Two months after the trauma, root resorption was observed externally, which remained stable for 12 months. It was concluded that post-trauma treatment should be immediate and that follow-up sessions should be done carefully to minimize sequelae and to receive better prognosis.

RESUMO Traumatismo dentoalveolar é uma lesão traumática grave envolvendo osso alveolar e estruturas dentárias. Como qualquer trauma, pode deixar sequelas irreparáveis e até causar perda dentária. O objetivo deste estudo é relatar o caso de um trauma dentoalveolar em um paciente de 10 anos e o tratamento realizado com 12 meses de acompanhamento. A criança apresentou luxação lateral e deslocamento dos dentes 11 e 21 na direção labial após uma queda da própria altura. O paciente foi examinado em um hospital, recebeu medicação e foi encaminhado a uma clínica odontológica. No consultório odontológico, os dentes foram reposicionados, posteriormente, tratados endodônticamente e realizado a reanatomização dentária. Dois meses após o trauma, a reabsorção radicular foi observada externamente, permanecendo estável por 12 meses. Concluiu-se que o tratamento pós-trauma deve ser imediato e que as sessões de acompanhamento devem ser realizadas com cuidado, a fim de minimizar sequelas e obter melhor prognóstico.

Abordagem integral em odontopediatria: relato de caso clínico / Integral Approach in Pediatric Dentistry: clinical case report

Objetivo: Relatar um caso clínico envolvendo a abordagem cirúrgica/restauradora e medidas preventivas. Relato do caso: Paciente MEMO, 6 anos e 8 meses de idade, feminino, com alto risco/atividade de cárie, apresentando biofilme visível em superfícies lisas livres, lesões de cárie ativa, perda precoce do dente 85, fístula relacionada com a região do dente 75, mudança de cor do dente 61 e perda significativa de dimensão vertical posterior, apresentou-se para tratamento na Clínica de pós-graduação em Odontopediatria da FOP/Unicamp. O plano de tratamento consistiu na abordagem integral focada na promoção da saúde como desfecho principal, ou seja, mudança de comportamento em relação à saúde bucal, e como desfecho secundário, a abordagem cirúrgica/restauradora. Instrução de higiene bucal foi realizada em todas as sessões. O manejo do comportamento foi conduzido por meio da evidenciação e controle de biofilme, profilaxia e adequação do meio bucal seguido da extração do dente 75, selamento de fossas e fissuras dos dentes 36, 46 e 16 e restaurações no 55 e 65. Mantenedor de espaço removível inferior foi realizado. Conclusões: Após seis meses pôde-se observar ausência de biofilme visível, o índice de placa estava controlado e não havia evidência de novas lesões de cárie. Pode-se concluir que o sucesso obtido neste caso destaca a importância da abordagem integral focada na promoção da saúde na clínica odontopediátrica.

Objective: To report a clinic case involving the surgical/restorative approach and preventive actions. Case report: The patient MEMO, aged 6y and 8mo, female, with high caries risk/activity, presenting visible biofilm on free smooth surfaces, active carious lesions, early loss of the 85 tooth, fistula related with the 75 tooth region, color change on 61 tooth and significant loss of posterior vertical dimension has been driven to Pediatric Dentistry Graduate Clinic at FOP/ Unicamp. Treatment plan consisted on integral approach focused as primary outcome on health promotion, behavior change in relation to oral health, and as secondary outcome, the surgical/ restorative approach. Oral hygiene instruction was conducted in all sessions. The behavior management was conducted by evidence and control of visible dental plaque, prophylaxis and oral environment adequation; extraction of 75 tooth, pit and fissure sealing of the 36, 46, 16 teeth, and restorations in the 55 and 65. Removable lower space maintainer appliance was made. Conclusions: After 6 months it could be observed that there was not visible biofilm, the IP was controlled. In addition, there was no evidence of new caries lesions. It could be concluded that the success obtained on this clinical case bring about the importance of the integral performance focused on healthy promotion in pediatric dentist clinic.

