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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 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.

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 e...

Background and Overview Molar-incisor hypomineralization (MIH) is a qualitative developmental defect of enamel, which has been a daily concern in clinical practice owing to its difficult treatment. Case Description An 11-year-old girl was admitted to the pediatric dental clinic with a symptom of severe hypersensitivity in the permanent molars owing to MIH. The treatment consisted of a simplified occlusal replica adapted technique with conventional glass ionomer cement in the MIH-affected molars, which involved laboratory and clinical stages. The patient was reexamined every 3 months, and after 18 months there was no additional tooth structure loss, restoration failure, or pain. This technique may be considered a feasible alternative to restore hypomineralized teeth owing to its reduced procedure time and good performance in the follow-up period of 18 months. Conclusions and Practical Implications The technique successfully restored the function and shape of the affected teeth, decreasing the sensitivity by means of covering the demarcated MIH opacities.

This study evaluated the viability, proliferation, and protein expression after photobiomodulation (PBM) of stem cell from human exfoliated deciduous teeth (SHED). The groups were the following: G1 (2.5 J/cm2), G2 (3.7 J/cm2), and control (not irradiated). According to the groups, cells were irradiated with InGaAlP diode laser at 660 nm wavelength, continuous mode, and single time application. After 6 h, 12 h, and 24 h from irradiation, the cell viability and proliferation, and the protein expression were analyzed by MTT, crystal violet, and ELISA multiplex assay, respectively. Twenty-four hours after PBM, SHED showed better proliferation. Over time in the supernatant, all groups had an increase at the levels of VEGF-C, VEGF-A, and PLGF. In the lysate, the control and G2 exhibited a decrease of the VEGF-A, PECAM-1, and PLGF expression, while control and G3 decreased VEGF-C, VEGF-A, and PDGF expression. The dosimetries of 2.5 J/cm2 and 3.7 J/cm2 maintained viability, improved proliferation, and synthesis of the angiogenic proteins in the supernatant in the studied periods on SHED.

Objectives The aim of this ecological study was to analyze the relationship of social restriction measures and people's interest in searching toothache‐related information on the Internet. Materials and Methods The following indicators Stringency Index (SI), Years Lived with Disability (YLDs) for untreated caries in permanent teeth, Google market share, Internet penetration, and relative search volume (RSV) for the Topic "Toothache" in Google Trends were determined for 21 countries with available data, from April 2018 to May 2020. Statistical analysis was performed using Mann–Whitney U test, t‐Student test, Pearson's Chi‐square test, and Spearman and Pearson's cross‐correlation tests (α = 0.05). Results Relative search volume values increased significantly after restriction measures in all countries, except for Japan. Higher RSV values were found among 11 countries that presented a cross‐correlation between RSV and SI with r≥│0.6│. The most common queries were linked to the treatment and self‐resolution of toothache, with a sudden increase of searches that combined the symptom with COVID‐19. Conclusions The interests in toothache‐related digital information were associated with social restriction measures. These results allow the identification of dental demands of distinct populations, contributing to the planning of specific public health policies during and after the pandemic period.

Statement of problem Patients with cleft lip and palate generally present with lateral incisor agenesis, which may be treated with an implant-supported prosthesis. However, whether implants can stabilize the dental arches in patients with cleft lip and palate is unclear. Purpose The purpose of this retrospective clinical study was to analyze the stability of the maxillary dental arch after orthodontic treatment and oral rehabilitation in the cleft area with an implant-supported prosthesis or a fixed partial denture. Material and methods Fifty-five participants, 20 with unilateral cleft lip and palate rehabilitated with implants (CLPI), 15 with unilateral cleft lip and palate rehabilitated with fixed partial dentures (CLPFP), and 20 in the noncleft group (NCLP) and their gypsum casts (N=110) were digitized and evaluated through 3D stereophotogrammetry. Measurements were made on casts obtained immediately after the orthodontic treatment (T1); for the cleft lip and palate group, casts were made 1 year after implant-supported restoration placement (T2), and for the noncleft group, 1 year after the conclusion of the orthodontic treatment (T2). The dimensions of the dental arches were measured digitally. Formula Δ=T2-T1 evaluated the stability of dental arches for intercanine distances, intermolar distances, arch length, palate surface, and volume (3D). Stability (Δ) was compared through 1-way ANOVA in all groups (α=.05). Results A statistically significant difference was found in the stability of the CLPI and CLPFP groups for intercanine measurement (P=.002). For the intermolar measurement, a statistically significant difference was detected between the CLPFP and NCLP groups (P=.002). From the 3D measurements, the stability was similar in all groups. Conclusions In patients with clefts, a fixed partial denture may provide better stability of the orthodontic outcomes than an implant-supported prosthesis. However, greater instability occurred at the molar area.

