Factors associated with preschool children's sleep bruxism

OBJECTIVE

To evaluate the prevalence of sleep bruxism, related factors, and quality of life of preschool children and their families.

METHOD

The sample was 475 children between 4 and 5 years old enrolled in schools in the city of Bauru-Brazil. Parents/legal guardians answered two questionnaires, one to assess the presence of bruxism and related factors and another that was the validated Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Intraoral clinical examination was performed by two trained examiners (Kappa = 0.82) within the school environment. The data were analyzed using statistics and the Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient. The significance level was p < 0.05.

RESULTS

The prevalence of sleep bruxism was 47.4%. The highest prevalence was related to Class I canines and marked overjet, oral habits, such as nail biting, lip biting, chewing gum, and mouth breathing. Children with agitated sleep, reports of headache, and those considered aggressive, anxious, and/or shy were also more related.Conclusion: In the studied sample, sleep bruxism prevalence was high and related to important oral and general factors. Data also indicated SB as the main factor that interfered in the OHRQoL of children and their families.

Research on Cleft Lip and Palate: What Is New?

Craniofacial development begins during the fourth week of intrauterine life (IUL) [...].

Shaping ability of a pediatric motor-driven instrumentation system in primary molar root canal prototypes

Evaluate the shaping ability and preparation time using a pediatric motor-driven rotary instrumentation compared to other systems in resin prototypes of primary molars.

METHODS

Thirty specimens were scanned in micro-CT and divided into three groups according to the instrumentation type: pediatric motor-driven Sequence baby File (SBF); conventional motor-driven (Sequence Rotary File - SRF); manual K file. Instrumentation time was timed. After preparation, the specimens were scanned again. The pre- and post-instrumentation images were superimposed to measure the amount of root canal deviation and the resin remnant thickness. ANOVA followed by the Tukey test analyzed the comparisons between groups (p<0.05).

RESULTS

No statistically significant differences occurred in root canal deviation among groups (p>0.05). There were statistically significant differences in the comparison among root thirds (p<0.001) but without significant differences in the interaction group vs. root third (p>0.05). Both motor-driven instrumentations showed statistically greater weariness than manual instrumentation (p<0.001), without significant significant differences between SBF and SRF. Motor-driven instrumentation had a shorter working time than manual instrumentation (p<0.001).

CONCLUSION

Pediatric motor-driven instrumentation demonstrated good outcomes in relation to root canal deviation and amount of remnant structure, with shorter instrumentation time. SBF can be a suitable alternative for endodontic instrumentation in primary molars.

Customized Tray for Impression Taking in Children With Cleft Lip and Palate

The assessment of rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, their effects, as well as between different rehabilitation centers. The aim of this paper was to present proper trays for babies with different types of cleft lip and palate, which are used in the outpatient routine at Hospital of Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP). The customized trays are made with self-curing acrylic resin. The tray must have suitable depth to copy the buccal sulcus, and wax is usually applied to contour the tray edge, and the adjustment of the tray to the fornix, making the tray specific for each child. The impression precludes the utilization of dental casts for diagnosis, treatment plan, and research measurements. In the clinical practice at HRAC-USP, it was observed that customized trays increased the quality of impression, accurately reproducing anatomical features of dental arches of babies with oral clefts.

Comparative 3D study of dental arches in children with microcephaly associated with congenital Zika syndrome, orofacial cleft, and without craniofacial anomalies

INTRODUCTION

The dentist participates in the treatment protocol for craniofacial anomalies in individuals from the first months of life.

OBJECTIVE

to compare in a retrospective cohort study the morphometry of the edentulous palate of children microcephaly associated with congenital Zika syndrome (CZS), unilateral complete cleft lip and alveolus (UCL), and without craniofacial anomalies.

METHODS

Forty-five digitized dental molds composed the sample divided into three groups: CZS; UCL; and without craniofacial anomalies (control group). The following measurements were evaluated: intercanine and intertuberosity distances; dental arch length, area, volume, and mismatch superimposition. Parametric and non-parametric tests were applied (α = 5%).

RESULTS

CZS group showed the smallest means of intercanine distance and area than those of the other groups (p = .001 and p = .010, respectively). The dental arch length was greater in the CZS group than in the control group (p = .020). The evaluation of the mismatch superimposition showed that the CZS group had the lowest means of maximum distance and root mean square than that of the UCL group (p = .025 and p = .005, respectively).

CONCLUSION

CZS participants tended to palatal narrowing, while UCL individuals had parameters similar to those of the control group, despite the alveolus defect.

What Are the Effects on Palate of Early Lip Surgery in Children With Cleft Lip and Palate? Cross-Sectional Evaluation From 5-Year-Old

This study aimed to evaluate the postsurgical effects from 5 years on the palate after surgical repair of the lip at 3 or 9 months of age in children with cleft lip and palate. Eighty-four digitized dental impressions were divided into the following groups: group 1 (G1): lip surgery at 3 months of life; group 2 (G2): lip surgery at 9 months of life; group 3 (G3): without orofacial cleft. Five angular (C'IC, ICM, IC'M', CMM', and C'M'M) and 3 linear parameters (C-C', c-c', and M-M') were evaluated. Statistical analysis was applied with α=5%. Intraclass Correlation Coefficient was significantly smaller in G1 than in G3 ( P =0.005), while IC'M' was significantly smaller in G3 than in G1 ( P <0.001). C'M'M was significantly smaller in G1 than in G2 and G3 ( P <0.001). The distances C-C' and c-c' were significantly smaller in G1 than in G2 and G3 ( P <0.001). There was a statistically significant difference in both G1 and G2 ( P <0.001, in all) in the analysis of palatal symmetry. Linear regression analysis showed that the, 11.2% of outcomes determined by c-c' distance can be explained by the age of lip repair ( P =0.013). In conclusion, lip surgery at 3 months of life showed a tendency toward more restriction in 5-year postsurgery palate development. The age of cheiloplasty is one of the factors that can influence palatal development; however, other factors may be associated and should be studied.

