Abstract The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013–0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985–1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014–0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

Abstract Objective: To evaluate the efficacy of xylitol varnishes in the inhibition of enamel demineralization in vitro. Material and Methods: Bovine enamel blocks (n=120) were randomly allocated to four groups (n = 30), and the surface hardness (SH) was measured at baseline. The blocks were treated with the following varnishes: 20% xylitol, 20% xylitol plus F (5% NaF), Duraphat™ (5% NaF, positive control), and placebo (no-F/xylitol, negative control). The varnishes were applied and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH cycles (demineralization and remineralization for 2 and 22h/day, respectively, for 8 days). Surface and cross-sectional hardnesses were measured to calculate the percentage of SH loss (%SHL) and the integrated loss of the subsurface hardness (ΔKHN). Data were statistically analyzed using Kruskal-Wallis and Tukey’s tests (p<0.05). Results: %SHL was significantly decreased by 20% xylitol plus F, Duraphat™, and 20% xylitol varnishes compared to placebo. The use of 20% xylitol plus F varnish led to a significantly lower percentage of SH loss compared to the use of 20% xylitol varnish without F. However, the experimental and commercial varnishes led to significantly lower subsurface demineralization compared to placebo and did not differ from each other. Conclusion: Xylitol varnishes, especially when combined with F, effectively prevent enamel demineralization.

RESUMO A síndrome Shprintzen-Goldberg é uma entidade muito rara descrita em 75 pessoas, caracterizada por craniossinostose e habitus marfanóide. O objetivo deste estudo é apresentar o relato de um caso clínico de uma criança brasileira de 6 anos com síndrome da craniossinostose de Shprintzen-Goldberg, apresentando as características craniofaciais e orais e seu manejo clínico, comparando com a literatura. O paciente apresentava deficiência intelectual, craniossinostose, proptose ocular, orelhas anômalas de implantação baixa e outros defeitos esqueléticos e do tecido conjuntivo. As características orais incluíram má oclusão, micrognatia, pseudo fenda palatina, atividade de cárie e controle ineficiente do biofilme. O tratamento foi iniciado com orientações sobre alimentos cariogênicos, higiene oral e indicação de suspensão do uso de mamadeira. Em seguida, as lesões cariosas foram restauradas com resina composta e o paciente encaminhado para cirurgia ortopédica, tratamento ortodôntico, fonoaudiologia e nutricionista. O paciente foi acompanhado periodicamente por 5 anos. Este relato de caso enfatiza a importância do conhecimento das características craniofaciais e orais para o diagnóstico e manejo clínico de uma criança do sexo feminino com síndrome de craniossinostose de Shprintzen-Goldberg rara, destacando a necessidade de cuidados com a saúde bucal em indivíduos com deficiência intelectual.

ABSTRACT Shprintzen-Goldberg craniosynostosis syndrome, characterized by craniosynostosis and marfanoid habitus, is a very rare entity described in 75 individuals worldwide. This study aimed to present a case report of a 6-year-old female Brazilian child with Shprintzen-Goldberg’s craniosynostosis syndrome. We described the craniofacial and oral characteristics and its clinical management, comparing to the existing literature. The patient presented with intellectual disability, craniosynostosis, ocular proptosis, low-set anomalous ears, and other skeletal and connective tissue defects. Oral features included malocclusion, micrognathia, pseudo-cleft palate, dental caries, and inefficient biofilm control. The treatment started with guidance on cariogenic foods, oral hygiene, and an indication to discontinue bottle feeding. Subsequently, the carious lesions were restored with composite resins, and the patient was referred for orthopedic surgery, orthodontic treatment, speech therapy, and nutritional counseling. The patient was followed for 5 years. This case report emphasizes the importance of knowing the craniofacial and oral characteristics for the diagnosis and clinical management of a female child with a rare Shprintzen-Goldberg’s craniosynostosis syndrome. The case also highlights the need for oral health care in individuals with intellectual disabilities.

