Alternative approach to proximal carious lesion in anterior teeth using the abrasion technique: Case report

The treatment of proximal carious lesions in primary teeth is usually difficult to implement. The success is related to cavity preparation, the proper color choice of the restorative material and the restorative technique itself. This case report describes for proximal carious lesions in primary teeth alternative approach, by using abrasion technique of the decayed surface and with the technique of surface abrasion of decayed, with clinical and radiographic follow-up of 07 months. It is concluded that, the abrasion technique can be effective to arrest proximal carious lesions in primary anterior teeth

Validity and reliability of methods for the detection of secondary caries around amalgam restorations in primary teeth

Secondary caries has been reported as the main reason for restoration replacement. The aim of this in vitro study was to evaluate the performance of different methods - visual inspection, laser fluorescence (DIAGNOdent), radiography and tactile examination - for secondary caries detection in primary molars restored with amalgam. Fifty-four primary molars were photographed and 73 suspect sites adjacent to amalgam restorations were selected. Two examiners evaluated independently these sites using all methods. Agreement between examiners was assessed by the Kappa test. To validate the methods, a caries-detector dye was used after restoration removal. The best cut-off points for the sample were found by a Receiver Operator Characteristic (ROC) analysis, and the area under the ROC curve (Az), and the sensitivity, specificity and accuracy of the methods were calculated for enamel (D2) and dentine (D3) thresholds. These parameters were found for each method and then compared by the McNemar test. The tactile examination and visual inspection presented the highest inter-examiner agreement for the D2 and D3 thresholds, respectively. The visual inspection also showed better performance than the other methods for both thresholds (Az = 0.861 and Az = 0.841, respectively). In conclusion, the visual inspection presented the best performance for detecting enamel and dentin secondary caries in primary teeth restored with amalgam

Evaluation of the dental structure loss produced during maintenance and replacement of occlusal amalgam restorations

The aim of this in vitro study was to evaluate four different approaches to the decision of changing or not defective amalgam restorations in first primary molar teeth concerning the loss of dental structure. Ditched amalgam restorations (n = 11) were submitted to four different treatments, as follows: Control group - polishing and finishing of the restorations were carried out; Amalgam group - the ditched amalgam restorations were replaced by new amalgam restorations; Composite resin group - the initial amalgam restorations were replaced by composite resin restorations; Flowable resin group - the ditching around the amalgam restorations was filled with flowable resin. Images of the sectioned teeth were made and the area of the cavities before and after the procedures was determined by image analysis software to assess structural loss. The data were submitted to ANOVA complemented by the Student Newman Keuls test (p < 0.05). The cavities in all the groups presented significantly greater areas after the procedures. However, the amalgam group showed more substantial dental loss. The other three groups presented no statistically significant difference in dental structure loss after the re-treatments. Thus, replacing ditched amalgam restorations by other similar restorations resulted in a significant dental structure loss while maintaining them or replacing them by resin restorations did not result in significant loss

Differences in responses to the Oral Health Impact Profile (OHIP14) used as a questionnaire or in an interview

The objective of this study was to compare the completion rates and performance of the Brazilian version of the Oral Health Impact Profile (OHIP14) when applied as an interview or in its original self-reported form. A convenience sample of 74 adult patients was selected in a Dental Clinic (University of Araras, Brazil). One examiner administered the instrument in both formats to participants with an interval of 2 weeks between each administration. Data about dental health condition and socioeconomic status were collected and associated with total OHIP14 scores in both formats using linear regression analyses. No differences were found in the total scores and in each subscale of the OHIP14 according to the form of administration. Higher values of completion were found in the interview format. More severe impacts were recorded in the interview format than in the questionnaire format. Higher values of total OHIP-14 scores in both formats were related to the presence of dental caries. Total OHIP14 scores were not influenced by the method of administration. However, the use of the OHIP14 in the questionnaire format may result in lower completion rates and loss of data

Efeito da concentração de clorexidina na resistência de união à dentina em dentes decíduos