The Promotion of Hearing Health through Wikipedia Campaigns: Article Quality and Reach Assessment

This case study examined the feasibility, reach, and potential impact of using Wikipedia as a tool for hearing health promotion. Activities involved editing existing Portuguese-language Wikipedia hearing health articles, as well as translating English-language hearing health articles to Portuguese during the Wiki4WorldHearingDay2019 and Wiki4YearOfSound2020 online campaigns. The Wikipedia efforts that took place in Brazil were carried out by 10 volunteer undergraduate students in Speech-Language Pathology and Audiology at the Federal University of Santa Catarina, in Brazil. Among new and existing Wikipedia articles, the group edited 37 articles, which attracted more than 220,000 views during the set tracking period. Students were responsible for 60% of the Portuguese-language edits during the Wiki4WorldHearingDay2019 campaign and more than 90% of the Portuguese-language edits during the first half of the Wiki4YearOfSound2020 campaign. Moreover, the quality indexes for pages either created or edited were improved in all situations by registering an increase rate ranging from 33% to 100%. Wikipedia-centered activities expanded the availability of quality scientific content, written in plain language, to the public. Students worked together in order to select topics, assess existing information, validate it, create new content, and share information-steps that contributed to the mission of health promotion and knowledge dissemination for the benefit of society.

Reacting, Sharing, and Commenting: How Many Facebook Users Are Engaging with Posts Related to Dental Caries That Contain Misinformation?

Recent studies have been concerned about the vast amount of misinformation detected on social media that directly hampers the prevention and control of chronic diseases. Based on these facts, the aim of this study was to identify and characterize misinformation about dental caries-related content found on Facebook, regarding the predictive factors of user interaction with posts. Then, CrowdTangle retrieved 2,436 posts published in English, ordered by the total interaction of the highest users. A total of 1,936 posts were selected for inclusion and exclusion criteria to select a sample of 500 posts. Subsequently, two independent investigators characterized the posts by their time of publication, author's profile, motivation, the aim of content, content facticity, and sentiment. The statistical analysis was performed using Mann-Whitney U and χ2 tests and multiple logistic regression models to determine differences and associations between dichotomized characteristics. p values <0.05 were considered significant. In general, posts were predominantly originated from the USA (74.8%), related to business profiles (89%), presented preventive content (58.6%), and noncommercial motivation (91.6%). Furthermore, misinformation was detected in 40.8% of the posts and was positively associated with positive sentiment (OR = 3.43), business profile (OR = 2.22), and treatment of dental caries (OR = 1.60). While the total interaction was only positively associated with misinformation (OR = 1.44), the overperforming score was associated with posts from the business profile (OR = 5.67), older publications (OR = 1.57), and positive sentiment (OR = 0.66). In conclusion, misinformation was the unique predictive factor of increased user interaction with dental caries-related posts on Facebook. However, it did not predict the performance of the diffusion of posts such as business profiles, older publications, and negative/neutral sentiment. Therefore, it is essential to promote the development of specific policies toward good quality information on social media, which includes the production of adequate materials, the increase of the critical sense of consuming health content, and information filtering mediated by digital solutions.

Current Perspectives on Cleft Lip and Palate and Children's Health

Orofacial clefts are the most prevalent craniofacial congenital anomalies, affecting the lip, with or without involvement of the palate, or solely the palate [...].

Dentists' Self-evaluated Ability in Diagnosing and Updating About Pulpotomy

OBJECTIVE

This study aimed to self-evaluate the knowledge of different dental professionals' profiles in Brazil on diagnosing and indicating pulpotomy in primary teeth and how these groups updated on this theme.

METHODS

Three groups (G1: professors, G2: specialists, and G3: professionals) answered an online questionnaire containing 20 questions and returned 416 questionnaires. Data were subjected to Chi-square associative tests and t tests, with P < .05.

RESULTS

G1 and G2 reported to indicate pulpotomy, highlighting the tendency of these groups towards seeking updates on this subject. All 3 groups used academic materials for updating. However, G2 had a high demand for updates through congresses, whilst G3 had a high demand for updates through social media (Google and Google Scholar). The most cited indication by G1 and G2 was "accidental pulp exposure" and by G3 was "teeth with extensive carious lesions that have involved the pulp with radiographic confirmation." All 3 groups opted for pulpotomy to keep the tooth in the arch. Thus, G1 and G2 are the groups who are more updated on the subject, using mainly academic materials, which can be associated with the fact that such groups indicated pulpotomy in primary teeth. The lower interest in searching about pulpotomy in G3 can be understood as a nonclinical application of the topic for this group.

CONCLUSIONS

Professionals who work directly with paediatric dentistry (professors or specialists) felt more capable of diagnosing and treating cases of pulpotomy. In addition, most of the professionals used scientifically based sources for getting information and actualisation on the subject of pulp therapies.

Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate

Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) – children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) – children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) – children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C’), anterior length of dental arch (I-CC’), and total length of the dental arch (I–MM’), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study

Oral cleft surgical repairs are performed using different techniques worldwide.

3D morphometric evaluation of the dental arches in children with cleft lip and palate submitted to different surgical techniques

OBJECTIVES

This study aimed to compare dimensional alterations of dental arches in children with unilateral complete cleft lip and palate before and after different techniques of primary plastic surgeries.

MATERIALS AND METHODS

The sample was divided into two groups: group 1-cheiloplasty by Millard's technique and one-stage palatoplasty by von Langenbeck's technique; group 2-cheiloplasty by Millard's technique and two-stage palatoplasty: anterior palatoplasty by Hans Pichler's technique and posterior palatoplasty by Sommerlad's technique. Dental arches were evaluated before (T1), after the first phase (T2), and 1 year after the second phase (T3) of primary surgeries. Linear measurements and palatal area were assessed. To analyze the method's error, interclass correlation coefficient was applied. ANOVA (followed by Tukey test), dependent, and independent t-test were used (p < 0.05).

RESULTS

At T1, the intertuberosity distance was statistically greater in G2 (p = 0.004). At T2, the anterior length of the dental arch was statistically greater in G2 (p = 0.025), while the area of the smaller palatal segment (p = 0.001), cleft area (p = 0.014), and total area (p = 0.002) were statistically smaller in G2. At T3, the intertuberosity distance was statistically greater in G2 (p = 0.017).

CONCLUSION

This study suggests that cheiloplasty and one-stage palatoplasty resulted in smaller growth of maxilla than cheiloplasty and two-stage palatoplasty in the linear measurements (T-T' and I-CC') and total area of the dental arches.

CLINICAL RELEVANCE

Surgical protocols need to be evaluated to verify their effects aiming at improving the clinical practice of the interdisciplinary team, determining new parameters for the rehabilitation of individuals with cleft lip and palate.