Abstract Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question “In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?” was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR= 1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR= 1.81; 95% CI: 1.51-2.15), dental trauma (PR= 1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR= 1.36; 95% CI:1.18-1.57), dental crowding (PR= 1.60; 95% CI:1.40-1.83), midline diastema (PR= 1.30; 95% CI:1.11-1.44), tooth loss (PR= 1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR= 1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR= 1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents.

ABSTRACT Objective: To determine the initial mechanical stabilization of conventional glass ionomer cements (GICs) indicated for the atraumatic restorative treatment (ART) in different storage periods. Material and Methods: Specimens were divided according to the GIC (n=12): IZ - Ion-Z, KM - Ketac Molar Easymix, RS - Riva Self Cure, and GL - Gold Label 9. They were prepared and stored in distilled water. Superficial microhardness (SMH) was evaluated (KHN) in three phases: (A) after 1, (B) 3, and (C) 7 days of storage. Data were submitted to 2-way ANOVA and Tukey tests (α = 5%). Results: The average KHN values for phases A, B, and C were, respectively, 33.05 ± 9.74; 33.21 ± 10.31 and 52.07 ± 11.75 (IZ); 50.35 ± 11.39; 66.05 ± 10.48 and 67.77 ± 13.80 (KM); 89.63 ± 15.59; 71.31 ± 23.86 and 57.70 ± 16.89 (RS); 42.18 ± 9.03; 68.54 ± 6.83 and 57.95 ± 8.24 (GL). Significant differences were observed: GIC, time, and interaction of both (p<0.05). KHN values differed between the groups, except in the GIC parameter for KM and GL. The time parameter values of phase A were lower than those of B and C, except for IZ and RS. Conclusion: The initial mechanical stabilization differed between the types of GIC tested and the storage time, and after the final period, all had similar SMH.

ABSTRACT Introduction: Cerebral palsy involves loss or impairment of motor function attributed to non-progressive disturbances occurring in the developing fetal or infant brain. Self-inflicted oral trauma is a recurrent parafunctional habit in individuals with cerebral palsy. Objective: Describe two treatment modes for self-inflicted oral trauma in a 6-year-old male patient with cerebral palsy over a 5-year follow-up period. Case presentation: The child had been having pain due to injuries to the mouth floor and lingual frenum regions. Initially, low-level laser therapy was applied to accelerate the healing process of the wounds. Five years later, the child started to present worse oral injuries and placement of a fixed oral appliance was proposed. Intraoral examination showed that the wounds had healed completely in response to the oral appliance. Conclusions: Different therapies may be useful to control the recurrence of self-inflicted oral injuries.

RESUMEN Introducción: La parálisis cerebral provoca una pérdida o deterioro de la función motora atribuida a trastornos no progresivos del desarrollo cerebral fetal o infantil. La lesión autoinfligida es un hábito parafuncional recurrente en personas con parálisis cerebral. Objetivo: Describir dos modalidades de tratamiento para las lesiones autoinfligidas en un niño de 6 años de edad con parálisis cerebral durante un periodo de seguimiento de 5 años. Presentación del caso: El niño presentaba dolor debido a lesiones en la región del suelo de la boca y el frenillo lingual. Inicialmente se aplicó terapia con láser de baja intensidad para acelerar el proceso de cicatrización de las heridas. Cinco años más tarde el niño empezó a presentar lesiones bucales más severas, por lo que se propuso la colocación de un dispositivo oral fijo. El examen intraoral mostró que las lesiones habían cicatrizado completamente en respuesta al dispositivo oral instalado. Conclusiones: Diferentes terapias pueden ser útiles para controlar la recurrencia de las lesiones orales autoinfligidas.

