Oral health education strategies for biofilm control in children with neurodevelopmental disorder – a case report/ Estratégias de educação em saúde bucal para o controle de biofilme em criança com transtorno de neurodesenvolvimento – um relato de caso

Objective: To report oral health education strategies for biofilm control in a child with a neurodevelopmental disorder. Case report: A 9-year-old boy with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) was presented at the dental clinic with extreme difficulties in the oral hygiene practice. The intraoral examination revealed a massive presence of dental biofilm, moderate gingivitis, and caries experience. An individualized educational strategy using visual pedagogy added an adapted toothbrush was implemented. The improvement in the simplified oral hygiene indexes and gingival bleeding index demonstrated the success of this intervention. Conclusion: The individualized educational strategies can be successful implemented in a child with ASD and ADHD

Extraction of an impacted supernumerary mesiodens tooth in a child: a clinical case report

Mesiodens are supernumerary teeth located between the central incisors, close to the midline; Generally, they have a conical shape, can be impacted, and cause aesthetic-functional imbalance of the stomatognathic system. It is essential to emphasize that early diagnosis, through clinical and complementary exams, provides an optimized therapeutic strategy. The aims of the present study were to report a clinical case on strategies used to delimit the surgical opportunity as well as operative procedures performed in the presence of impacted mesiodens in a child patient. An 11-year-old female patient presented to the dental clinic for evaluation of a mesiodens-type supernumerary tooth. During the clinical examination, no areas of swelling were evident that would indicate the presence of the supernumerary. During the complementary examination, carried out using a panoramic x-ray in semi-open occlusion and ConeBeam® computed tomography, a supernumerary tooth of the mesiodens type can be seen impacted between the roots of the permanent maxillary central incisors. The mesiodens had an intimate relationship with the superior cortex of the nasopalatine canal, promoting luminal stenosis and an intimate relationship with the floor of the nasal fossa. Exodontia was chosen as a therapeutic strategy. Management strategies were reinforced until the surgical procedure session. The patient and legal guardian received post-operative guidance, were monitored for 15 days after the procedure, and were informed of the importance of monitoring until complete rhizogenesis of the permanent maxillary central incisors. In conclusion, it is highlighted that the surgical opportunity needs to be well-defined

Prevalence of TMD and its impact on quality of life in male construction workers / Prevalência de DTM e impacto na qualidade de vida de trabalhadores na construção civil

Background: Temporomandibular joint disorder (TMD) can significantly affect the quality of life of individuals. However, evidence of TMD involvement and the extent of the impacts caused by it, in groups exposed to a stressful routine, are still scarce. Therefore, the aim of the present study was to evaluate the prevalence of TMD signs and symptoms and their impact on quality of life related to oral health in construction workers. Material and methods: This cross-sectional study included only male individuals. Illiterate workers and functional illiterate were excluded. The diagnosis of TMD was established according to the Research Diagnostic Criteria for TMD (RDC/TMD). The Oral Health Impact Profile questionnaire validated for Portuguese (OHIP-14) was used to assess the impact of TMD on oral health and quality of life. Descriptive analysis of TMD signs and symptoms was performed. Data related to the OHIP-14 questionnaire were compared using the Mann-Whitney U test. Pearson's correlation was also performed. The established alpha of this study was 5%. Results: 230 individuals were included. The mean age was 37.8 (SD=11) years. The most frequent TMD sign and the symptom was disc displacement, 86 (37.39%) of the individuals. OHIP-14 demonstrated a statistically significant difference when compared to all TMD signs and symptoms (p<0.001). A weak correlation was observed between pain and OHIP-14 (r=0.366; p<0.0001). Conclusion: TMD affects oral health and quality of life for construction workers

Polyethylene terephthalate clamps : optimization in endodontic and restorative practices

There is a growing search for innovations in dental materials and instruments and, therefore, an increase need to optimize the instruments used in the absolute isolation. The gold standard procedure contributes significantly to the quality of restorativ

Investigating the association between dental age and polymorphisms in genes encoding estrogen receptors