Objectives: this study systematically reviewed the literature in order to better understand the association among COVID-19, pregnancy and neonates. Methods: MEDLINE, EMBASE, Web of Science, BVS and SCOPUS were assessed, considering the terms: (covid 19 OR covid-19 OR novel coronavirus OR 2019 novel coronavirus OR 2019-nCoV OR sarscov 2 OR sars-cov-2 OR sarscov2 OR sars cov-2) AND (pregnancy OR pregnant OR pregnant women OR gestation OR gestational) AND (infant OR fetal OR neonatal). Thirty full-text were included (408 pregnant women, 11 non-pregnant women and 279 neonates). Results: fever (45.83%) and cough (31.61%) were the main symptoms of COVID-19 during the pregnancy. Low levels of lymphocytes (32.10%), elevated levels of C-reactive protein (32.35%); leukocytosis (29.41%); neutrophil (5.88%); and radiographic alterations on chest CT, x-ray or ultrasound (45.84%) were the main laboratorial findings. Cesarean delivery and preterm were registered in 239 and 49 cases, respectively. Ten neonates tested positive for SARS-CoV-2. Conclusion: when COVID-19 pneumonia affects women during pregnancy, the symptoms are similar to those experienced by non-pregnant women. In addition, there is still no plausible evidence suggesting vertical transmission of SARS-CoV-2 virus from mother to child. Resumo Objetivos: este estudo revisou sistematicamente a literatura para melhor compreender a associação entre COVID-19, gravidez e neonatos. Métodos: MEDLINE, EMBASE, Web of Science, BVS e SCOPUS foram acessadas, considerando os termos: (covid 19 OR covid-19 OR novel coronavirus OR 2019 novel coronavirus OR 2019-nCoV OR sarscov 2 OR sars-cov-2 OR sarscov2 OR sars cov-2) AND (pregnancy OR pregnant OR pregnant women OR gestation OR gestational) AND (infant OR fetal OR neonatal). Trinta textos completos foram incluídos (408 gestantes, 11 mulheres nãogestantes e 279 recém-nascidos). Resultados: febre (45,83%) e tosse (31,61%) foram os principais sintomas da COVID-19 durante a gestação. Baixos níveis de linfócitos (32,10%), elevados níveis de proteínas Creativa (32,35%); leucocitose (29,41%); neutrófilo (5,88%); e alterações radiográficas sob tomografia computadorizada de tórax, radiografia ou ultrasom (45,84%) foram os principais achados laboratoriais. Parto por cesárea e prematuridade foram registrados em 239 e 49 casos, respectivamente. Dez recém-nascidos testaram positivo para o virus SARS-CoV-2. Conclusão: quando a pneumonia COVID-19 afeta mulheres durante a gravidez, os sintomas são semelhantes aos experimentados por mulheres não grávidas. Além disso, ainda não há evidências plausíveis que sugiram a transmissão vertical do vírus SARS-CoV-2 de mãe para filho.

This study aimed to evaluate longitudinally the volume of the dental arches in children with unilateral cleft lip and palate before and after the rehabilitative plastic surgeries. This is a longitudinal retrospective study was composed by 102 digitized dental casts of children with unilateral complete cleft lip (G1) and cleft lip and palate (G2). The palate volume was evaluated at 3 periods: preoperative (T1), postoperative 1 (T2), and postoperative 2 (T3). The intra- and inter-examiner reliability was analyzed by Wilcoxon test/Dahlberg formula and interclass correlation coefficient, respectively. The intragroup comparison was analyzed by Wilcoxon test and Friedman test followed by post-hoc Dunn test. Mann-Whitney test was applied for the intergroup comparison (α = 5%). G1 had a significant growth at T2 (P = 0.031). G2 demonstrated a positive development at T2, but decreased at T3 (P = 0.003). The intergroup analysis revealed that G2 showed a greater volume at T1 and T2 (P