Innovative method to assess maxillary arch morphology in oral cleft: 3d-3d superimposition technique

This study aimed to analyze the maxillary growth and development of children with oral clefts using the innovative method of 3D-3D superimposition technique. Children with unilateral complete cleft lip (UCL) and unilateral cleft lip and palate (UCLP) participated in the study. The impressions of the dental arches were executed 1 day before and 1 year after lip repair surgery. A 3D laser scanner digitized the dental models and the stereophotogrammetry system software analyzed the 3D-3D superimpositions in two groups of matches (same child, UCL and UCLP) and one group of mismatches (different individuals). The differences were evaluated by Root Mean Square (RMS) and expressed in millimeters (mm). Kruskal-Wallis test followed by post-hoc Dunn test and Mann-Whitney test were assessed to compare the groups (α=5%). RMS was 1.34 mm (± 0.37) in UCL group, 1.41 mm (± 0.32) in UCLP group, and 3.38 mm (± 1.28) in mismatches group. RMS was significantly greater in mismatches than in matches groups (p<0.0001). No statistically significant differences occurred between genders. The 3D-3D superimposition technique showed the maxillary development after lip repair surgery in the anterior region of the palate. Thus, it is suggested that the cleft amplitude and the palatal segments proportion influenced the morphological heterogeneity and, consequently, the development and maxillary growth of children with orofacial cleft.

Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition

BACKGROUND

Cohort studies have evaluated dental arches of children.

AIM

To evaluate the volumetric, linear, palatal surface area, and the dental arch superimposition of participants with bilateral complete cleft lip (BCL) and bilateral cleft lip and palate (BCLP) surgically treated in a specialized hospital.

DESIGN

One hundred and thirty six digitized dental models evaluated before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The stereophotogrammetry software analysed the volume, palate superimposition, linear, and area measurements.

RESULTS

In BCL group, at T2, C-C', T-T', area, and volume significantly increased (P = .000, P < .000, P = .010 e P = .003, respectively). In BCLP group, the comparison T3 × T1 showed that C-C' decreased, whereas T-T' and the area increased (P < .000, P < .000, P = .000). The volume increased at T2, but decreased at T3 (P < .000) in participants with BCLP. The intergroup analysis revealed that C-C', T-T', I-C', and I-C were significantly smaller in participants with BCLP (P < .000, P = .016, P = .001 e P = .020, respectively), whereas the volume, superimposition, and area were statistically similar between groups (P > .05).

CONCLUSION

The comparison between bilateral orofacial clefts showed reduction in the transversal and anteroposterior linear measurements, but not in the area and volume, which was confirmed by the superimposition of the dental arches.

Could the photobiomodulation therapy induce angiogenic growth factors expression from dental pulp cells?

This study aimed to evaluate the effect of different photobiomodulation (PBM) radiant exposures on the viability, proliferation, and gene expression of pulp fibroblasts from human primary teeth (HPF) involved in the pulp tissue repair. HPF were irradiated with Laser InGaAlP (Twin Flex Evolution, MMOptics®) at 660-nm wavelength (red); single time, continuous mode, 0.04-cm² laser tip area, and 0.225-cm laser tip diameter, keeping the distance of 1 mm between the laser beam and the cell culture. The doses used were between 1.2 and 6.2 J/cm² and were evaluated at the 6 h, 12 h, and 24 h after PBM. MTT and crystal violet assays evaluated the cell viability and proliferation. RT-PCR verified VEGF and FGF-2 mRNA expression. A blinded examiner analyzed the data through two-way ANOVA followed by Tukey test (p < 0.05). The groups with higher powers (10 mW, 15 mW, 20 mW, and 25 mW), shortest application periods (10 s), and radiant exposures between 2.5 and 6.2 J/cm² exhibited statistically higher viability than that of the groups with small power (5 mW), longer application period (50 s), and radiant exposure of 6.2 J/cm² (p < 0.05). VEGF and FGF-2 mRNA expression were observed at the three evaluated periods (6 h, 12 h, and 24 h) and the highest expression was in the shortest period (p < 0.05). All radiant exposures maintained HPF viable. The period of 6 h after irradiation showed statistically greater gene expression for both growth factors than other periods. VEGF mRNA had no differences among the dosimetries studied. The best radiant exposures for FGF-2 gene expression were 2.5 J/cm² and 3.7 J/cm².

Pulp liner materials in selective caries removal: study protocol for a randomised controlled trial

INTRODUCTION

The literature shows that selective carious tissue removal (SCTR) decreases the number and diversity of bacteria, stops the caries process and reduces the risk of pulp exposure. However, no consensus exists on which pulp liner would be suitable for teeth undergoing SCTR. So, this study will verify the in vivo response of dentine-pulp complex after SCTR in primary teeth with or without pulp liner material.

METHODS AND ANALYSIS

A randomised clinical trial, double-blinded, parallel-group and allocation concealment will be conducted with the enrolment of 384 patients from 5 to 9 years, with one maxillary/mandibular first/second primary molars with deep occlusal/occlusoproximal cavities. The remaining dentine will be lined with calcium hydroxide cement-group 1; mineral trioxide aggregate-group 2 and without liner-group 3. The primary outcome will be success of the of dentine-pulp complex evaluated clinically and radiographically at 6, 12 and 24 months, while the secondary outcomes will be the measurement of the dentine barrier on periapical radiographs. During all study, two trained and calibrated examiners will evaluate the treated teeth clinically and radiographically. Interexaminer and intraexaminer reliability will be verified by casual and systematic error. The Kolmogorov-Smirnov test will be adopted to test the normality of continuous variables. Comparisons among groups will be performed by using the χ² test and anaylsis of variance, followed by Tukey test (p<0.05). The logistic regression will be applied, and the degrees of this association will be measured using the OR and 95% CI.

ETHICS AND DISSEMINATION

The present protocol was submitted and approved by the Ethical Committee of the University of São Paulo, Bauru, São Paulo, Brazil (CAAE: 79123517.0.0000.5417). Consent for publication will be obtained from all parents or legal guardians. Results of this study will be reported in full through peer-reviewed journals.

TRIAL REGISTRATION NUMBER

RBR-9fsxnn.

Pulp repair response after the use of a dentin-pulp biostimulation membrane (BBio) in primary teeth: study protocol for a randomized clinical trial

Background

Vital pulp therapy aims at maintaining the pulp tissue injured but vital. Thus, the use of capping materials that induce tissue regeneration is a great current trend. This study aims to evaluate clinically and radiographically the pulp repair after the use of dentin-pulp biostimulation membrane in primary teeth.

