Abstract Objective: Compare the occurrence of choking and gagging in infants subjected to three complementary feeding (CF) methods. Methods: Randomized clinical trial with mother-infant pairs, allocated according to the following methods of CF: a) Parent-Led Weaning (PLW) — group control, b) Baby-Led Introduction to SolidS (BLISS), and c) mixed (initially BLISS and if the infant presents a lack of interest or dissatisfaction, PLW), with the last two methods guided by the infant. Mothers received nutritional intervention on CF and prevention of choking and gagging according to the method at 5.5 months of age and remained in follow-up until 12 months. Frequencies of choking and gagging were collected by questionnaire at nine and 12 months. The comparison between groups was performed using the analysis of variance test (p < 0.05). Results: 130 infants were followed, and 34 (26.2%) children presented choking between six and 12 months of age, 13 (30.2%) in PLW, 10 (22.2%) BLISS, and 11 (26.2%) mixed method, no significative difference between methods (p > 0.05). The choking was caused mainly by the semi-solid/solid consistency. Moreover, 100 (80%) infants aged from six to 12 months presented gagging and their characteristics were not statistically different among groups (p > 0.05). Conclusion: Infants following a baby-led feeding method that includes advice on minimizing choking risk do not seem more likely to choke than infants following traditional feeding practice that includes advice on minimizing choking risk.

Resumo Embora o tratamento endodôntico seja amplamente recomendado para polpa dentária comprometida, não há informações sobre os fatores associados ás falhas nos dentes decíduos. O objetivo do trabalho foi avaliar a sobrevida e os fatores associados à falha de pulpectomias realizadas em dentes decíduos por estudantes de odontologia. A amostra foi constituída por pacientes atendidos em um Serviço Odontológico Universitário e necessitaram de tratamento endodôntico em dentes decíduos. O estudo investigou variáveis relacionadas ao tratamento e fatores do paciente potencialmente associados à falha do tratamento. A sobrevivência das pulpectomias foi analisada pelas curvas de Kaplan-Meier seguido do teste de log-rank (p<0,05). A análise incluiu 81 pulpectomias realizadas em 62 crianças (5,6 ± 1,5 anos). A sobrevida atingiu 62,9% em até 12 meses de seguimento. A maioria das falhas ocorreu nos primeiros 3 meses (p<0,001). Os dentes com lesões cariosas no início do tratamento apresentaram mais falhas do que aqueles com restaurações ou história de trauma (p = 0,002). A sobrevida de dentes endodonticamente tratados restaurados com compósito foi maior do que os preenchidos com cimento de ionômero de vidro (p = 0,006). Pulpectomias realizadas em duas ou mais sessões apresentaram mais falhas (p = 0,028). Os pacientes com gengivite apresentaram mais falhas no tratamento endodôntico (p = 0,022). As falhas do tratamento do canal radicular em dentes decíduos foram mais propensas a ocorrer em um curto período de tempo e quando o tratamento foi realizado em dentes com lesões cariosas. O uso de compósito em vez de cimento de ionômero de vidro aumentou a sobrevivência pulpectomias. Sessões repetidas para o tratamento endodôntico e a falta de hábitos de higiene bucal tiveram um efeito negativo sobre os resultados.

Abstract Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.

The aim of this study was to evaluate flossing as a diagnostic method for interproximal gingival bleeding in children. For this crossover study, 23 pre-schoolchildren presenting neither restorations nor approximal carious cavities and with at least 15% of gingival bleeding sites were selected. Examinations were performed at three different moments (3-4 days interval). Examinations comprised repeated measurements of two gingival indices with a 10-minute interval in the following sequences: the Ainamo & Bay Gingival Bleeding Index (GBI) followed by the Carter & Barnes flossing index (CBI); CBI followed by GBI; and GBI followed by GBI. Data analysis was performed only for the interproximal sites, considering the GBI as the gold-standard. Agreement between indices, sensitivity (SE), specificity (SP), positive (PPV) and negative predictive values (NPV) were estimated. Percentage agreements in sequences GBI-CBI, CBI-GBI and GBI-GBI were 70.3%, 76.4% and 84.5%, respectively. Validation of flossing in the first sequence (GBI-CBI) resulted in values of 0.61 (95%CI 0.53 - 0.68), 0.72 (95%CI 0.69 - 0.76), 0.33 (95%CI 0.28 - 0.39) and 0.89 (95%CI 0.86 - 0.92) respectively for SE, SP, PPV and NPV. It can be concluded that professional flossing is a useful tool in the diagnosis of interproximal gingival inflammatory status in children, especially in conditions of gingival health.

The purpose of this study was to validate the elastomeric impression after temporary tooth separation as a method of cavitation detection in proximal caries lesions in primary molars with outer half dentin radiolucency. Fifty-one children (4-10 years old), presenting radiolucency in the outer half of the dentin at the proximal surfaces of primary molars and proximal anatomic contact with the adjacent tooth (without restoration/cavitated caries lesion) were enrolled in the study. Temporary tooth separation was performed with an orthodontic rubber ring placed around the contact point during 2-3 days. Thereafter, impression of the proximal surfaces was made. The elastomeric impressions were classified as "non-cavitated" or "cavitated" surfaces. Visual inspection after tooth separation was considered as the gold standard. Examiner reliability of visual inspection after tooth separation was determined (kappa 0.92). Impression examination was repeated every 5 participants to evaluate the reproducibility of the method. The frequency of cavitated lesions was 65%, and 67% of those were inactive. Sensitivity, specificity, positive and negative predictive values were 0.88% (95%CI 0.73-0.95), 0.89% (95%CI 0.67-0.97), 0.94% (95%CI 0.79-0.98) and 0.80% (95%CI 0.58-0.92), respectively. Impression examination showed total agreement regarding cavitation. The evaluation of elastomeric impression after tooth separation is a useful clinical resource in cavitation detection for clinicians and researchers when visual inspection is doubtful.