This study aimed to evaluate longitudinally the alteration of the dental arch dimensions of children with different oral cleft types, before and after the primary surgeries. Three-dimensional images of the maxillary dental casts of children with unilateral complete cleft lip (G1), unilateral complete cleft lip and palate (G2), and cleft palate (G3). The children were evaluated at pre-cheiloplasty (T1), pre-palatoplasty (T2), and 1 year after palatoplasty (T3). The measurements obtained: intercanine (C-C') and intertuberosity (T-T') distances, anterior (I-CC') and total (I-TT') arch lengths. To analyze the intraexaminer error, paired t-test was applied and Dahlbergh formula. The intragroups comparisons were applied: paired t-test, ANOVA followed by Tukey, Wilcoxon test, and Kruskal-Wallis test followed by Dunn test. The intergroup comparisons were performed by independent t-test and Mann-Whitney test. In G1, the C-C', T-T', and the I-TT' distances revealed a significant increase of the maxilla. In G2, the C-C' distance statistically decreased from T1 to T3, T-T' distance showed statistical increase from T1 to T3. The I-TT' length increased with statistically significant differences between T1 and T3, T2 and T3. In G3, the C-C', T-T', and I-TT' distance increased was statistically significant. The longitudinal evaluation of the changes occurred in the dental arches with different oral cleft types showed that cheiloplasty and palatoplasty caused the most alterations in the development of the maxillary dimensions of children with complete cleft lip and palate.

The adolescent with oral cleft must deal with the process of body changing and the psychological implications caused by morphological, functional, and esthetic impairments of the cleft itself. This study aimed to evaluate whether the cleft lip and palate types affects health-related quality of life of adolescents through Short-form Health Survey (SF-36) questionnaire. Fifty-seven adolescents (29 males and 28 females; mean age 15 years and 11 months ± 1 year and 2 months) were divided into 2 groups: Group 1-single cleft-unilateral or bilateral CL or CP; Group 2-complex cleft-unilateral or bilateral cleft lip and palate. The participants filled in SF-36 questionnaire to verify their functional, physical, and mental well-being profile. Spearman test assessed SF-36 scores correlation with age. Mann-Whitney U test verified the differences between genders and cleft types. Linear regression models were used to analyze confounding factors (age and gender). P was set at0.05. The different SF-36 domains weakly correlated with age, ranging from -0.07 (P = 0.60) for the social aspects and 0.31 (P = 0.02) for general health. Females had statistically lower SF-36 scores than males in the domains Bodily pain (P = 0.02), Vitality (P 0.001), and Mental Health (P 0.001). G1 showed lower scores in the domains Limitations due to Emotional Problems (P = 0.008) and Mental Health (P = 0.036). However, when the confounding factors (age and gender) were analyzed, the oral cleft type did not affect health-related quality of life (P 0.05). Considering the age and gender, the cleft lip and palate types did not affect the health-related quality of life of adolescents.

Background: Chlorhexidine digluconate (CHX) is commonly applied as positive control of new antimicrobials, because it is considered the gold-standard for chemical plaque control. The aim of this study was to compare the effect of treatments with curcumin-mediated aPDT and CHX in relation to the viability of specific microorganism groups in two distinct times (immediately and 24 h later). Methods: Dentin caries microcosms were grown on bovine dentin discs (37 °C, anaerobiosis) for 3 days in the Active Attachment Amsterdam Biofilm Model. The biofilms were treated with 300 μM curcumin and 75 J.cm−² LED, or 0.06% and 0.12% CHX. Then, total microorganisms, total streptococci, mutans streptococci, and total lactobacilli counts were determined. The statistical analysis was conducted by Kruskal-Wallis and post-hoc Dunn's tests (P Results: Curcumin-mediated aPDT (C + L+), 0.06% and 0.12% CHX reduced mutans streptococci counts (0.19, 0.10 and 0.07 log10 respectively) in the immediate analysis. After 24 h, it was observed a re-growth of microorganisms treated by curcumin-mediated aPDT, whereas both CHX concentrations demonstrated a decrease of the viable microorganisms. Conclusion: This study confirmed the substantive effect of CHX and the immediate effect of aPDT. The use of a neutralizer solution was important to block the substantivity of CHX and permit its fair comparison with aPDT, allowing its use as a positive control in further studies.