Methods

Four hundred and sixty-eight teeth from children aged between 5 and 9 years old, both genders, with deep caries lesion with pulp involvement, but no furcal impairment and any sign of necrosis will be selected. The vital pulp therapy will be performed with mineral trioxide aggregate (control group) and dentin-pulp biostimulation chitosan membrane (BBio group). The clinical and radiographic outcomes will be assessed at 12 and 24 months after treatment. The thickness of the dentin barrier will be verified through Image J2 software. The Wilcoxon signed rank test and Mann-Whitney test will respectively compare the intra- and intergroup clinical and radiographic outcomes. Paired t test and independent t test will respectively compare the intra- and intergroup radiographic measurements. The logistic regression will be applied, and the degrees of this association will be measured using odds ratio (OR) and 95% confidence interval (95% CI).

Discussion

Therefore, this study protocol aims at new perspectives of vital pulp therapy of primary teeth by employing new easy-handling, low-cost material to keep viable the pulp tissue capable of regenerating and maintain the physiological process of deciduous tooth exfoliation.

Trial registration

Brazilian Registry of Clinical Trials RBR-6vr58b. Registered on 17 February 2019.

In vitro effect of curcumin-mediated antimicrobial photodynamic therapy on fibroblasts: viability and cell signaling for apoptosis

Although it was demonstrated that curcumin-mediated antimicrobial photodynamic therapy (aPDT) is effective for reducing the viability of microbial cells and the vitality of oral biofilms, the cytotoxicity of this therapeutic approach for host cells has not been yet elucidated. Hence, the aim of this study was to evaluate the cytotoxicity and apoptotic effects of curcumin-mediated aPDT on mouse fibroblasts. Cells were treated with 0.6 or 6 μmol.L^-1 curcumin combined with 0.075 or 7.5 J.cm^-2 LED at 455 nm. Cytotoxicity was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and crystal violet (CV) assays, while quantitative reverse transcriptase-PCR (qRT-PCR) was used to assess the expression of Bax, Bad, Bcl-2, VDAC-1, cytochrome C, and Fas-L genes for apoptosis. The differences between groups were detected by Kruskal-Wallis and post hoc Dunn's tests for MTT and CV assays and by ANOVA and post hoc Tukey test for qRT-PCR (P < 0.05). The effect of 0.6 μmol.L^-1 curcumin plus 0.075 J.cm^-2 LED (minimum parameter) did not differ statistically from control group; however, the combination of 0.6 μmol.L^-1 curcumin plus 7.5 J.cm^-2 LED reduced viable cells in 34%, while the combinations of 6 μmol.L^-1 curcumin plus 0.075 and 7.5 J.cm^-2 LED reduced viable cells in 47% and 99%, respectively. aPDT increased significantly the relative expression of Bax/Bcl-2, cytochrome C, VDAC-1, and Fas-L genes, without influence on the ratio Bad/Bcl-2. Therefore, curcumin-mediated aPDT activated Bcl-2 apoptosis signaling pathways in mouse fibroblasts regarding present conditions, reducing the viability of cells with the increase of curcumin concentrations and light energies.

Parental-oriented educational mobile messages to aid in the control of early childhood caries in low socioeconomic children: A randomized controlled trial

•

Educational mobile text messages were effective to control the severity of ECC.

•

They influenced changes in parental reports about children’s sugar consumption.

•

Also, they seemed beneficial to improve parental electronic health literacy levels.

Objectives

To evaluate the effectiveness of educational messages as an aid in the control of early childhood caries (ECC) in low socioeconomic children.

Methods

A single-blinded, randomized, and parallel-group study was conducted with 104 dyads of parents and children aged between 36–60 months, recruited in preschools from Bauru, Brazil. The participants were randomly allocated into control and intervention groups (1:1), stratified by parental eHealth literacy scores (eHEALS) and children's caries experience. Every 2 weeks, text messages were sent to parents of intervention group via WhatsApp. Visible plaque index (VPI) and the International Caries Detection and Assessment System (ICDAS) were assessed at baseline, 3- and 6-month follow-ups, while eHEALS and dietary habits were determined at baseline and 6-month follow-up. Statistical analysis was performed to intra and intergroup comparisons through Fischer’s exact and McNemar tests, and Mann-Whitney U and Friedman tests, respectively (P < 0.05).

Results

Despite similarities between groups, intervention increased parental eHEALS scores, influencing the reports about the children’s consumption of sugar-free sweets and controlling the severity of ECC.

Conclusion

Therefore, mobile text messages were effective to control the severity of ECC in low socioeconomic preschoolers, improving parental eHealth literacy and changing children’s dietary patterns.

Clinical significance

These findings demonstrate that parental-oriented WhatsApp messages can contribute to oral health education of socioeconomic vulnerable parents towards risk behavior changes to control ECC.

Parental perspectives on early childhood caries: A qualitative study

BACKGROUND

Early childhood caries (ECC) affects about 621 million children worldwide, causing chronic pain, infections, sleeping disorders, and tooth extraction.

AIM

To determine perspectives of parents and caregivers of preschoolers regarding ECC.

DESIGN

Three focus groups were conducted with attendees of the Clinics of Paediatric Dentistry from the Bauru School of Dentistry. The meetings were video- and audio-recorded, and the contents were transcribed verbatim. Then, textual passages were examined and coded using the software NVivo 12 Plus.

RESULTS

The participants associated the presence of dental caries lesions with negative consequences for children, such as problems for permanent dentition, discrimination, and psychological damages. Although regular oral hygiene and healthy diet were recognized as important factors for the prevention of ECC, specific doubts about feeding, toothpaste usage, oral hygiene, and dental eruption were detected among parents. Additionally, they declared that their children brush teeth alone, intake fermentable carbohydrates frequently, and sleep during breastfeeding without dental plaque removal, because uncooperativeness, permissiveness, and convenience.

CONCLUSIONS

Based on these results, parents and caregivers understand the unfavourable effects of ECC on children's quality of life; however, their attitudes against the disease seemed to be inaccurate, influenced by their daily routines, doubts, and beliefs.

What is the response profile of deciduous pulp fibroblasts stimulated with E. coli LPS and E. faecalis LTA?

Background

Oral fibroblast immunological responses to bacterial stimuli are well known. However, there are few studies about pulp fibroblasts from deciduous teeth (HDPF) responses, which are important for the treatment of pulp infections in children. The aim of this study was to evaluate expression and production of inflammatory cytokines and chemokines by HDPF when challenged with bacterial antigens normally present in advanced caries lesions.

