An investigation on the presence of certain anaerobic bacterial species in necrotic primary teeth and an evaluation of two endodontic instrumentation techniques in pediatric dentistry

Maintaining the integrity and function of primary dentition is one of the main purposes of pediatric dentistry. Bacteria and their products are responsible for the development of endodontic pathologies in primary teeth. This study aimed to identify the presence of specific anaerobic bacteria in infected pulp chambers (PC) and root canals (RC) of necrotic primary teeth by the PCR method and to make an in vivo comparison of the effectiveness between two molar tooth endodontic instrumentation techniques manual and rotary with reference to the time instrumentation and the time to perform the filling. The study consisted in the microbial investigation of primary teeth with pulp necrosis of 15 patients. Samples were collected by using cotton balls (PC) and sterile absorbent paper points (RC). Bacterial DNA was extracted by means of DNA extraction kits. After DNA extraction, PCR reaction was performed through the use of specific primers to detect the occurrence of the following microorganisms: Filifactor alocis, Fusobacterium nucleatum, Parvimonas micra, Porphyromonas endodontalis, P. gingivalis, Prevotella intermedia, P. nigrescens, P. tannerae, Tanerella forsythia, Treponema denticola and T. socranskii. PCR products were analized by 1% agarose gel stained by red gel and viewed under ultraviolet transillumination. To compare instrumentation techniques, 8 patients (4 for each technique used) between 6 and 8 years of age were selected. Teeth were prepared by using n. 15 up to 30 K-type files for the manual technique; for the rotary technique, S2, F1 and F2 Pro Taper instruments were used. Filling was performed with iodoform-based paste. Instrumentation and filling duration were recorded. Collected data for each study were typed on Excel spreadsheets and analyzed statistically. A 5% significance level (P<0.05) was adopted for all tests. The results showed that the most frequently detected species were P. nigrescens (12/15), P. gingivalis (11/15) and F. alocis in the PC, and P. gingivalis (15/15) and P. nigrescens (14/15) in the RC. The red complex was not found in the PC, but was found in the RC in three cases. Only the simultaneous presence of P. nigrescens in the PC and in the RC was statistically associated (p=0.04). There were no significant statistical differences in instrumentation and filling duration between the techniques used, and differences in the quality of fillings were not observed. Thus, strict anaerobic bacteria were often detected in PC and RC samples. RC preparation with rotary instrumentation may be an alternative to manual instrumentation; however, it does not decrease the time of pediatric dentistry work in a significant wayA manutenção da integridade e função da dentição decídua, até a esfoliação fisiológica, constitui um dos principais objetivos da odontopediatria. Bactérias e seus produtos são os responsáveis pelo desenvolvimento de patologias endodônticas nos dentes decíduos. O objetivo deste estudo foi identificar a presença de bactérias anaeróbias específicas na câmara pulpar (CP) e nos canais radiculares (CR) de dentes decíduos necrosados através do método de PCR e comparar, in vivo, a eficácia de duas técnicas de instrumentação endodôntica em molares decíduos, manual e rotatória, em relação ao tempo de instrumentação e ao tempo para realização da obturação. A amostra foi constituída de 15 pacientes, que apresentavam dentes decíduos com necrose pulpar, para a investigação microbiana. As amostras foram coletadas usando bolinhas de algodão (CP) e pontas de papel absorvente estéreis (CR). O DNA bacteriano foi extraído através de um kit próprio para extração de DNA. Após a extração do DNA, a reação de PCR foi realizada utilizando primers específicos para detectar a presença das seguintes espécies de microrganismos: Filifactor alocis, Fusobacterium nucleatum, Parvimonas micra, Porphyromonas endodontalis, P. gingivalis, Prevotella intermedia, P. nigrescens, P. tannerae, Tanerella forsythia, Treponema denticola e T. socranskii. Os produtos de PCR foram analisados por gel de agarose 1%, corados com gel red e visualizados sob transiluminação de luz ultravioleta. Para a comparação entre as técnicas de instrumentação, foram selecionados oito pacientes, entre seis e oito anos de idade, com molares decíduos inferiores que necessitavam de tratamento endodôntico (quatro para cada técnica utilizada). Para técnica manual, os dentes foram preparados com limas tipo K e a técnica rotatória foi realizada com limas de Ni-Ti Pro Taper. Todos os canais foram preparados da lima #20 até a #30, para a técnica manual. Para a técnica rotatória foram utilizados instrumentos Pro Taper S2 F1 e F2. A obturação foi ralizada com pasta iodoformada. Os tempos de instrumentação e de obturação foram coletados através de um cronômetro digital. Os dados de cada estudo foram digitados numa planilha Excel e analisados estatisticamente. Para todos os testes foi adotado nível de significância de 5% (p<0.05). Os resultados mostraram que as espécies mais frequentemente detectadas na CP foram P. nigrescens (12/15), P. gingivalis (11/15) e F. alocis (11/15) e nos CR foram P. gingivalis (15/15) e P. nigrescens (14/15). O "complexo vermelho", não foi encontrado na CP, mas foi encontrado no CR de três casos. Apenas a presença simultânea de P. nigrescens na CP e no CR foi estatisticamente associada (p = 0.04). Não houve diferença estatística significante entre os tempos de instrumentação das técnicas utilizadas e também entre os tempos de obturação analisados. Assim, bactérias anaeróbias estritas foram frequentemente detectadas em amostras de CP e CR e o preparo dos CR com instrumentação rotatória pode ser uma alternativa à instrumentação manual, entretanto não diminui, significativamente, o tempo de trabalho do odontopediatr