Aim This study aimed to clarify whether dental plaque disclosing before professional prophylaxis would improve the visualization of dental plaque, therefore optimizing the procedure. Materials and methods The sample comprised both the smooth and occlusal surfaces of the teeth of 25 children from 18 to 36 months. A randomized crossover clinical trial was conducted with two groups: GI-with disclosing and GII-without disclosing (washout/1 month). The teeth were stained with 1% malachite green solution to assess the amount of dental plaque on smooth and occlusal surfaces. Results Dental plaque removal was more effective and statistically faster (391.27 seconds ±142.2) in GI. The plaque index and the prophylaxis duration were inversely related in GI. The child's behavior did not affect the plaque removal effectiveness, regardless of plaque disclosure (p > 0.05). Conclusion Dental plaque disclosing in young children is an effective and less time-consuming method that improves the quality of the professional dental prophylaxis. Clinical significance Biofilm control is important for the success of programs for prevention of early childhood caries (ECC) and considering the particularities inherent to the dental care of infants, it is necessary that periodic professional prophylaxis is effective in eliminating the oral biofilm, ideally reducing chair time. Although dental plaque disclosing has been traditionally performed on educational basis during oral hygiene instruction, this resource can be safely employed to help professional prophylaxis in infants. How to cite this article de Alencar CRB, de Oliveira GC, et al. Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood. Int J Clin Pediatr Dent 2019;12(3):189-193.

Palm oil has demonstrated preventive potential against initial erosive demineralization in vitro. This in situ study evaluated the effect of palm oil alone or associated with stannous-containing (Sn) solution on preventing enamel loss from an erosive/abrasive challenge.This single-blind, randomized, crossover in situ/ex vivo study was developed in four phases (one per group of five days) with sixteen volunteers. Enamel blocks (n = 256) were allocated to groups according to the treatment: Palm oil; Palm oil plus Sn solution; Sn solution - positive control; and Deionized water - negative control. Half of the enamel blocks of each group was subjected to erosion and the other half to erosion + abrasion. The daily ex vivo protocol consisted of four citric acid immersions (2 min). Before the first and third acid exposure, the blocks were treated with the test solutions (1 drop/block) for 1 min followed by acid immersion and abrasive challenge (toothpaste was applied on all blocks and half were brushed for 15 s/block). Enamel loss was quantified profilometrically and data were analyzed by two-way ANOVA and Tukey's test (p 0.05).A significant difference was found for type of treatment (p 0.001); wear condition (p = 0.38) and the treatment x condition interaction (p = 0.33) was non-significant. Palm oil associated or not to Sn solution significantly reduced enamel wear in comparison with the negative control but did not differ from the positive control (p 0.05).Palm oil was able to prevent enamel loss under erosive and erosive + abrasive challenges in a similar extend to stannous-containing commercial solution.

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

Arch asymmetry in cleft patients is a current problem that interdisciplinary treatment aims to solve. This research proposed to analyze the final rehabilitation, according to the arch symmetry of these patients. Thirty-five patients aged between 18 and 30 years, rehabilitated with a fixed partial denture or implants in the cleft area. The analysis was performed using digitalized dental casts with a laser model scanner (R700TM; 3Shape A/S, Holmens Kanal 7, 1060, Copenhagen/Denmark), analyzed with a Vectra Analysis Module software program (VECTRA H1; Canfield Scientific, 4 Wood Hollow Road, Parsippany, NJ 07054). Three linear measurements were evaluated, incisal-canine, canine-molar, and incisal-molar distance. The Student t test was applied to test the significance (P = 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and significant symmetry at all maxillary distances. Finally, according to the cleft side in the maxillary dimensions, even though the majority of patients had clefts on the left side, only patients with a cleft on the right side showed symmetry in this area. Patients rehabilitated with implants in the cleft area showed a more symmetrical maxillary arch than those restored with fixed partial dentures.