Methods

Triplicate HDPF from 4 children (n = 4; 2 boys and 2 girls) were cultured by explant technique and challenged or not with Escherichia coli lipopolysaccharide/1 μg/mL (EcLPS) or Enterococcus faecalis lipoteichoic acid/1 μg/mL (EfLTA) for 6 and 24 h. Most of published studies employed immortalized cells, i.e., without checking possible gender and genetic variables. mRNA expression and protein production were evaluated by RT-qPCR and ELISA MILLIPLEX®, respectively, for Interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, Chemokine C-C motif ligand 2/monocyte chemoattractant protein 1 (CCL2/MCP-1), Chemokine C-C motif ligand 3/macrophage inflammatory protein 1-alpha (CCL3/MIP1-α), Chemokine C-C motif ligand 5/ regulated on activation, normal T cell expressed and secreted (CCL5/RANTES), C-X-C motif chemokine 12/ stromal cell-derived factor 1 (CXCL12/SDF-1), Tumor Necrosis Factor-alpha (TNF-α), Interferon-gamma (IFN γ), Vascular Endothelial Growth Factor (VEGF), Colony stimulating factor 1 (CSF-1) and Macrophage colony-stimulating factor (M-CSF).

Results

EcLPS increased IL-1α, IL-1β, IL-8, CCL2, CCL5, TNF-α and CSF-1 mRNA and protein levels while EfLTA was only able to positively regulate gene expression and protein production of IL-8.

Conclusion

The results of the present study confirmed our hypothesis, since pulp fibroblasts from deciduous teeth are capable of increasing gene expression and protein production after being stimulated with EcLPS and EfLTA.

A Biobank of Stem Cells of Human Exfoliated Deciduous Teeth: Overview of Applications and Developments in Brazil

A biobank is an organized collection of biological human material and its associated information stored for research according to regulations under institutional responsibility, without commercial purposes, being a mandatory and strategical activity for research, regenerative medicine, and innovation. Stem cells have largely been employed in research and frequently stored in biobanks, which have been used as an essential source of biological materials. Stem cells of human exfoliated deciduous teeth (SHED) are stem cells which have a high multipotency and can be easily obtained. Besides, this extremely accessible tissue has advantages with respect to storage, as the SHED obtained in childhood can be used in later life, which implies the necessity for the creation and regulation of biobanks. The proper planning for the creation of a biobank includes knowledge of the material types to be stored, requirements regarding handling and storage conditions, storage time, and room for the number of samples. Thus, this study aimed to establish an overview of the development of a SHED biobank. Ethical and legal standardization, current applications, specific orientations, and challenges for the implementation of a SHED biobank were discussed. Through this overview, we hope to encourage further studies to use SHED biobanks.

Photobiomodulation effect on angiogenic proteins produced and released by dental pulp cells

OBJECTIVE

To verify the photobiomodulation effect on angiogenic proteins produced and released by dental human pulpal fibroblasts (HPFs).

MATERIAL AND METHODS

HPFs were irradiated with 660-nm low-level laser at fluences of 2.5 J/cm² and 3.7 J/cm². The control group was not irradiated. MTT, crystal violet, and ELISA assays respectively verified viability, proliferation, and angiogenic protein (supernatant/lysate) at 6 h, 12 h, and 24 h after photobiomodulation. Capillary-like structure formation assay verified functional role. Two-way ANOVA/Tukey's test and ANOVA/Bonferroni's multiple comparisons test respectively verified cell viability/proliferation and intragroup and intergroup comparisons of protein synthesis (p < 0.05).

RESULTS

Irradiated and non-irradiated HPFs showed statistically similar cell viability and proliferation pattern. Intragroup comparisons showed similar patterns of protein synthesis for all groups: VEGF-A, VEGF-C, and vascular endothelial growth factor receptor 1 (VEGFR1) increased significantly in the supernatant, while FGF-2 and VEGF-A increased significantly in the lysate. The lower fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (6 h and 12 h) and VEGF-D (24 h) in the lysate, while the higher fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (12 h) in the lysate. Regardless of the time, both fluences statistically downregulated placental growth factor (PLGF) and PDGF secretion. Both fluences statistically decreased VEGF-A secretion (24 h) and PLGF production (6 h).

CONCLUSION

Photobiomodulation produced stimulatory effects on angiogenic protein secretion by pulp fibroblasts. In terms of photobiomodulation, over time, both fluences significantly increased the secretion of VEGF-A, VEGF-C, and VEGFR1 and significantly upregulated BMP-9 (6 h) in the supernatant; for capillary-like structure formation, the fluence of 2.5 J/cm² was better than the fluence of 3.7 J/cm².

CLINICAL RELEVANCE

This study results addressed effective photobiomodulation parameters tailored for pulp angiogenesis.

Using Augmented Reality to Motivate Oral Hygiene Practice in Children: Protocol for the Development of a Serious Game

Background

New technologies create possible new ways of action, interaction, and learning which is extremely relevant in the field of oral health education. There is a lack of protocol in using an immersive interactive ludic-educational interface to motivate oral hygiene practice in children by means of augmented reality.

Objective

This study aims to present a protocol on the development of a serious game to motivate oral hygiene practice in children.

Methods

A serious game will be designed by augmented reality techniques to improve toothbrushing effectiveness of children aged 6 to 10 years. The functional structure of this interface is activated by means of movements recognized by Kinect (Microsoft Corp). The toothbrushing technique will be available in the game, enabling the children to execute the movement in the virtual environment. By identifying errors, this game will be tailored to improve the oral health of children by correcting the technique and teaching the user the adequate toothbrushing method. A template analysis will be performed to identify barriers and facilitators in each scenario.

Results

After the implementation of the virtual interactive and immersive panels, enrollment will begin and evaluations will be made by means of questionnaires distributed to participants who interact with the game. Thus, an analysis of the product efficacy will be conducted. The expected outcome will be to obtain a digital instrument to motivate oral hygiene practice and enhance health awareness in children.

Conclusions

The serious game will support the prevention of oral diseases by sharing scientific research in the school environment and community.

International Registered Report Identifier (IRRID)

PRR1-10.2196/10987

Does photobiomodulation change the synthesis and secretion of angiogenic proteins by different pulp cell lineages?