RESUMO Introdução: As exostoses são definidas como protuberâncias ósseas localizadas, de caráter benigno, sendo uma rara patologia em bebês. Objetivo: Relatar um caso de exostose palatina bilateral em um bebê melanoderma do sexo feminino de 1 ano e 4 meses de idade. Relato de caso: A criança compareceu a Clínica Escola de Odontopediatria, acompanhada de sua mãe, para avaliação odontológica. Durante a anamnese, o responsável queixou-se de atraso na irrupção dos dentes decíduos e presença de protuberância na arcada superior, sem sintomatologia dolorosa. Foi relatado que três membros da família também apresentavam essa mesma alteração na maxila ou mandíbula, possivelmente sugerindo um componente genético. Ao exame clínico intrabucal, verificou-se um aumento de volume ósseo bilateral plano localizado na maxila, na região lingual das tuberosidades palatinas, recoberto por mucosa bucal normal. A superfície era rígida à palpação e com bordas claramente definidas. O componente genético foi associado ao aspecto clínico da lesão, bem como o sexo e a etnia. O diagnóstico estabelecido foi exostose palatina bilateral. A biópsia e o tratamento ativo para remoção da patologia não se justificaram devido à pouca idade da criança, ausência de sintomatologia dolorosa e de interferências na alimentação, deglutição ou outra função bucal. A paciente foi acompanhada periodicamente e apresentou sequência de irrupção dos dentes decíduos normal. Conclusão: Embora a exostose palatina apresente baixa prevalência em crianças, é importante que o cirurgião-dentista tenha conhecimento para realizar seu correto diagnóstico e plano de tratamento.

ABSTRACT Introduction: Exostoses are localized bony lumps of a benign nature. They are an infrequent condition in infants. Objective: Present a case of bilateral palatal exostosis in a dark-skinned female infant aged one year and four months. Case presentation: The girl was brought by her mother to the Children's Dental Clinic for oral examination. During anamnesis, the mother referred to delay in the eruption of deciduous teeth and the presence of lumps on the upper arch without any painful symptom. She also reported that three relatives had the same alteration in their maxilla or mandible. Oral examination revealed a bilateral flat bony lump in the maxilla, in the lingual region of the palatal tuberosities, covered by normal oral mucosa. The surface was stiff to palpation with well defined borders. The genetic factor was associated to the clinical aspect of the lesion, as well as the sex and ethnicity of the patient. The diagnosis was bilateral palatal exostosis. Biopsy and active treatment for removal of the lesion were not justified due to the patient's age, absence of painful symptoms, and potential interference with feeding, swallowing and other oral functions. The patient was periodically followed-up and was observed to present a normal process of deciduous tooth eruption. Conclusions: Even though palatal exostosis is infrequent in children, it is important for dental surgeons to be knowledgeable about the topic so as to reach an appropriate diagnosis and treatment plan.

RESUMEN Introducción: Las exostosis son definidas como bultos óseos, de carácter benigno, y contituyen una infrecuente afección en bebés. Objetivo: Describir un caso de exostosis palatina bilateral en un bebé melanoderma del sexo femenino de 1 año y 4 meses de edad. Presentación del caso: La niña acudió a la Clínica Escuela de Odontopediatría, con su madre, para evaluación odontológica. Durante la anamnesis, la madre refiere retraso en la erupcíon de los dientes deciduos, además de la presencia de bultos en la arcada superior, sin dolores sintomáticos. Fue informado que tres familiares también presentaban la misma alteración en la maxila o mandíbula, posiblemente sugiriendo componente genético. El examen clínico intrabucal, verificó un aumento de volumen óseo bilateral plano ubicado en la maxila, en la región lingual de las tuberosidades palatinas, recubierto por una mucosa bucal normal. La superficie era rígida a la palpación y con bordes bien definidos. El componente genético fue asociado al aspecto clínico de la lesión, al igual que el sexo y la etnia. El diagnóstico establecido fue exostosis palatina bilateral. La biopsia y el tratamiento activo para la remoción de la afección no se pudieron justificar por la poca edad de la niña, ausencia de dolores sintomáticos, además de interferencias en la alimentación, deglución u otra función bucal. La paciente fue controlada periódicamente y presentó secuencia de irrupción de dientes deciduos normal. Conclusiones: Aunque la exostosis palatina sea infrecuente en niños, es importante que el cirujano dentista tenga conocimiento para realizar el correcto diagnóstico y el plan de tratamiento.