Controle de placa no primeiro molar permanente: análise de custo/benefício / Plaque control in the first permanent molar: cost/benefit analysis

Objetivo: Avaliar a eficácia e a eficiência do autocontrole de placa em primeiros molares permanentes. Métodos: Participaram 278 escolares de 6 a 8 anos de duas escolas públicas de Belo Horizonte-MG com amostra calculada por estimativa de proporção. Os exames foram realizados, sem prévia escovação dentária, na escola com consultório móvel, por uma profissional calibrada. Os dentes foram categorizados quanto ao estágio de erupção: não erupcionado (0), parcialmente erupcionado (1), totalmente erupcionado (2) e quanto à presença de placa estagnada na superfície oclusal: sem placa visível (0), restrita a sulcos e fissuras (1), facilmente detectável (2) e totalmente coberta por placa (3). Foram desenvolvidas atividades coletivas de orientação para escovacão, com ênfase no primeiro molar permanente. Após 6 meses, outra avaliação foi realizada juntamente com o reforço à orientação da escovação. Os dados foram submetidos ao teste de Mann- Whitney e à regressão logística. Resultados: Os dentes em processo de erupção mostraram maior possibilidade de apresentar placa que aqueles com completa erupção (Odds Ratio=0,52 [0,40-0,68]; p<0,0001), no exame inicial. Foi observada uma redução de 13% da presença de placa estagnada nos primeiros molares permanentes após o trabalho educativo. O tempo despendido para o programa foi de aproximadamente 53 horas, com custo total de R$ 637,34 (~1,23/criança). Conclusão: A orientação para uma técnica de escovação com remoção de placa estagnada no primeiro molar permanente mostrou-se eficaz e eficiente para o controle da cárie dentária, sobretudo quando o mesmo se encontra em infra-oclusão.(AU)

Aim: To evaluate the effectiveness and efficiency of plaque self-control in first permanent molars. Methods: Two hundred seventy eight schoolchildren, 6-8 years of age, from two public schools in the city of Belo Horizonte, MG, Brazil, participated in this study. The sample was calculated by an estimate of proportion. The examinations were performed without prior tooth brushing at schools with mobile dental offices by two calibrated professionals. The teeth were categorized according to the eruption stages: not erupted (0), partially erupted (1), and fully erupted (2), as well as regards the presence of stagnant plaque on the occlusal surface: without visible plaque (0), restricted to pits and fissures (1), easily detectable (2), and fully covered by plaque (3). Collective dental advice activities for proper tooth brushing were developed with emphasis on the first permanent molar. After six months, another evaluation, along with reinforcement of advice on proper tooth brushing, were performed. The data were submitted to the odds ratio (OR), Mann-Whitney test, and logistic regression in BioEstat 5.3 program. Results: Teeth in the eruption process showed a greater probability of presenting plaque than did those after full eruption (OR=0.52 [0.40-0.68]; p <0.0001), in the first examination. A reduction of 13% in the presence of stagnant plaque in the first permanent molars was observed after having provided educational advice. The partially erupted teeth showed a greater reduction of the presence of plaque (18%) than did the teeth after full eruption (13%). The time spent for the program was approximately 53 hours, with a total cost of R$637.34 (~R$1.23/child). Conclusion: Dental advice for proper brushing techniques to remove stagnant plaque on the first permanent molar was effective and efficient in the control of dental caries, especially when in infraocclusion.(AU)

Factors Associated with Early Weaning

Objective: To identify the factors that influenced early weaning and its incidence among children from six months old in five public hospitals of two states - Minas Gerais and Bahia, Brazil. Material and Methods: The sample (N = 104) was of convenience type composed of mothers of six-month-old infants from five public hospitals. Mothers answered a personal interview by phone when the child was six months old. Data analysis was performed by the association between the dependent variable, early weaning, and independents variables, maternal age, mother's marital status, education and job, family income, maternal belief about the amount of milk produced to be or not enough to feed her baby and breastfeeding interruption reason, through the chi-square test in SPSS software version 17.0 (p<0.05). Results: Among the relationships found, only maternal belief in milk failure was significantly associated with early weaning (p <0.001). Most mothers who did not perform early weaning believed they had satisfactory amount of milk (66.7%). The general weaning rate was ≅ 30%. Conclusion: Early weaning was related to maternal belief that the amount of milk was insufficient to meet the needs of the newborn and its incidence was high in the study population.