An investigation of the presence of specific anaerobic species in necrotic primary teeth

Different microbial identification methods have shown that the microbial community profiles in endodontic infections are diverse and assorted. The aim of this study was to evaluate the frequency of selected endodontic pathogens in the pulp chambers (PCs) and root canals (RCs) of infected primary teeth using PCR methods. Paired PC and RC samples were collected from 15 subjects and analyzed by PCR for the presence of Filifactor alocis, Fusobacterium nucleatum, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Prevotella tannerae, Tanerella forsythia, Treponema denticola, and Treponema socranskii. The frequency of each species was determined in the PC and RC of each case. The species most frequently detected in PCs were P. nigrescens (86.7%), P. gingivalis (73.3%), and F. alocis (73.3%). Of the PC samples, 13.3% contained P. micra and T. denticola, and 6.7% contained T. forsythia. The species most frequently detected in RCs were P. gingivalis (100%) and P. nigrescens (93.3%). P. tannerae, P. micra, and T. denticola were found in 40% of the RC samples; T. forsythia was found in 26.7% of the RC samples. The &#8220;red complex&#8221;, which comprises P. gingivalis, T. denticola, and T. forsythia, was not found in the PC of any tooth but was found in 30% of the RC samples. The detection of P. nigrescens in the PC was statistically associated with the presence of P. nigrescens in the RC (p = 0.04). The results suggest high heterogeneity among the samples, even among those from the same subject

Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth

The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI) to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90) for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (&#945; = 5%). Enamel fracture was the most prevalent type of TDI (48.7%) and the upper central incisors were the most affected teeth (88.4%). The frequency of seeking dental treatment was low (9.7%). The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR = 1.170; 95%CI 1.018-1.341), parents/caregivers&#8217; perception of a child&#8217;s oral health as poor (PR = 1.100; 95%CI 1.026-1.176), and the non-perception of TDI by parents/caregivers (PR = 1.250; 95%CI 1.142-1.360). In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child&#8217;s oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth

Association between oronasopharyngeal abnormalities and malocclusion in Northeastern Brazilian preschoolers

Abstract Objective: Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers. Methods: A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05). Results: The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC. Conclusion: Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers

Dental emergencies in a university pediatric dentistry clinic: a retrospective study

A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%), pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%). Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used