Background: Genetic polymorphisms have been shown to influence several physiological traits, including dental and craniofacial characteristics. Understanding the clinical relevance of genetic polymorphisms in dental practice is crucial to personalize treatment plans and improve treatment outcomes. Objective: to evaluate the association between dental age and genetic polymorphisms in genes encoding estrogen receptors alpha and beta (ESR1 and ESR2, respectively) in a sample of Brazilian children. Methodology: This retrospective cross-sectional study was performed with children undergoing orthodontic treatment. Patients with syndromes, congenital anomalies, craniofacial deformities, under hormonal or systemic treatment, and with a previous history of facial trauma were excluded. Panoramic radiographs were used to assess dental age according to the Demirjian, Goldstein, and Tanner method. A delta [dental age-chronological age (DA-CA)] was obtained, which shows whether the patient tends to have a normal, delayed (negative values), or advanced (positive values) dental age. DNA isolated from buccal cells was used to genotype four genetic polymorphisms: rs9340799 (A>G) and rs2234693 (C>T), located in ESR1; and rs1256049 (C>T) and rs4986938 (C>T), located in ESR2. A statistical analysis was performed and values of p<0.05 indicated statistical difference. Results: A total of 79 patients were included, 44 (55.70%) girls and 35 (44.30%) boys. The Demirjian, Goldstein, and Tanner method, in general, overestimated patients’ age by 0.75 years. There was no difference in the delta of dental age between the sexes (p>0.05). Genetic polymorphisms in ESR1 and ESR2 were not associated with dental age (p>0.05). Conclusion: The studied genetic polymorphisms in ESR1 and ESR2 were not associated with dental age in Brazilian childre

Management of the epileptic patient in the dental office: a clinical case report and brief literature review

Outpatient care of epileptic patients can be a significant challenge for dental professionals. Therefore, the present study aimed to report, through a clinical case report, the management of epileptic patients in the dental office. A 16-year-old male patient attended dental care due to tooth decay and periodontal disease. The patient routinely used 250 mg of sodium valproate once a day to control epilepsy. During the clinical and radiographic examination, it was observed the need for guidance regarding dental caries, periodontal disease, suitability of the environment, periodontal, endodontic, surgical, and restorative treatment. Care was taken regarding stress control and, the use of local anesthetics and antibiotics. Given this clinical case report, it was possible to review and act in an optimized manner in the management of epileptic patients in the dental office. The complexity of the disease, the prevalence of those affected, and compromised oral health are highlighted. Dental surgeons must be desensitized to this issue and significantly accommodate this demand from the population

Single Nucleotides Polymorphisms in COX2 Gene and their Association with Signs and Symptoms of Teething – A Pilot Study

Objective: To investigate the association between single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) and local and systemic signs and symptoms of teething. Material and Methods: Forty-four pairs of mothers-babies/toddlers were included. Erupted primary teeth were evaluated during clinical examination. Local and systemic signs and symptoms of teething were obtained from mothers\u27 reporting via anamnesis. Samples of buccal cells were retrieved for DNA genotyping using real-time PCR. The T-test, Chi-square test, logistic regression, and haplotype analyses were applied. Results: Almost all mothers (95.5%) reported at least one local or systemic sign and symptom of teething. The most common was increased salivation (79.5%), diarrhea (72.3%), and fever (70.5%). The mean number of signs and symptoms per child was higher in boys than girls (mean = 5.1; SD= 1.5; p=0.008). Sleep disturbance (p=0.03) and loss of appetite (p=0.05) were more reported in boys. The rs689466 and rs5275 were not associated with signs and symptoms of teething (p>0.05). Conclusion: The single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) were not associated with local and systemic signs and symptoms of teething

Does Suppression Levels of Testosterone Have an Impact in The Craniofacial Growth? A Systematic Review in Animal Studies/ A supressão de testosterona impacta o crescimento craniofacial? Uma revisão sistemática de estudos com animais