This study aimed to compare the synthesis and secretion of VEGF-A, VEGF-C, VEGF-D, VEGFR1, VEGFR2, and FGF-2 between pulp fibroblasts from human primary teeth (HPF) and stem cell from human deciduous teeth (SHED) before and after photobiomodulation. HPF were obtained from explant technique and characterized by immunohistochemistry, while SHED were obtained from digestion technique and characterized by flow cytometry. HPF (control group) and SHED were plated, let to adhere, and put on serum starvation to synchronize the cell cycles prior to photobiomodulation. Then, both cell lineages were irradiated with 660-nm laser according to the following groups: 2.5 and 3.7 J/cm². MTT and crystal violet assays respectively verified viability and proliferation. ELISA Multiplex Assay assessed the following proteins: VEGF-A, VEGF-C, VEGF-D, VEGFR1, VEGFR2, FGF-2, at 6, 12, and 24 h after photobiomodulation, in supernatant and lysate. Two-way ANOVA/Tukey test evaluated cell viability and proliferation, while angiogenic production and secretion values were analyzed by one-way ANOVA (P < .05). Statistically similar HPF and SHED viability and proliferation patterns occurred before and after photobiomodulation (P > .05). HPF exhibited statistically greater values of all angiogenic proteins than did SHED, at all study periods, except for FGF-2 (supernatant; 12 h); VEGFR1 (lysate; non-irradiated; 12 h); and VEGFR1 (lysate; non-irradiated; 24 h). Photobiomodulation changed the synthesis and secretion of angiogenic proteins by HPF. HPF produced and secreted greater values of all tested angiogenic proteins than did SHED before and after irradiation with both energy densities of 2.5 and 3.7 J/cm².

The effectiveness of curcumin-mediated antimicrobial photodynamic therapy depends on pre-irradiation and biofilm growth times

BACKGROUND

The aim of this study was to determine the influence of distinct pre-irradiation times (PIT) of curcumin on the effectiveness of antimicrobial photodynamic therapy (aPDT) against intact dentin caries biofilms grown for 3 or 5 days.

METHODS

The microcosm biofilms grew on non-fluorescent glass blocks immersed in McBain medium with 1% sucrose, using microaerophilic conditions at 37 °C for 3 or 5 days. The biofilms were treated by the association of 600 μmol.L^-1 curcumin using different pre-irradiation times (1, 2 or 5 min) combined with 0 or 75 J.cm^-2 blue LED. Then, the vitality of biofilms was determined by confocal scanning laser microscopy (CSLM), after being stained with the mixture of ethidium bromide and fluorescein diacetate. Statistical analysis was performed by two-way ANOVA and post-hoc Tukey tests, after arcsine transformation (P < 0,05).

RESULTS

In comparison to control, curcumin alone (PIT = 5 min) and all combinations of curcumin and LED reduced significantly the vitality of 3-day biofilms. Distinctly, only curcumin plus LED using PITs of 2 or 5 min were effective in reducing the vitality of 5-day biofilms.

CONCLUSION

Curcumin-mediated aPDT significantly decreased the vitality of intact dentin caries microcosms grown during 3 or 5 days, although successful treatments of 5-day biofilms required longer PITs in comparison to their counterparts.

A randomized clinical trial of cavity liners after selective caries removal: one-year follow-up

INTRODUCTION

Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years.

OBJECTIVE

To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal.

METHODOLOGY

Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05).

RESULTS

Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05).

CONCLUSION

The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.

In Vitro Antimicrobial Effect of Bioadhesive Oral Membrane with Chlorhexidine Gel

This study aimed to evaluate in vitro the antimicrobial effect of a bioadhesive chitosan-based oral membrane with chlorhexidine for local treatment of infections in the oral tissues. Five oral membranes of different compositions were tested: 5% chitosan (G1); 5% chitosan ± 0.2% chlorhexidine (G2), 5% chitosan ± 0.6% chlorhexidine (G3), 5% chitosan ± 1.0% chlorhexidine (G4), and 5% chitosan ± 2.0% chlorhexidine (G5). Also, five gel types were tested according to the following compositions: 5% chitosan gel (G6), 0.2% chlorhexidine gel (G7), 2.0% chlorhexidine gel (G8), 5% chitosan gel ± 0.2% chlorhexidine gel (G9), and 5% chitosan gel ± 2.0% chlorhexidine gel (G10). The antimicrobial action of the samples was tested against Candida albicans and Streptococcus mutans through antibiogram by measuring the inhibition halos. Data were statistically analyzed by Kruskal-Wallis and one-way ANOVA followed by Tukey test (p<0.05). The 2.0% chlorhexidine membrane (G5) and the disks containing 2.0% chlorhexidine gel (G8) showed the greatest inhibition halos for both microorganisms, with statistically significant difference when compared to others tested groups (p=0.008) only for Candida albicans inhibitions results. All the other formulations of membranes and gels showed inhibition halos, but without statistically significant difference. The bioadhesive chitosan-based oral membrane with 2% chlorhexidine and 2% chlorhexidine gel were the most effective in inhibiting the tested microorganisms.

Curcumin-mediated antimicrobial photodynamic therapy reduces the viability and vitality of infected dentin caries microcosms

BACKGROUND

To our knowledge, there is a lack of evidence on the effect of Antimicrobial Photodynamic Therapy (aPDT) by the application of curcumin against complex biofilms of dental caries lesions. This study aimed to evaluate the viability, vitality, and acid metabolism of infected dentin caries microcosms treated with curcumin-mediated aPDT.

METHODS

After microcosm biofilms growing anaerobically on bovine dentin disks immersed in McBain medium with 1% sucrose at 37 °C for 5 days, the biofilms were treated by the association of DMSO water solution or 600 μmol L^-1 curcumin with 0, 37.5 or 75 J cm^-2 blue LED (455 nm). Then, the colony-forming units (CFU) counts of total microorganisms, total streptococci, mutans streptococci, and total lactobacilli were determined by plating. The lactic acid concentration was analyzed by enzymatic spectrophotometry method, while the vitality of intact biofilms was evaluated by confocal laser scanning microscope (CLSM). Statistical analysis was performed by Kruskal Wallis and post-hoc Dunn's tests (P < 0.05).

RESULTS

Curcumin alone did not affect the viability of microorganisms and the vitality of intact biofilms. However, 75 J cm^-2 LED alone decreased the total microorganisms and total lactobacilli counts. The combination of curcumin and LED reduced significantly the counts of all microorganism groups and the vitality of intact biofilms. Differences were not observed between the lactic acid concentrations of distinct groups.

CONCLUSIONS

Therefore, curcumin-mediated aPDT was effective in reducing the viability and the vitality of infected dentin caries microcosms, without interfering in their acidogenicity.