This study evaluated the palatal surface area in children with different oral clefts after primary surgeries and at five years of age. This longitudinal study was composed by 216 digital models: unilateral complete cleft lip (UCL), unilateral complete cleft lip and palate (UCLP), and complete cleft palate (CP). The models were analysed at four time periods: T1 (before cheiloplasty), T2 (before palatoplasty), T3 (after palatoplasty); and T4 - (at five years of age). Area of the dental arches was measured through stereophotogrammetry software. Measurements evaluated with Student's test and ANOVA followed by the Tukey test (p0.05) (AQ 1). In the UCL group, the palatal surface area significantly increased among phases. In the primary surgery periods, UCLP and CP significantly decreased (p0.001). Palatal area in the UCLP group was significantly greater than the CP group. Overall, no statistically significant differences occurred among groups. At T4, the area of the palate in the UCL group was significantly greater than the UCLP group and no significant differences occurred between UCLP and CP groups. This study suggests that cheiloplasty did not inhibit the growth of the palatal surface area in children with UCL and UCLP. Palatoplasty significantly decreased the palatal area in children with UCLP and CP, demonstrating a significant negative effect of palatal repair on maxillary growth. At five years, children with UCLP and CP had a significantly smaller palate area than those with UCL.

IntroductionThe 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 analysisA 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 (pEthics and disseminationThe 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 numberRBR-9fsxnn.

The aim of this study was to develop and characterize a pulp capping multilayer membrane with chitosan, regarding physicochemical properties of radiopacity, pH, calcium release, and biological properties of cytocompatibility. Human pulp fibroblasts (HPF) exposed to membrane solutions were subjected to MTT assay for viability analysis. All developed and tested membranes showed alkaline pH, satisfactory calcium release, and radiopacity higher than 3 mm Al. The cytocompatibility assay demonstrated the highest scores of viability at 48 h, without statistical difference between groups overtime. Although these results were compatible with properties of adequate pulp capping materials, further in vivo and clinical studies are needed to determine the suitability of these membranes to be applied in human teeth.

Esta tese teve como objetivo verificar a resposta celular de fibroblastos pulpares após a variação nos parâmetros de fotobiomodulação. Fibroblastos pulpares de dentes decíduos humanos em 4a passagem foram plaqueados, deixados a aderir, submetidos a privação nutricional, e em seguida irradiados com laser de baixa intensidade a 660 nm. Os grupos em estudo foram baseados na variação da potência e tempo, resultando em dosimetrias diferentes, variando entre 2,5 a 6,2 J/cm2. No artigo 1, o efeito dos diferentes parâmetros da fotobiomodulação foram verificados por meio da expressão gênica do COL1 por RT-PCR, nos períodos de 6, 12 e 24 horas. No artigo 2, avaliou-se a síntese proteica de fatores angiogênicos (VEGF-A, VEGF-C, VEGF-D, VEGFR1, VEGFR2, FGF-2, PDGF, PLGF, PECAM-1, e BMP-9) por ELISA Multiplex, nos períodos de 6, 12 e 24 horas após fotobiomodulação, no sobrenadante e lisado celular. Os dados foram analisados por ANOVA a dois critérios seguido pelo teste de Tukey (p

Cohort studies have evaluated dental arches of children.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.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.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).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.

Background Although arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. Therefore, we compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft. Methods Forty participants, 20 with a complete unilateral cleft lip and palate and 20 non-cleft patients aged from 18 to 30 years, with anterior and/or posterior crossbite and receiving orthodontic treatment were evaluated retrospectively. Eighty gypsum casts were digitized using a laser model scanner casts for both groups made immediately after the orthodontic treatment was completed (T1). Also, for the Cleft Lip and Palate group, casts were obtained and digitized 1 year after implant-supported rehabilitation (T2) and for the Non-Cleft Lip and Palate group, 1 year after the conclusion of the orthodontic treatment (T2). The formula: Δ = T2-T1 evaluated the stability of dental arches for inter-canine distances (C-C′), inter-molar distances (M-M’), arch length (I-M), palate surface and volume. The dimensions of the dental arches were measured digitally. The independent t test was used for statistical analysis (α = 0.05). Results A statistical difference was found in the stability of the groups for inter-canine (cleft area) measurement. At the times T1 and T2, a statistically significant difference was found in the arch length, surface and volume. Conclusions This study concluded that in the Cleft Lip and Palate group, the maxillary dimensions were not stabilized after 1 year of orthodontic and prosthodontic treatment (mainly for the inter-canine linear measurement) and that the transverse arch dimensions were smaller compared with those of non-cleft patients.