Sexual hormonal disturbances in humans alter the growth bone. Suppression testosterone is performed in animals for evaluated their effects on craniofacial complex. The aim of this study is to investigate, through of a systematic review from animal studies, the effects of testosterone suppression on the craniofacial complex development. Seven databases, including Open Grey literature, were searched since inception to March 01, 2021, following strategy MEDLINE for terms conducted the search. The study design PICOS was used to establish the eligibility criteria: P - Animals; I - Suppression of testosterone production; C - Animals with normal levels of testosterone; O - Effect in craniofacial growth/development; S - In vivo studies. Relevant data were collected and inserted in characteristics of studies table. Risk of bias was assessed using SYRCLE’s risk of bias tool. Ten studies were included in the systematic review. Two were classified with low risk of bias and eight with unclear. The mandible in experiment group was significantly smaller than control group. The trabecular bone mineral density of the mandible was decrease after testosterone suppression. There was an increase in the number of osteoclasts in the experimental groups. All cephalometric measurements of the maxilla, except in one study, were reduced in orchiectomized rats. The expression of androgen receptor was significantly reduced in head condyle of the experimental group. Testosterone suppression decreases the growth of craniofacial complex bones through imbalance of the bone turnover due to the increase in the number of osteoclasts

Manifestações orais em pacientes infectados com sars COV-2 / Oral manifestations from sars COV-2 in infected patients

The recent outbreak of the novel coronavirus 2019 (Covid-19) spread rapidly throughout several countries around the worldand has posed enormous health challenges. Symptom of Covid-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. The most commonly reported oral manifestations in the literature are ulcer, erosion, bulla, vesicle, pustule, fissured or depapillated tongue, macule, papule, plaque, pigmentation, halitosis, among others. The professionals must be prepared to recognize theoral manifestations of the disease to promote the most adequate treatment. This study presents 5 cases of oral manifestations in patients diagnosed with Covid-19. The patients presented ulcerations, vesiculopapular lesions, papillary lesions, lingual erythesa, keratose-like lesions and white plaque. Lips, tongue, labial mucosa, palate and gum were affected. If this hypothesis is proven, when health professionals observe these oral manifestations, they could refer these patients to be tested and perform the appropriate treatment.