Abstract Objective: To identify the social representations of children in relation to the image of the dentist. Material and Methods: This is a descriptive cross-sectional study with quantitative-qualitative approach. The sample consisted of 80 children of both sexes aged 7-10 years attended at a clinic-school of a university in eastern Minas Gerais, Brazil. For data collection, the Test of Free Words Association (TALP) was used, with the word "dentist" as its inducing theme. The four items included in the research instrument were: 1) evoke up to five words or expressions related to the dentist; 2) to order each of them numerically, with number one being the most important and number five being the least important; 3) to conceptualize the one elected as number one; and 4) to justify the reason for that choice. The EVOC software was used to carry out quantitative analyses and the Analysis of Content of Bardin for qualitative analyses. Results: The words that composed the central nucleus of social representations were "tooth", "pain", "brushing" and "treats". This grouping of ideas points to the following conceptual formulation: "The dentist is someone who 'brushes' and 'treats' teeth, but sometimes performs procedures that cause 'pain’. The categories abstracted from participants' discourse were "oral health", "personal characteristics of the dentist" and "child-dentist interaction". Conclusion: Children presented predominantly positive image regarding the dentist.

Abstract Obesity is considered a risk factor for periodontal health due to the low- grade inflammation promoted by the increased adipose tissue. Objective: This study aimed to determine correlations and associations between gingival inflammation (Simplified Oral Hygiene Index, and Gingival Index), salivary immunoglobulin A (s-IgA), and salivary parameters (salivary flow and osmolality) in normal-weight and overweight/obese children. Material and Methods: Ninety-one children, aged 6 to 12 years old (8.6±1.9 years), were divided into two groups according to their body mass index (BMI), circumferences, skinfold measurements and body fat percentage: normal- weight group (NWG; n =50) and overweight/obese group (OG; n =41). A calibrated examiner performed the clinical examination using the Simplified Oral Hygiene Index, Gingival Index, and salivary collection. Data analysis included descriptive statistics and association tests ( p <0.05). Results: OG presented statistically higher s-IgA values compared with NWG, especially among the obese children ( p <0.05). Significant positive correlations between s-IgA and salivary osmolality in OG ( p <0.05), and between s-IgA and BMI values ( p <0.05) and body fat percentage ( p <0.05) were observed among all the children. Effect size varied from moderate for s-IgA values ( d =0.57) to large for BMI ( d =2.60). Conclusion: Gingival inflammation and salivary parameters were similar for NWG and OG; however, s-IgA presented higher values in OG, with correlations between BMI and body fat percentage.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar a necessidade normativa de tratamento ortodôntico e a percepção dessa necessidade entre alunos de 11-14 anos de idade. Métodos: realizou-se um estudo transversal com uma amostra de 346 alunos selecionados aleatoriamente de escolas públicas e privadas. O Índice de Estética Dental (DAI) foi utilizado para avaliar a necessidade normativa de tratamento ortodôntico (NNTO). A percepção da necessidade de tratamento entre os estudantes foi avaliada por meio de um questionário previamente validado. Os dados foram analisados pelo teste qui-quadrado de Pearson (α = 5%). Resultados: a prevalência de má oclusão e NNTO foi de 65,6%. Da amostra, 73,7% relataram que precisavam de tratamento, 66,2% queriam tratamento ortodôntico e 62,7% estavam satisfeitos com sua estética dentária. Observou-se associação estatisticamente significativa entre o NNTO e a percepção da necessidade de tratamento entre os alunos (p < 0,001). Conclusão: o presente estudo demonstrou alta prevalência de má oclusão, o que se refletiu na alta necessidade normativa de tratamento ortodôntico. A opinião dos pacientes sobre suas expectativas de tratamento ortodôntico deve ser valorizada. Os alunos perceberam a necessidade de tratamento ortodôntico.

ABSTRACT Objective: The aim of the present study was to evaluate the normative need for orthodontic treatment and the perception of such need among students aged 11-14 years. Methods: A cross-sectional study was conducted with a sample of 346 students, randomly selected from public and private schools. The Dental Aesthetic Index (DAI) was used to evaluate the normative need for orthodontic treatment (NNOT). The perceived need for treatment among students was assessed by a previously validated questionnaire. Data was analyzed by Pearson’s Chi-squared test (α = 5%). Results: The prevalence of malocclusion and NNOT was 65.6%. Of the sample, 73.7% felt they needed treatment, 66.2% wanted orthodontic treatment and 62.7% were satisfied with their dental aesthetics. A statistically significant association was observed between NNOT and the perception of the need for treatment among the students (p < 0.001). Conclusion: The present study demonstrated a high prevalence of malocclusion, which was reflected in the high normative need for orthodontic treatment. The opinion of patients regarding their expectations of orthodontic treatment should be valued. The students perceived a need for orthodontic treatment.