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.

Highlights • 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 (blinded). The participants were randomly allocated into control and intervention groups (1:1), stratified by eHealth literacy scores (eHEALS) of parents and caries experience of children. Each 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-up, 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

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.

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.

Treatment for a patient with a dental anomaly pattern is challenging and complex. This article presents a rare case with an association of multiple ectopic eruptions treated in 2 phases. An 8-year-old boy in the early mixed dentition showed a Class II, Division 2 malocclusion, and an ectopic eruption of the mandibular right lateral incisor. The treatment plan included extractions of the deciduous mandibular right lateral incisor and canine, followed by partial mandibular fixed appliances and a lingual arch. In the late mixed dentition, the panoramic radiograph showed bilateral ectopic eruptions of the maxillary canines. The deciduous maxillary canines were extracted, and a cervical headgear was installed. Within 12 months, both permanent maxillary canines spontaneously erupted. Comprehensive orthodontic treatment was initiated when the patient was aged 13 years to level the curve of Spee and reduce the overbite. Phase 2 lasted 15 months. In patients with dental anomaly patterns, longitudinal follow-up during the mixed dentition is highly important and might contribute to simplifying comprehensive orthodontic treatment and reducing complications and adverse effects.

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

Avaliar a qualidade da assistencia em enfermagem por meio do nivel de satisfacao do usuario de um hospital terciario e publico do interior do estado de Sao Paulo, Brasil. Participaram da pesquisa, 16 pacientes que realizaram cirurgias na area de otorrinolaringologia e que tinham permanecido internados 48 horas ou mais na Unidade de Internacao no ano de 2016 em um hospital especializado do interior paulista. Os participantes responderam ao questionario Instrumento de Satisfacao do Paciente (ISP). Levando-se em consideracao a media total ponderada de todos os dominios estudados (3,9) e seu desvio padrao (0,7), os usuarios desse hospital terciario e publico possuem um bom nivel de satisfacao com a assistencia de enfermagem, pois o valor esta acima da media e o desvio padrao expressou que os dados nao estao dispersos. O paciente deste hospital terciario e publico possui um bom nivel de satisfacao com a assistencia de enfermagem prestada. Descritores: Satisfacao do Paciente, Cuidados de Enfermagem, Qualidade da Assistencia a Saude. Evaluation of nursing care in a specialized hospital Abstract : To evaluate the quality of nursing care quality through the level of user satisfaction of a tertiary and public hospital in the interior of Sao Paulo state, Brazil. The study included 16 patients who underwent otorhinolaryngology surgeries and who had been hospitalized for 48 hours or more at the Care Unit in 2016 at a specialized hospital in the interior of Sao Paulo. Participants answered the Patient Satisfaction Instrument (PSI) questionnaire. Considering the total weighted average of all domains studied (3.9) and their standard deviation (0.7), the users of this tertiary and public hospital had a good level of satisfaction with nursing care because the value is above average, and the standard deviation expressed that the data is not dispersed. The patient of this tertiary and public hospital has a good level of satisfaction with the nursing care provided. Descriptors: Patiente Satisfaction, Nursing Care, Quality of Health Care. Evaluacion de la atencion de enfermeria en un hospital especializado Resumen : Evaluar la calidad de la atencion de enfermeria a traves del nivel de satisfaccion del usuario de un hospital terciario y publico en el interior del estado de Sao Paulo, Brasil. El estudio incluyo a 16 pacientes que se sometieron a cirugia en el area de otorrinolaringologia y que habian sido hospitalizados durante 48 horas o mas en la unidad de pacientes hospitalizados en 2016 en un hospital especializado en el interior de Sao Paulo. Los participantes respondieron el cuestionario del Instrumento de Satisfaccion del Paciente (ISP). Considerando el promedio total ponderado de todos los dominios estudiados (3.9) y su desviacion estandar (0.7), los usuarios de este hospital terciario y publico tienen un buen nivel de satisfaccion con la atencion de enfermeria, ya que Este valor esta por encima del promedio y la desviacion estandar expreso que los datos no estan dispersos. El paciente de este hospital terciario y publico tiene un buen nivel de satisfaccion con la atencion de enfermeria brindada. Descriptores: Satisfaccion del Paciente, Atencion de Enfermeria, Calidad de la Atencion Medica.