Post-surgical effects on the maxillary segments of children with oral clefts: New three-dimensional anthropometric analysis

This study aimed to use new three-dimensional (3D) anthropometric analyses to verify the post-surgical effects on the maxillary segments of children with unilateral cleft lip and palate. The sample was composed by digitized dental models of 60 children with unilateral complete cleft lip and alveolus (UCLA) and complete unilateral cleft lip and palate (UCLP). The impressions were taken before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The 3D anthropometric analyses of digitized dental casts were obtained through a specific software. Intragroup changes were applied paired t test and Wilcoxon test (UCLA group) and for the UCLP group, repeated-measures analyses of variance followed by the Tukey test. For intergroup analyses, an independent t test and Mann-Whitney test were used. The palatal dimensional changes of UCLA group showed that the distances IC, I-T', and I-T significantly increased after cheiloplasty (p = 0.0002, p = 0.0007 and p < 0.0001, respectively). In the UCLP group, the IC' distance statistically decreased in the post-surgical periods (p < 0.0001), while the I-T distance increased (p < 0.0001). The IC distance increased after cheiloplasty (p < 0.0001). The I-T' distance increased between T2 and T3 with statistically significant differences (p = 0.0037). The intergroup analysis of palatal development (T2-T1) showed that the distances IC' and I-T' demonstrated a reduction of the dental arches growth of UCLP group compared with the UCLA group, with statistically significant differences. The new 3D anthropometric analysis showed that the development of the maxillary segments changed after surgical repair. The UCLP group demonstrated a reduction of the dental arches growth compared with the UCLA group.

Oral health-related quality of life of children with oral clefts and their families

Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being.

Evaluating the Dental Caries-Related Information on Brazilian Websites: Qualitative Study

BACKGROUND

Dental caries is the most common chronic oral disease, affecting 2.4 billion people worldwide who on average have 2.11 decayed, missing, or filled teeth. It impacts the quality of life of patients, socially and economically. However, the comprehension of dental caries may be difficult for most people, as it involves a multifactorial etiology with the interplay between the tooth surface, the dental biofilm, dietary fermentable carbohydrates, and genetic and behavioral factors. Therefore, the production of effective materials addressed to the education and counseling of patients for the prevention of dental caries requires a high level of specialization. In this regard, the dental caries-related contents produced by laypersons and their availability on the Internet may be low-quality information.

OBJECTIVE

The aim of this study was to assess the readability and the quality of dental caries-related information on Brazilian websites.

METHODS

A total of 75 websites were selected through Google, Bing, Yahoo!, and Baidu. The websites were organized in rankings according to their order of appearance in each one of the 4 search engines. Furthermore, 2 independent examiners evaluated the quality of websites using the DISCERN questionnaire and the Journal of American Medical Association (JAMA) benchmark criteria. The readability of the websites was assessed by the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). In addition, the information presented on the websites was categorized as etiology, prevention, and treatment of dental caries. The statistical analysis was performed using Spearman rank correlation coefficient, Mann-Whitney U test, hierarchical clustering analysis by Ward minimum variance method, Kruskal-Wallis test, and post hoc Dunn test. P<.05 was considered significant.

RESULTS

The Web contents were considered to be of poor quality by DISCERN (mean 33.48, standard deviation, SD 9.06) and JAMA (mean 1.12, SD 0.97) scores, presenting easy reading levels (FRE-BP: mean 62.93, SD 10.15). The rankings of the websites presented by Google (ρ=-.22, P=.08), Baidu (ρ=-.19, P=.53), Yahoo! (ρ=.22, P=.39), and Bing (ρ=-.36, P=.23) were not correlated with DISCERN scores. Moreover, the quality of websites with health- and nonhealth-related authors was similar (P=.27 for DISCERN and P=.47 for JAMA); however, the pages with a greater variety of dental caries information showed significantly higher quality scores than those with limited contents (P=.009).

CONCLUSIONS

On the basis of this sample, dental caries-related contents available on Brazilian websites were considered simple, accessible, and of poor quality, independent of their authorship. These findings indicate the need for the development of specific policies focused on the stimulus for the production and publication of Web health information, encouraging dentists to guide their patients in searching for recommended oral health websites.

Storage protocol of dental pulp cells from human exfoliated deciduous teeth

Objective: This study aimed to isolate the cells from the dental pulp tissue of human primary teeth, study the capacity of proliferation, characterize the cells and standardize the technique of culture and expansion to create a cell banking. Material and Methods: Primary teeth with no caries and orthodontic reasons were extracted for pulp tissue obtainment. The cells were extracted from the pulp cells, isolated and cultured under ideal conditions until full expansion. Results: After consecutive passages, the cultured cells were characterized using immunofluorescence technique and frozen between the 2nd and 6th passage, thus creating a biorepository of dental pulp cells from human primary teeth. Conclusion: The creation of a cell banking from dental pulp cells from human primary teeth enables the easy application of cells in laboratorial studies, reducing the cost and time for obtaining the samples, avoid the involvement of new subjects and allow a fast reproducibility of the researches. KeywordsCell culture techniques; Tooth, deciduous; Pulp; Fibroblasts; Cryopreservation.

Three-dimensional digital evaluation of dental arches in infants with cleft lip and/or palate

The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.

Effects of low-level laser therapy on stem cells from human exfoliated deciduous teeth

Low-Level Laser Therapy stimulates the proliferation of a variety of types of cells. However, very little is known about its effect on stem cells from human exfoliated deciduous teeth (SHED).

Do technology-based devices improve carious lesion detection?

Objective:  To compare the visual-tactile examination with the technology-based caries detection examinations in children. Methods: We assessed the teeth next to the cleft area of 95 children aged 6 to 12 years with oral clefts but without the presence of any associated syndrome or craniofacial anomaly, according to the following detection methods: visual-tactile examination (Method 1), visual-tactile examination through operating microscope (Method 2), visual examination through LED-based fluorescence device (Method 3), using ICDAS-II scores. The caries detection methods were compared by Friedman test (P<0.05). Results: The efficacy of carious lesion detection methods were statistically similar (P=0.786). Conclusions: Technology-based devices did not improve caries diagnosis in children because their results were similar to those of visual-tactile clinical examination. From a clinical point of view, we recommended the dentists to be cautious in using these additional diagnostic measures to avoid false positive errors mainly in tooth surfaces difficult to be examined.Keywords: Dental Caries. Lenses. Fluorescence. Cleft lip. Cleft palate.