Resumo Introdução Os métodos de descontaminação ou desinfecção de escovas dentais têm sido questionados. Objetivo Este estudo avaliou a eficácia da infusão de cascas de romã como um desinfetante de escovas dentais contra Streptococcus mutans. Material e método Uma amostra de 16 escolares com idade entre 7 e 9 anos realizou escovação dentária cuidadosa, uma vez ao dia por 5 dias/semana durante 4 semanas. Após cada dia de escovação, as escovas foram lavadas e pulverizadas com uma solução desinfetante. Este procedimento foi repetido por 4 semanas utilizando uma das diferentes soluções por semana: água destilada (G1; grupo controle), infusão de casca de romã (Punica granatum Linn) (G2), hipoclorito de sódio a 1% (G3) e digluconato de clorexidina a 0,12% (G4). Após o quinto dia, as escovas foram coletadas para análise laboratorial. As cabeças das escovas foram agitadas em solução salina diluída em 10–1, 10–2,10–3, e 25μL de cada diluição foi semeada em meio de cultura agar mitis salivarius para contagem de unidade formadora de colônias (UFC) de S. mutans. Um examinador calibrado (Kappa = 0,91) realizou a contagem de UFC mL–1 × 104. Os testes de Kruskal-Wallis e de Comparações Múltiplas de Dunn foram usados em um nível de significância de 5%. Resultado G1 apresentou o maior número de UFC (3,9 ± 8,4), seguido de G2 (3,2 ± 4,0). Não foi observado crescimento de S. mutans em G3 e G4. Não houve diferença estatisticamente significante entre G1 e G2 e entre G3 e G4 (p>0,05). Conclusão A infusão de romã foi completamente ineficaz para a desinfecção de escovas dentais contra S. mutans quando comparada às soluções de hipoclorito de sódio a 1% e digluconato de clorexidina a 0,12%.

Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control), pomegranate (Punica granatum Linn) peels infusion (G2), 1% sodium hypochlorite (G3) and 0.12% chlorhexidine digluconate (G4). After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU) counting. One calibrated examiner (Kappa = 0.91) performed the CFU (mL–1 × 104) counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4), followed by G2 (3.2 ± 4.0). No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05). Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.

As pigmentações negras do esmalte se devem à coloração extrínseca e estão associadas com problemas estéticos. O objetivo é apresentar dois casos clínicos de crianças com pigmentações extrínsecas negras do esmalte dentário, com ênfase no tipo de tratamento e no acompanhamento. Trata-se de um paciente de 5 anos de idade que utilizava constantemente sulfato ferroso para tratamento de anemia por deficiência de ferro; e outro paciente de 12 anos de idade com diabetes mellitus tipo 1 e dermatomiosite. No primeiro caso observou-se a presença de pigmentações negras extrínsecas nos dentes decíduos e nos primeiros molares permanentes, principalmente nas superfícies lingual e vestibular na região cervical e terço médio, além de lesões de cárie incipientes nas superfícies oclusais dos molares e manchas brancas ativas nos primeiros molares permanentes. No segundo caso, havia pigmentações negras extrínsecas na região cervical das superfícies lisas dos dentes decíduos e permanentes. No primeiro caso, foi realizado tratamento para remoção das pigmentações negras e polimento dos dentes por meio de profilaxia profissional com creme dental abrasivo que contém pedra pomes microgranulada. Houve uma melhora no aspecto clínico a partir da segunda sessão e finalizado na quinta sessão. Para o caso 2, observou-se dificuldade na remoção de manchas pigmentadas na região cervical e risco de sangramento gengival. Uma vez que a criança necessitava de antibiótico profilático, optamos pelo controle diário de biofilme e não remoção pela profilaxia profissional, uma vez que o paciente não se queixava do impacto estético. Conclui-se que as pigmentações negras extrínsecas podem ser observadas facilmente em crianças, e ainda que haja um comprometimento estético, não traz danos à manutenção da saúde bucal. Cabe ressaltar que não está claro como sua presença na superfície dentária reduz a suscetibilidade à cárie. Além disso, a escolha do tratamento sempre deverá ser baseada no risco-benefício para o paciente.