A simple and effective technique to guide the ectopic eruption of a first permanent molar: a case report

Objective: To report the case of a 5-year-old patient diagnosed with ectopic eruption of the lower left first permanent molar that was mesially inclined, initially based on the clinical examination and followed by periapical radiographic examination. Case report: The treatment consisted of the placement and maintenance of an elastic separator for one week between the space of the lower second primary molar and the lower first permanent molar. Subsequently, the elastic separator was removed, allowing the tooth to erupt freely. After 1 week without the elastic separator, the patient returned and the tooth was observed in adequate eruption. Final considerations: The treatment of ectopic eruption was effective, since it repositioned the first permanent molar and allowed its vertical eruption in a short time using a simple technique. Moreover, the early diagnosis of this eruption disorder of permanent molar in mixed dentition is important to avoid more complex treatments and enable normal occlusion development.

Avaliação da infiltração apical de cimento endodôntico acrescido de MTA e Portland / Apical leakage evaluation of endodontic cement with addition of MTA and Portland

Objetivo: O objetivo deste estudo foi avaliar a infiltração apical do cimento AH Plus e AH Plus com adição de diferentes proporções de MTA e Portland. Material e Métodos: Foram utilizadas 80 raízes palatinas de molares permanentes superiores extraídos, instrumentadas no Sistema Reciproc e obturadas com cone único. Posteriormente, as raízes foram impermeabilizadas e submersas em solução aquosa de azul de metileno a 2%. Em seguida, foram lavadas em água corrente por 24 horas e seccionadas ao longo eixo para avaliação em microscópio operatório. Os dados foram submetidos ao teste T de Wilcoxon no Programa SPSS (p>0,05). Resultados: Não houve diferença estatística significante na infiltração apical dos cimentos. Conclusão: Pode-se concluir que a adição de MTA e Portland ao cimento AH Plus não influenciou o selamento apical.

Objective: The aim of this study was to evaluate the apical leakage of the AH Plus cement and AH Plus with addition of different proportions of MTA and Portland. Material and Methods: Eighty palatal roots of extracted upper permanent molars were instrumented in Reciproc System and filled with single cone. Subsequently, the roots were waterproofed and submerged in aqueous solution of methylene blue at 2%. They were then washed in running water for 24 hours and sectioned along axis for evaluation in surgical microscope. The data were submitted to Wilcoxon T test using SPSS software (p>0.05). Results: There was no statistically significant difference in apical leakage of the cements. Conclusion: In conclusion, the addition of MTA and Portland to AH Plus cementnot influenced the apical sealing.

A saúde bucal na estratégia de saúde da família: como prosseguir? / Oral health in the family health strategy: how to proceed?

Considerando-se a importância de instituir um planejamento mais adequado e desenvolvimento eficaz das ações na Saúde Bucal de Várzea da Palma-MG, este estudo objetivou analisar a condição bucal de 380 escolares (5-6 anos de idade) e subsidiar ações em prol da qualidade dos serviços. Observou-se que 47,5% dos escolares não apresentavam doença cárie. Ao considerar-se somente o primeiro molar permanente (70,0% erupcionados), a presença de cárie foi menor (27,6%). Os resultados sugerem que atividades de promoção da saúde geraram mudanças positivas, no entanto, as metas da OMS-2010 não foram atingidas. Com finalidade de aumentar a resolubilidade destas ações, procurar-se-á promover educação em saúde, por meio de métodos mais descontraídos e includentes, como a orientação direta associada a recursos audiovisuais.

Considering the importance of establishing more adequate planning and effective development of the actions in the oral health of Várzea da Palma-MG, this study aimed to analyze the oral condition of 380 students (5-6 years old) and support actions in favor of quality of services. It was observed that 47.5% of the children did not present dental caries. When considered first permanent molars only (70.0% erupted), the presence of caries was lower (27.6%). The results suggest that health promotion activities generated positive changes, however, the goals of the WHO-2010 were not met. In order to increase solvability of these actions, health education will be promoted, through more relaxed and inclusive methods, such as direct guidance associated with audio visual resources.

Oral rehabilitation of a child with dentinogenesis imperfecta: case report

Introduction and Objective: To report the clinic case of a 5-yearold boy with presenting yellow-gray teeth and generalized severe tooth crown wear. Case report: After clinical and radiographic examination, he was diagnosed with dentinogenesis imperfecta. After the behavior management, we performed the adequacy of oral environment and diet and oral hygiene instructions. Study models were obtained and then, the rehabilitation treatment was performed through acetate crowns and orthodontic bands. Conclusion: Early diagnosis and treatment are very important in preventing further damage to dental tissues, other oral diseases, and orthodontic changes. Therefore, knowledge of the etiology and family history of the patient is crucial.