Biophysical and biological characterization of intraoral multilayer membranes as potential carriers: A new drug delivery system for dentistry

The current study developed through layer-by-layer deposition a multilayer membrane for intraoral drug delivery and analyzed the biochemical, functional, and biological properties of this membrane. For that purpose, we designed a three-layer chlorhexidine-incorporated membrane composed by pure chitosan and alginate. The biochemical, functional, and biological properties were analyzed by the following tests: degradation in saliva medium; controlled drug release; water absorption, mass loss; pH analysis; and biocompatibility through fibroblast cell viability by MTT assay. All tests were conducted at three different periods (24, 48 and 72hours). The results demonstrated that hybrid membranes composed by alginate and chitosan with glycerol had greater water absorption and mass loss in buffer solution and in artificial saliva. The controlled drug release test revealed that the hybrid membrane exhibited greater drug release (0.075%). All chlorhexidine-incorporated membranes reduced the cell viability, and chitosan membranes with and without glycerol did not interfere with fibroblast viability. The biochemical and biophysical characteristics of the designed membranes and the findings of cell viability tests indicate great potential for application in Dentistry.

Impact of malocclusion on oral health-related quality of life in Brazilian children with cleft lip and palate

Objective: This cross-sectional study aimed to evaluate the impact of malocclusion on the oral health-related quality of life (OHRQoL) in Brazilian children with non-syndromic oral clefts at tertiary craniofacial center. Material and methods: Sixty-nine children with non-syndromic oral clefts, aged between 8 and 10 years, were selected and divided into groups according to the cleft type: Group 1 – Children with complete unilateral cleft lip and alveolus; Group 2 – Children with unilateral cleft lip and palate; Group 3 – Children with cleft palate. Each child answered the Child Perceptions Questionnaire8-10 (CPQ 8-10) which is a multiple-choice questionnaire, with 29 questions on the impact of oral diseases on the OHRQoL. Then, a visual examination of dental occlusion was carried out. Kruskal-Wallis and Mann-Whitney tests were used to determine statistical significant differences among groups (p<0.05). Results: No statistically significant differences were verified for the impact of cleft type (p=0.895) and malocclusion (p=0.528) on OHRQoL of Brazilian children with oral clefts. Conclusion: The malocclusion did not impact on the OHRQoL of 8-10 year-old children with non-syndromic clefts.

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

BACKGROUND

Individuals with cleft lip and palate have many anatomic and functional alterations compromising esthetics, hearing, speech, occlusion, and development/craniofacial growth. The rehabilitative treatment of these patients is very challenging and starts at birth aiming at the best treatment for all functional demands. This study aimed to evaluate the dimensional alterations of the dental arches of neonates with cleft lip and palate after two different primary surgical techniques.

MATERIALS AND METHODS

The sample comprised 114 digital models of children aged from 3 to 36 months, with unilateral complete cleft lip and palate divided into two groups. Two different phases were evaluated: precheiloplasty and 1 year after palatoplasty. The evaluation was performed through the digital models of each child obtained by scanning digitalization (3D Scanner). Dental arches measurements were accomplished through Appliance Designer software. The following measurements were assessed: dental arch area, anterior amplitude of the cleft, total length of dental arch, intercanine distance, and intertuberosity distance. t-test was applied to compare differences between groups.

RESULTS

No statistically significant differences were observed between groups at precheiloplasty phase. At 1 year after palatoplasty, the groups differed in the total length of dental arch (P = 0.002), with greater values for Group I.

CONCLUSION

This study suggests that the results of the different surgical techniques may alter the growth and development of the dental arches of neonates with cleft lip and palate.

General anesthesia for dental care management of a patient with epidermolysis bullosa: 24-month follow-up

Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient.

Clinical and radiographic outcomes of the use of capping materials in vital pulp therapy of human primary teeth

Objective: The aim of this study was to compare the clinical and radiographic outcomes of Calcium Hydroxide (CH), Calcium Hydroxide preceded by corticosteroid/antibiotic solution (O+CH) and diluted formocresol (FC) in the vital pulp therapy of human primary teeth. Material and methods: Forty-five mandibular primary molars of children aged between 5-9 years were randomly assigned in the three study groups, FC, CH and O+CH and received conventional pulpotomy treatment. Clinical and radiographic follow-up was made at 3, 6 and 12-months. Results: No sign of clinical failure was observed in the three study groups during all the periods of evaluation. Radiographic analysis showed a total of six cases of internal root resorption in CH and O+CH groups after the 12 months follow-up, with statistically significant difference as compared with FC group. FC group did not show hard tissue barrier formation, that was observed in CH and O+CH groups in all the follow-up periods. Conclusion: All employed materials showed acceptable clinical and radiographic success rates. The results showed that the use of an anti-inflammatory solution prior the dressing material has therapeutic properties that help with pulpal healing. Continued clinical investigations using these medicaments as vital pulpotomy treatment in primary molars are recommended. 

Clinical and radiographic outcomes of the use of Low-Level Laser Therapy in vital pulp of primary teeth

AIM

This study aimed to compare the clinical and radiographic effectiveness of Low Level Laser Therapy in vital pulp of human primary teeth.

METHODS

Sixty mandibular primary molars of children aged between 5-9 years were assigned into four groups: Diluted Formocresol (FC), Calcium Hydroxide (CH), Low Level Laser Therapy (LLLT) and Calcium Hydroxide preceded by Low Level Laser Therapy (LLLT + CH). The clinical and radiographic evaluations were performed at 6, 12 and 18 post-operative months.

RESULTS

All the groups studied were successful in the clinical evaluation over the follow-up period. At 6 months, the radiographic success rate for FC group was 100%, 60% for CH group, 80% for LLLT group and 85.7% for LLLT + CH group. After 12 months, the radiographic success rate was 100% for FC group, 50% for CH group, 80% for LLLT group and 78.6% for LLLT + CH group. At the 18 months follow-up, 100% of the FC group, 66.7% of CH group, 73.3% of the LLLT group and 75% of the LLLT + CH group.

CONCLUSION

These findings suggest that Low Level Laser Therapy may be considered as an adjuvant alternative for vital pulp therapy on human primary teeth. Low Level Laser Therapy preceding the use of calcium hydroxide showed satisfactory results.

Mini-implants: alternative for oral rehabilitation of a child with ectodermal dysplasia

Ectodermal dysplasia is a rare congenital disease that affects several structures of ectodermal origin. The most commonly related oral characteristics are hypodontia, malformed teeth and underdeveloped alveolar ridges. New alternative treatments are needed due to the failure of the conventional prosthesis retention. This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The treatment was performed with conventional prosthesis upon mini-implants. The mini-implants provided prosthetic retention. The patient reported a good adaptation of the dental prosthesis and satisfaction with the treatment. The increased self-esteem improved the socialization skills of the girl. In this case report, use of prosthesis with mini-implants was satisfactory for prosthetic retention. However, clinical studies with long-term follow-up are needed to test the mini-implants as an alternative for oral rehabilitation of children with ectodermal dysplasia.