Dark enamel pigments are due to extrinsic staining and associated with aesthetic problems. The objective is to present two cases of children with black extrinsic pigmentation in the tooth enamel, with emphasis on the type of treatment and monitoring. This is a 5-year-old patient of who constantly used ferrous sulfate to treat anemia by iron deficiency, and another 12-year-old patient with type 1 diabetes and dermatomyositis. In the first case, we observed the presence of black extrinsic pigments in the primary teeth and the first permanent molars, especially in the lingual and vestibular part in the cervical region and middle third, together with incipient caries lesions on the occlusal surfaces of molars and active white spots on the first permanent molars. In the second case, there were strange black pigmentation in the cervical region of the smooth surfaces of the primary and permanent teeth. In the first case, the treatment performed was to remove black pigments and polishing the teeth by means of professional prophylaxis and using an abrasive toothpaste containing micro-granules of pumice. There was an improvement in the clinical aspect from the second session and the treatment ended at the fifth session. For the second case, we observed difficulty to remove the pigmented spots in the cervical region, together with the risk of bleeding gums. When the child needed prophylactic antibiotics, we opted for the daily control of the biofilm and it was not removed by professional cleaning, because the patient did not complain about the aesthetic impact. As conclusions, the extrinsic black pigments can be easily observed in children, and despite its aesthetic effect, it does damage oral health. It should be noted that it is unclear how their presence on the tooth surface reduces susceptibility to caries or tooth decay. In addition, the choice of treatment should always be based on the relation risk-benefit for the patient.

Los pigmentos de esmalte negro se deben a la tinción extrínseca y están asociados con problemas estéticos. El objetivo es presentar dos casos clínicos de niños con pigmentaciones extrínsecas negras del esmalte dental, con énfasis en el tipo de tratamiento y el seguimiento. Se trata de un paciente de 5 años de edad, que utilizaba constantemente sulfato ferroso para el tratamiento de la anemia por deficiencia de hierro, y otro paciente de 12 años de edad con diabetes mellitus tipo 1 y dermatomiositis. En el primer caso se observó la presencia de pigmentos extrínsecos negros en los dientes primarios y los primeros molares permanentes, principalmente en la parte lingual y vestibular en la región cervical y tercio medio; además de lesiones de caries incipientes en las superficies oclusales de los molares y manchas blancas activas en los primeros molares permanentes. En el segundo caso, había pigmentaciones negras extrañas en la región cervical de las superficies lisas de los dientes primarios y permanentes. En el caso 1, se realizó el tratamiento para eliminar los pigmentos negros y el pulido de los dientes por medio de una profilaxis profesional con crema dental abrasiva que contiene microgránulos de piedra pómez. Hubo una mejora en el aspecto clínico a partir de la segunda sesión y se finalizó en la quinta sesión. Para el caso 2, se observó dificultad en la eliminación de manchas pigmentadas en la región cervical y el riesgo de sangrado de las encías. Una vez que el niño necesitaba antibióticos profilácticos, optamos por el control diario de la biopelícula y no se eliminó por la limpieza profesional, ya que el paciente no se quejaba del impacto estético. Se concluye que los pigmentos negros extrínsecos pueden observarse fácilmente en los niños, y aunque haya un efecto estético, no hace daños al mantenimiento de la salud bucal. Cabe señalar que no está claro cómo su presencia en la superficie del diente reduce susceptibilidad a la caries. Además, la elección del tratamiento siempre se debe basar en el beneficio-riesgo para el paciente.