Influence of estrogen deficiency on tooth eruption rate in murine model

A erupção dentária é um processo fisiológico definido como a migração do dente em desenvolvimento intraósseo até a sua emergência e posicionamento funcional na cavidade bucal. No entanto, alterações sistêmicas e/ou síndromes, decorrentes do desequilíbrio hormonal, são descritas como principais causadores de distúrbios nesse processo. O estrógeno apesar de ser um hormônio presente e ativo do período embrionário à puberdade, quando relacionado a taxa de erupção dentária, seu papel ainda não é elucidado. Desta forma, o objetivo do presente estudo foi avaliar o efeito da deficiência de estrógeno e seus receptores na taxa de erupção dentária. Quarenta ratas da linhagem Wistar Hannover foram divididas em dois grupos segundo a intervenção recebida: Grupo OVX - cirurgia de ovariectomia e Grupo SHAM - cirurgia fictícia. Os procedimentos cirúrgicos foram realizados no 25º dia de vida pós-uterina. A taxa de erupção dentária (mm/dia) dos incisivos inferiores foi avaliada nas condições de hipo- e hiperfunção. Imagens dos incisivos foram capturadas de forma padronizada por câmera acoplada ao estereomicroscópio óptico a partir do 35º dia de vida pós-uterina, a cada 48 e 72 horas durante 21 dias. A mensuração da taxa de erupção dentária foi realizada pelo cálculo de média, por meio da diferença entre medidas iniciais e após o período de 48/72 horas. Após a eutanásia, a região odontogênica foi utilizada para identificação histológica, análise da presença de receptores de estrógeno (ERα e ERβ) e expressão gênica dos genes codificadores de ERα e ERβ (ERS1 e ERS2). As análises foram realizadas por meio da reação de imunohistoquímica e técnica de PCR em tempo real quantitativo. A avaliação referente a taxa de erupção dentária, peso corporal, peso do útero e expressão gênica de ERS1 e ERS2 foram analisadas estatisticamente utilizando os softwares SPSS 24.0 e GraphPad Prism 7.04. O teste t de Student foi utilizado para comparação das médias entre os grupos OVX e SHAM. O nível de significância adotado foi de 5%. A condição de hipofunção, não apresentou diferença estatística significativa quando se compara os dois grupos, OVX e SHAM (p=0.09). Por outro lado, quando se compara os grupos em condição de hiperfunção, o grupo OVX demonstrou taxa de erupção dentária diminuída em relação ao grupo SHAM (p=0.03). O grupo OVX apresentou um aumento de peso corporal significativamente maior quando comparado ao grupo SHAM (p=0.002). Em relação ao peso do útero, o grupo OVX apresentou uma diminuição de peso em relação ao grupo SHAM (p≤0.0001). Nos cortes histológicos foi possível identificar a presença de ERα e ERβ. O ERα foi expresso em ameloblastos em ambos os grupos. Já o ERβ demonstrou-se presente em células da papila dentária do grupo OVX e, em células do tecido de sustentação de ambos os grupos, OVX e SHAM. Quanto a expressão gênica, o ESR1 não demonstrou diferença estatística significativa quando os grupos foram comparados (p=0.33). Entretanto, a expressão gênica de ESR2 foi significativamente maior no grupo OVX (p=0.05). Pode-se concluir que a deficiência de estrógeno influencia negativamente a taxa de erupção dentária.Dental eruption is a physiological process defined as dental migration in intraosseous development until its emergence and functional positioning in the oral cavity. However, systemic changes and/or syndromes, resulting from hormonal imbalance, are described as the main causes of disturbances in this process. Although estrogen is a hormone present and active during the embryonic period at puberty, when related to the rate of tooth eruption, its influence remains unclear. The aim of this study was to evaluate the effect of estrogen deficiency and its receptors on tooth eruption rates in murine model. Forty Wistar Hannover rats were divided into two groups after the intervention: OVX Group - ovariectomy surgery and SHAM Group - fictitious surgery. Surgical procedures were performed on the 25th postoperative day of life. A tooth eruption rate (mm/day) of the lower incisors was evaluated on hypo- and hyperfunction conditions. Incisor images was captured by optical stereomicroscope from the 35th postoperative day of life, every 48 and 72 hours for 21 days. Measurement of tooth eruption rate was performed by averaging the difference between initial measurements and after 48/72 hours. After euthanasia, the odontogenic region was used for histological identification, analysis of the presence of estrogen receptors (ERα and ERβ) and gene expression of ERα and ERβ coding genes (ERS1 and ERS2). Analyzes were performed by immunohistochemistry reaction and quantitative real time PCR technique. The evaluation regarding tooth eruption rate, body weight, uterine weight and ERα and ERβ gene expression was statistically analyzed using SPSS 24.0 and GraphPad Prism 7.04 software. Student\'s t-test was used to compare the means between OVX and SHAM groups. The adopted significance level was 5%. Hypofunction condition did not present statistically significant difference when comparing the two groups, OVX and SHAM (p 0.09). When comparing the groups in hyperfunction condition, the OVX group showed decreased tooth eruption rate compared to the SHAM group (p=0.03). The OVX group showed a significantly higher body weight increase when compared to the SHAM group (p=0.002). Regarding the weight of the uterus, the OVX group showed a decrease in weight compared to the SHAM group (p≤0.0001). In the histological sections it was possible to identify the presence of ERα and ERβ. ERα was expressed in ameloblasts in both groups. ERβ was found to be present in OVX group dental papilla cells and, in support tissue cells of both OVX and SHAM groups. ESR1 gene expression, OVX and SHAM groups did not show statistically significant difference when compared (p=0.33). However, ESR2 gene expression was significantly higher in the OVX group (p=0.05). It can be concluded that estrogen deficiency negatively influences the rate of tooth eruption