PURPOSE: To evaluate the effect of the use of 0.5% and 2% chlorhexidine digluconate on the immediate bond strength of a conventional adhesive system to dentin in primary teeth. METHODS: Twenty-one healthy primary molars were divided into three groups (n=7), being one control (A) and two experimental groups (B and C). After dentin exposure, in Group (A) the adhesive procedure was performed using 37% phosphoric acid gel (15 s); dentin was washed (15 s), air dried (30 s) and rehydrated with water. Groups B and C followed similar procedures but for re-hydration with 0.5% and 2% chlorhexidine, respectively, for 30 s. A resin composite block was built simulating a restoration, and the teeth were stored in distilled water at 37°C for 24 h before the microtensile bond strength test. The bond strength data were analyzed by analysis of variance. RESULTS: No statistically significant difference in bond strength was found among the tested groups (P>0.05) CONCLUSION: The 0.5% and 2% concentrations of chlorhexidine presented similar behavior and caused no adverse effects on the bond strength to dentin in primary teeth.OBJETIVO: Avaliar o efeito do uso de digluconato de clorexidina 0,5% e 2% na resistência de união imediata à dentina de dentes decíduos para um sistema adesivo convencional. METODOLOGIA: Vinte e um molares decíduos hígidos foram divididos em três grupos (n=7), sendo um controle e dois experimentais. Após a exposição da dentina, foi realizado no grupo controle (A) o procedimento adesivo utilizando ácido fosfórico gel a 37% (15 s); a superfície foi então lavada (15 s), seca com ar (30 s) e reidratada com água. Os grupos B e C foram idênticos ao grupo A, apenas com diferença no reumidecimento de clorexidina 0,5% e 2% respectivamente, por 30 s. Após a confecção do bloco de resina composta, os dentes foram armazenados em água destilada a 37°C por 24 h antes do teste de microtração. Os dados de resistência de união foram avaliados através de análise de variância. RESULTADOS: Os dados apresentaram distribuição homogênea, não havendo diferença estatisticamente significante entre os grupos (P>0,05). CONCLUSÃO: As concentrações de clorexidina a 0,5% e 2% apresentaram comportamentos similares e não causaram efeitos adversos na resistência de união em dentina de dentes decíduos, quando comparadas ao grupo controle

Dimensions of Occlusoproximal Cavitated Carious Lesions as a Cut-Off Point for Restorative Decision in Primary Teeth

Objective:&nbsp;To investigate whether the dimensions of cavitated dentin carious lesions on the occlusoproximal surfaces of primary teeth could predict the location of cement-enamel junction (CEJ).&nbsp;Material and Methods:&nbsp;Two hundred extracted primary molars were selected and digital images were obtained. The teeth were set in arch models for clinical measurement. The cervical-occlusal (CO) and buccal-lingual/palatal (BL/P) cavities’ dimensions were obtained by digital (Image J) and clinical (periodontal millimeter probe) assessments. The cervical margin location was also determined. The thresholds (cut-off points) were determined by sensitivity, specificity and the areas under the receiver operating characteristics curves (Az) for the two methods. Pearson's correlation coefficient was used to investigate the correlation between clinical and digital measurements. Logistic regression analysis was performed to evaluate the association between the dimensions and cervical margin location.&nbsp;Results:&nbsp;There was a strong correlation between methods for all measurements (CO: r=0.90, VL/P: r=0.95). Cavities with BL/P distance higher than 4.5 mm and CO dimension higher than 3.5 mm had a lower chance of presenting the cervical limit above the CEJ, irrespective of the measurement method.&nbsp;Conclusion:&nbsp;CO and VL/P dimensions could be used to predict the CEJ location and, ultimately, as a clinical parameter for restorative decision-making

Factors associated with early weaning

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 population16149149

Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial

Background: Hall technique (HT) has been indicated for teeth with dentinal caries lesion; however, extensive cavities, with more than two surfaces still seem challenging for restorative treatment in pediatric dentistry, resulting in a higher failure rate and an increased need for retreatment. Objectives: To compare the survival rate of the Hall technique preformed metal crown (HT) with resin composite restoration (RC) for multi-surface cavitated caries lesions in primary molars. Methodology: In this multicenter two-arm randomized clinical trial, children between 4 and 9 years of age with at least one primary molar with cavitated caries lesion involving more than two surfaces, including one buccal or palatal/lingual surface, were selected from 17 Brazilian cities. A total of 364 teeth were allocated into two groups: (1) teeth treated with selective caries removal and RC and (2) treated with the HT. The survival rate was assessed at 6 and 12 months after the interventions. Survival analysis was performed with the Kaplan‒Meier method. Cox regression was used to determine the influence of explanatory variables on the survival rate (α=5%). Results: After 12 months, 292 teeth were re-evaluated. A total of 358 teeth were re-evaluated at least once during the study and included in the survival analysis. The HT (87.8%) resulted in a higher survival rate than RC restoration (75.7%) (p=0.004). Conclusion: HT has a higher survival rate than RC as a treatment for multi-surface cavitated caries lesions in primary teeth. ClinicalTrials.gov: NCT0278239