Resumo Introdução Critérios clínicos vêm sendo utilizados para determinação da presença de tecido cariado remanescente, mas geram dúvidas, tornando-se relevante a utilização de métodos que auxiliem na determinação da presença de cárie dentária remanescente. Objetivo Avaliar in vitro a eficácia de métodos de indução de fluorescência no diagnóstico da remoção de tecido cariado artificial dentinário. Material e método O esmalte oclusal de 94 terceiros molares humanos hígidos foi removido, expondo a dentina subjacente, para indução microbiológica de lesão de cárie artificial. Após a remoção do tecido cariado induzido, o remanescente dentinário foi avaliado por dois examinadores com DIAGNOdent, DIAGNOdent pen e Quantitative Light-Induced Fluorescence (QLF). Após todas as avaliações, secções dos dentes foram observadas e fotografadas em lupa estereoscópica com 30× de aumento por um examinador independente. As imagens foram analisadas no software Image J, permitindo a quantificação de tecido remanescente em milímetros quadrados. Foi calculada a reprodutibilidade interexaminador através de coeficiente intraclasse, sensibilidade, especificidade e área sob a curva ROC, e o teste de McNemar (p<0,05) foi aplicado para comparação dos diferentes métodos. Resultado Dos 94 dentes, 51 (54,2%) apresentaram remanescente de tecido cariado. Os valores de sensibilidade, especificidade e área sobre a curva ROC foram semelhantes para os três grupos (p>0,05). Os valores de reprodutibilidade variaram entre 0,952 e 0,978. Conclusão Dentre os métodos utilizados, o DIAGNOdent e o DIAGNOdent pen apresentaram melhor desempenho na avaliação da presença de cárie artificial remanescente quando comparados ao QLF.

Abstract Introduction Clinical criteria have been used for the determination of the presence of residual caries, however in a subjective manner. Then the use of auxiliary methods that assist in determination of the remaining presence of caries can be considered for this purpose. Objective Evaluate the in “in vitro” efficacy fluorescence induction methods in the diagnosis of removing artificial dentinal caries. Material and method Ninety-four thirds sound human molars without occlusal enamel were used for microbiological artificial caries lesion induction. The decayed tissue was removed and the remaining dentin evaluated by two examiners with DIAGNOdent, DIAGNOdent pen and Quantitative Light-Induced Fluorescence - QLF. After all assessments, sections of the specimens were observed and photographed in stereoscopic lens with 30× increase by an independent examiner. These images were analyzed with Image J software, allowing quantitation of remaining caries tissue in mm2. The inter-examiner reliability, sensitivity, specificity, and area under the ROC curve was calculated and the McNemar test (p<0.05) was used to compare the different among methods. Result Of the 94 teeth, 51 (54.2%) had residual caries. The sensitivity, specificity, and area under the ROC curve were similar for the three methods (p>0.05). The inter-examiner agreement ranged between 0.952 and 0.978. Conclusion Among the methods used, the DIAGNOdent, DIAGNOdent pen showed better performance in residual caries detection after dentin caries removal when compared to QLF.

A atividade sexual na adolescência pode levar a uma gravidez indesejável que por sua vez pode trazer sérias complicações maternais e fetais. O presente estudo teve por objetivo avaliar as complicações relacionadas à gravidez na adolescência, por meio de uma revisão sistemática, utilizando como descritores do Medical Subject Headings: “pregnancy complication” AND “adolescent”OR “pregnancy in adolescence”. Foram considerados os artigos originais completos em inglês ou português, na íntegra, que apresentassem descrição clara da metodologia. Não foram incluídos estudos qualitativos, revisões ou metanálises, editoriais, série de casos e relatos de caso. A amostra foi constituída por 15 publicações, sendo 10 com delineamento transversal e 5 com delineamento coorte. A prevalência geral de gestação na adolescência foi de 10% e, entre os trabalhos nacionais, de 26%. A prevalência de parto cesárea foi menor que a descrita na população geral. As principais complicações maternas e neonatais de mães adolescentes foram doença hipertensiva específica da gestação, prematuridade e baixo peso ao nascer respectivamente. A gestação na adolescência se relacionou a maior frequência de complicações neonatais e maternas e à menor prevalência de parto cesariana.