This study aimed to evaluate the effects of photobiomodulation (PBM) on CD31 expression in pulp tissue repair of human primary teeth. Fifteen mandibular primary molars were divided into the following groups: GI—calcium hydroxide (CH), GII—PBM + CH, and GIII—PBM + zinc oxide/eugenol (ZOE). In the GII and GII groups, an indium–gallium–aluminum phosphide (InGaAlP) diode laser was used for the irradiation through 320-μm diameter optical fiber in contact with pulp tissue. The red laser diode parameters were set at 660-nm wavelength, 10-mW power output, 2.5-J/cm2 energy density, 50–60-Hz frequency, output beam area of 0.04 cm2, and irradiation time of 10 s in continuous mode. After pulpotomy treatment, clinical and radiographic follow-ups were accomplished until the teeth achieved regular exfoliation period. Teeth were extracted for histological analysis and immunolocalization of CD31. Histopathological statistical analyses were performed by Kruskal-Wallis followed by Dunn test to determine statistically significant differences (p

This retrospective observational study aimed to evaluate and identify the relapse rate after orthognathic surgery for maxillary advancement (Le Fort I maxillary osteotomy) in oral cleft patients through digitized cephalograms and 3D dental models, following 2 years. Lateral cephalograms and dental casts of 17 individuals, enrolled in Orthodontics Department in Hospital of Rehabilitation of Craniofacial Anomalies, were carried out. The digital cephalometric tracings were evaluated in: T1-before surgery, T2-immediate after surgery, T3-6-month to 1-year after surgery. The dental study casts were digitized and evaluated in: F1-before surgery; F2-3-month to 1-year after surgery; F3-1 to 2 years after surgery. The analyses of the dental arches were performed directly on the scanned images. A single examiner previously trained and calibrated performed all the assessments. Repeated measures ANOVA was applied to study the variables and compare the periods, followed by Tukey test to evaluate the statistically significant differences, with level of significance of 5%. The digital cephalogram results showed that the vertical movement statistically differed from T2 to T3 (p = 0.002). The right and left premolar relationship in digitized models revealed that at F2 the individuals exhibited ¼ Class II and Class I, in 29.4 and 23.5% of the cases, respectively; and at F3, Class I, 58.8 and 70.6% of the cases, respectively. The cephalometry showed the relapse in the vertical movement after orthognathic surgery for maxillary advancement, but no relapse in the other evaluated parameters.

The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue. Resumo O objetivo deste estudo foi avaliar os resultados clínicos, radiográficos e histológicos do complexo dentino-pulpar de molares decíduos após pulpotomia com agregado trióxido mineral (MTA) e sulfato férrico (SF) 15,5%. Trinta e um molares decíduos foram alocados aleatoriamente nos grupos MTA ou SF. As avaliações clínicas e radiográficas foram realizadas aos 3, 6, 12 e 18 meses de acompanhamento. Os dentes no período regular de esfoliação foram extraídos e processados para análise histológica. Os dados clínicos e radiográficos foram analisados estatisticamente (p≤0,01). O resultados histológicos foram analisados descritivamente. Todos os dentes tratados apresentaram sucesso clínico ao longo dos períodos experimentais. Ambos os grupos exibiram 100% de sucesso radiográfico aos 3, 6 e 12 meses. Aos 18 meses de acompanhamento, um dente do grupo SF apresentou radiolucidez interradicular (p>0,01). Histologicamente, os dentes tratados apresentaram vitalidade pulpar e ausência de infiltrado inflamatório no tecido conjuntivo. Somente o grupo MTA mostrou barreira de tecido duro rodeada por odontoblastos sobre os cotos pulpares. MTA e SF 15,5% são eficazes para pulpotomias de dentes decíduos. Embora o MTA seja considerado o material de primeira escolha, o SF pode ser uma alternativa adequada quando o custo do tratamento é um problema.

