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The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.

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This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

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Abstract The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.

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ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

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Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

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Objetivo: Relatar dois casos clínicos de alteração de frênulo lingual em gemelares, com 10 anos de idade, ambas do sexo feminino, avaliadas nos aspectos anatômicos e funcionais da língua antes e 15 dias após a frenectomia. Relato de casos: Inicialmente, o odontopediatra realizou a anamnese com a mãe. Em seguida, as participantes foram submetidas à avaliação clínica odontológica e, posteriormente, foi realizada a avaliação fonoaudiológica do frênulo lingual. A avaliação fonoaudiológica foi realizada por meio do Protocolo de Avaliação do Frênulo da Língua, que foi aplicado antes e 15 dias após a frenectomia. As duas participantes apresentaram melhor desempenho em provas anatômicas após o procedimento cirúrgico. Entretanto, algumas alterações, principalmente ao elevar a língua, continuaram sendo observadas em uma das pacientes 15 dias após a frenectomia. Ademais, as duas participantes passaram a executar a maioria dos movimentos de língua com maior precisão. No que se refere à fala, somente a participante que apresentava um maior número de alterações fonéticas anteriores, permaneceu com algumas alterações na fala decorridos 15 dias da cirurgia. Discussão: Algumas dificuldades envolvendo mobilidade da língua e alterações na fala podem persistir após a realização da cirurgia, indicando a necessidade de intervenção fonoaudiológica específica. Conclusão: Ambos os casos apresentaram melhora no desempenho tanto nas provas anatômicas quanto funcionais após a frenectomia.

Aim: to report two clinical cases of alteration of the lingual frenulum in twins, aged 10 years, both female, evaluated in the anatomical and functional aspects of the tongue before and 15 days after the frenectomy. Case reports: Initially, the paediatric dentistry performed the anamnesis with the mother. Then, the participants were submitted to a dental clinical evaluation and, sub-sequently, the speech language pathologist evaluation of the lingual frenulum was performed. The speech language pathologist assessment was performed using the Tongue Frenulum Evaluation Protocol, which was applied before and 15 days after the frenectomy. Both participants performed better in anatomical tests after the surgical procedure. However, some changes, especially when elevating the tongue, continued to be observed in one of the patients 15 days after the frenectomy. In addition, the two participants started to perform most of the tongue movements with greater precision. About speech, only the participant who had a greater number of previous phonetic changes, remained with some speech disorders after 15 days of surgery. Discussion: Some di-fficulties involving mobility of the tongue and changes in speech may persist after surgery, indicating the need for specific speech therapy intervention. Conclusion:Both cases showed improvement in performance both in anatomical and functional tests after frenectomy

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Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

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Abstract Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

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Abstract Objective: To analyze the association between Early Childhood Caries (ECC) and mother´s knowledge, attitudes, and practices (KAP). Material and Methods: This cross-sectional study included a random sample of 163 preschool children aged 3-4 old in southern Brazil. The severity of dental caries and ECC was assessed by ICDAS criteria, while mothers completed the semi-structured questionnaire (KAP-ECC). Maternal behavior characteristics and answered questions about socioeconomic and demographic variables. Logistic regression was performed to evaluate the association of exploratory variables with ECC. For this approach, we calculated the odds ratio (OR) and 95% confidence intervals (95% IC). Results: Dental examinations revealed that 91.4% of children presented ECC (ICDAS = 3, 4, 5 or 6). Among those children, 31.9% presented cavities (ICDAS ≥ 3). Family income was significantly associated with the presence of ECC (OR 2.17; 95% CI: 1.41-3.36). Regarding KAP-ECC, mothers have knowledge related to ECC etiology, reported dental hygiene attitudes and practices that can prevent ECC but reported less healthy attitudes and practices regarding child's diet, specifically with respect to bottle and breastfeeding habits (OR 0.52; 95% CI: 0.33-0.81). Conclusion: ECC was more frequent in children from low-income families and whose mothers reported the belief that milk with chocolate does not contribute to caries and that disagreed that it is normal that a 2-year-old baby wakes up during the night to suckle. That is, good knowledge toward health habits may impact on lower occurrence of ECC; however, this condition also depends on the socioeconomic level.

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Abstract Objective: To evaluate the impact of early childhood caries, maternal behaviors and associated factors on the oral health-related quality of life (OHRQoL) of preschool children. Material and Methods: This cross-sectional study was conducted with 163 preschool children aged 3-4 old from Porto Alegre, Southern Brazil. Mothers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions about sociodemographic and maternal behaviors characteristics. The severity of dental caries was assessed by ICDAS criteria for evaluated early childhood caries (ECC). A Poisson regression model was used to investigate the association of ECC and associated factors on OHRQoL. Results: A total of 91.4% of preschooler children was ECC (ICDAS ≥ 1). Mean ECOHIS function domain and parental anxiety domain scores were significantly higher in children with dental caries (p<0.05). The adjusted Poisson regression model showed that household income, maternal education, mother's job status and breastfeeding time was significantly associated with ECOHIS scores. Regarding oral conditions, child caries experience was associated with worsening child and family quality of life (RR 2.21; 95% IC: 1.43-3.41). Conclusion: Our findings suggest that ECC, socioeconomic and maternal behaviors characteristics influence children's OHRQoL.

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