Sexual activity during adolescence can lead to unwanted pregnancy, which in turn can result in serious maternal and fetal complications. The present study aimed to evaluate the complications related to adolescent pregnancy, through a systematic review using the Medical Subject Headings: “pregnancy complication” AND “adolescent” OR “pregnancy in adolescence”. Only full original articles in English or Portuguese with a clearly described methodology, were included. No qualitative studies, reviews or meta-analyses, editorials, case series, or case reports were included. The sample consisted of 15 articles; in that 10 were cross-sectional and 5 were cohort studies. The overall prevalence of adolescent pregnancy was 10%, and among the Brazilian studies, the adolescent pregnancy rate was 26%. The cesarean delivery rate was lower than that reported in the general population. The main maternal and neonatal complications were hypertensive disorders of pregnancy, prematurity and low birth weight, respectively. Adolescent pregnancy is related to increased frequency of neonatal and maternal complications and lower prevalence of cesarean delivery.

Introdução Os cimentos de ionômero de vidro (CIV) são materiais com baixa resistência à tração e ao cisalhamento, mostrando-se, portanto, contraindicados para áreas sujeitas às grandes cargas oclusais. Objetivo Avaliar o efeito da incorporação de nanotubos de carbono em CIV por meio de dureza superficial Knoop. Material e método Foram confeccionados 48 espécimes, divididos em quatro grupos, de acordo com o tipo de CIV (n=12) – convencional ou de alta viscosidade, incorporados ou não de nanotubos de carbono (NC) a 2%: (A) Vidrion R; (B) Vidrion R + NC 2%; (C) Vitro Molar, e (D) Vitro Molar + NC 2%. Os espécimes foram preparados utilizando-se seringa Centrix, para inserção do material em moldes plásticos, e armazenados em água deionizada por 24 horas. Após polimento, realizou-se o teste de dureza superficial com penetrador do tipo Knoop. Foram realizadas cinco endentações em cada espécime, distanciadas entre si em 100 µm. Resultado Os valores médios de dureza foram 58,96 ± 8,29 (A), 34,81 ± 5,78 (B), 60,84 ± 4,91 (C) e 41,97 ± 5,45 (D). O teste ANOVA detectou diferenças estatisticamente significantes para os dois parâmetros estudados, tipo de material (p=0,016) e inclusão de NC (p<0,0001). Pelo teste de Tukey, observou-se que os grupos A e C foram estatisticamente semelhantes (p>0,05), enquanto os grupos B e D apresentaram diferenças significativas (p<0,05). Ao comparar o fator incorporação ou não de NC, observou-se diferença significativa entre os grupos A e B, e entre os grupos C e D (p<0,05). Conclusão A incorporação de nanotubos de carbono influenciou negativamente os valores de dureza superficial para os dois tipos de CIV utilizados.

Introduction Glass ionomer cements (GIC) are materials with low tensile and shear bond strength and therefore contraindicated in areas subjected to high occlusal stress loads. Aim To evaluate the effect of incorporation of carbon nanotubes in GICs, conventional or indicated for the Atraumatic Restorative Treatment (ART), through the superficial microhardness test. Material and method Forty-eight specimens were prepared and divided into 4 groups according to the type of GIC (n=12): conventional or high viscosity, embedded or not with 2% carbon nanotubes (CN): (A) Vidrion R, (B) Vidrion R + 2% CN, (C) Vitro Molar and (D) Vitro Molar + 2% CN. The specimens were inserted into plastic molds with Centrix syringe and stored in deionized water for 24 hours. After polishing, the superficial hardness was performed with a Knoop indenter. Five indentations were made on each specimen, with distance of 100 micrometers between indentations. Result The average hardness values were 58.96 ± 8.29 (A) 34.81 ± 5.78 (B) 4.91 ± 60.84 (C) 41.97 ± 5.45 (D). ANOVA detected significant difference for the two varibales, material (p=0,016) and CN inclusion (p<0,0001). Tukey test revealed that the groups A and C were statistically similar (p>0.05), while the B and D groups showed significant differences (p<0.05). When comparing the incorporation or not of factor CN, there was significant difference between groups A and B and between C and D groups (p<0.05). Conclusion The incorporation of CNTs negatively influenced the values of surface hardness for the two types of GIC used.