The aim of this study was to test the hypothesis that duplication/hybridization of functional domains of naturally occurring pellicle peptides amplified the inhibitory effect of hydroxyapatite crystal growth, which is related to enamel remineralization and dental calculus formation. Histatin 3, statherin, their functional domains (RR14 and DR9), and engineered peptides (DR9-DR9 and DR9-RR14) were tested at seven different concentrations to evaluate the effect on hydroxyapatite crystal growth inhibition. A microplate colorimetric assay was used to quantify hydroxyapatite crystal growth. The half-maximal inhibitory concentration (IC50) was determined for each group. ANOVA and Student-Newman-Keuls pairwise comparisons were used to compare the groups. DR9-DR9 increased the inhibitory effect of hydroxyapatite crystal growth compared to single DR9 (p

The selective caries removal is increasingly spreading in daily clinical practice because this minimally invasive technique treats deep carious lesion and decreases the risk of pulp exposure. This case report was aimed at describing the selective removal to firm dentin on the primary mandibular left first molar of a girl aged 7 years and 6 months. The Mineral Trioxide Aggregate (MTA Angelus™) was used as liner, and the tooth was definitively restored with resin-modified glass ionomer cement (Vitremer™). The clinical and radiographic following-up was performed at 6, 12, and 18 months after treatment. The treatment showed satisfactory results after 18-month following-up, suggesting that this minimally invasive approach for carious lesion removal can replace the total removal, when properly indicated. Notwithstanding, further randomized clinical trials with longer following-up periods are still necessary.

Mangrove environments are important for maintaining biodiversity and carbon cycling. However, these systems are being degraded at alarming rates around the world, particularly in rapidly developing regions. Here, we examine a sediment profile from a mangrove forest near a large port complex at Suape, northeast Brazil, in order to assess the impact of rapid urbanization and industrialization. We find that total organic carbon (TOC) and total nitrogen (TN) accumulation rates have increased in the estuary since the 1980's, directly related to rapid urban development. The TN and heavy δ15N values in the sediment column suggest increasing anthropogenic influences. In contrast, heavy metal fluxes did not increase during these transitions. The increase in TOC and TN accumulation rates during the past four decades highlight the significant role mangrove areas play as sinks for anthropogenically enhanced nutrients in poorly-understood tropical areas.

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 2 nd and 6 th 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. Keywords Cell culture techniques; Tooth, deciduous; Pulp; Fibroblasts; Cryopreservation.

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 72 hours). 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.

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth’s exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

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

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

BACKGROUND Molar incisor hypomineralization (MIH) is a developmental enamel defect characterized by well-demarcated discolorations frequently detected in molars, causing pain and esthetic alterations. AIM To assess the interests of Google users on MIH-related information. DESIGN Digital data were collected in Google Trends through two search strategies, 'molar incisor hypomineralization' (topic) and 'MIH' (search term), between January 2004 and November 2018. ARIMA models were applied to analyze trends of curves and to predict the activity of Google users during 12 months. Autocorrelation and partial autocorrelation (ACF/PACF) plots were used to detect trends in the variation of relative search volume (RSV) related to search strategies over time. The most popular queries were analyzed qualitatively, whereas geographical heat maps were retrieved to determine search volumes according to countries (P

Cleft lip, alveolus and palate is a congenital malformation caused by the lack of fusion of the lip and palate embryonic processes, which may disrupt the main functions of the stomatognathic system. Aim: This study aimed to assess the orofacial dysfunction in individuals with cleft lip, alveolus, and palate compared to non-cleft patients. One hundred and twenty individuals between 32 and 65 years of age were selected in the Craniofacial Center and in the School of Dentistry and divided into two groups: non-cleft patients (N-CLAP) and cleft lip, alveolus, and palate patients (CLAP). The two groups were matched by gender. Each individual was interviewed and submitted to a clinical evaluation during which the NOT-S was used to assess orofacial dysfunction. To verify the intra-examiner agreement, the values were compared using the Kappa test. The Mann-Whitney test compared performance on the NOT-S between the groups. The Chi-Square test compared the NOT-S domains between the groups. A comparison of the NOT-S scores between the groups revealed statistically significant differences in gender (p