RESUMO
PURPOSE: This study investigated whether the report of mothers about the amount of dentifrice applied on a toothbrush could be a reliable method to estimate the inadvertent use of dentifrices. METHODS: A cross-sectional study was conducted in a randomly selected sample of 334 mothers of children enrolled in public day care centres of a city in the Brazilian northeast. Initially, the mothers chose the figure corresponding to the amount of dentifrice used during their children's daily toothbrushing. Then, they simulated real-life conditions with the toothbrush routinely used to brush the children's teeth. The amount of dentifrice on toothbrush was weighted using an analytical scale. Data were analysed by the Kruskal-Wallis followed by the Dunn test (α = 0.05). RESULTS: The weight of dentifrice on the toothbrush was high (> 0.3 g), mainly considering the categories 'covered only' and 'completely covered' that showed no statistical difference (p > 0.05). The proportion of agreement between the mothers' reports and the weight of dentifrice on the toothbrush was 0.23 (CI 0.18-0.28). CONCLUSION: The mothers' report regarding the amount of dentifrice on the toothbrush by demonstrative figures was not a reliable method to estimate the inadvertent ingestion of fluoride from dentifrices.
Assuntos
Dentifrícios , Brasil , Cariostáticos , Criança , Estudos Transversais , Feminino , Fluoretos , Humanos , Escovação DentáriaRESUMO
BACKGROUND: Neuromuscular impairment makes individuals with cerebral palsy (CP) more prone to drooling. Among the treatment options, there are procedures that interfere with saliva production. It is imperative to evaluate the effect of the different modalities since the reduction in salivary flow rate/production may exacerbate the risk of dental caries. MATERIAL AND METHODS: The aim of this study was to compare the effects of different treatments for drooling on caries risk and salivary parameters in children and adolescents with CP. STUDY DESIGN: A total of 142 children and adolescents with CP, aged 6 to 18 years, were assigned to groups based on the different treatments they had received for drooling: G1-anticholinergic drugs (n = 18), G2-botulinum toxin injection (n = 16), G3-salivary glands surgery (n = 16), G4-no treatment (n = 42), and G5-non-drooling subjects (n = 50). All participants were evaluated on the Simplified Oral Hygiene Index, and for the prevalence of dental caries (decayed, missing, and filled teeth index and white spot lesions). Unstimulated whole saliva was collected, and salivary flow rate and osmolality were measured. Chi-square, ANOVA and Poisson regression were calculated. Prevalence ratios and their respective 95 % confidence intervals were obtained. The significance level was fixed at 5%. RESULTS: No differences were found in the decayed, missing, and filled teeth index (p = 0.128) and Simplified Oral Hygiene Index (p = 0.674) among the different groups. G3 presented significantly higher percentages of WSL (p < 0.001), lower values of salivary flow rate (p < 0.001), and higher values of osmolality (p < 0.001). The white spot lesion prevalence ratio was higher only for G3 (Prevalence ratio = 14.36; IC 95% = 4.64-44.40; p < 0.001). CONCLUSIONS: Children and adolescents with CP who had received surgical treatment for drooling exhibited higher number of white spot lesions because of the reduced salivary flow rate and higher salivary osmolality.
Assuntos
Paralisia Cerebral/complicações , Cárie Dentária/epidemiologia , Sialorreia/complicações , Sialorreia/terapia , Adolescente , Toxinas Botulínicas/uso terapêutico , Brasil , Criança , Antagonistas Colinérgicos/uso terapêutico , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Higiene Bucal , Concentração Osmolar , Prevalência , Análise de Regressão , Saliva , Glândulas Salivares/cirurgia , Sialorreia/cirurgiaRESUMO
The aim of this study was to evaluate the performance of a pen-type laser fluorescence (LF) device (LFpen: DIAGNOdent pen) to detect and monitor the progression of caries-like lesions on smooth surfaces. Fifty-two bovine enamel blocks were submitted to three different demineralisation cycles for caries-like lesion induction using Streptococcus mutans, Lactobacillus casei and Actinomyces naeslundii. At baseline and after each cycle, the enamel blocks were analysed under Knoop surface micro-hardness (SMH) and an LFpen. One enamel block after each cycle was randomly chosen for Raman spectroscopy analysis. Cross-sectional micro-hardness (CSMH) was performed at different depths (20, 40, 60, 80 and 100 µm) in 26 enamel blocks after the second cycle and 26 enamel blocks after the third cycle. Average values of SMH (± standard deviation (SD)) were 319.3 (± 21.5), 80.5 (± 31.9), 39.8 (± 12.7), and 29.77 (± 10.34) at baseline and after the first, second and third cycles, respectively. Statistical significant difference was found among all periods (p < 0.01). The LFpen values were 4.3 (± 1.5), 7.5 (± 9.4), 7.1 (± 7.1) and 5.10 (± 3.58) at baseline and after the first, second, and third cycles, respectively, among all periods (p < 0.05). The CSMH values after the second and third cycles at 20, 40, 60, 80 and 100 µm were 182.8 (± 69.8), 226.1 (± 79.6), 247.20 (± 69.36), 262.35 (± 66.36) and 268.45 (± 65.49), and for the third cycle were 193.7 (± 73.4), 239.5 (± 81.5), 262.64 (± 82.46), 287.10 (± 78.44) and 284.79 (± 72.63) (n = 24 and 23), respectively. No correlation was observed between the LFpen and SMH values (p > 0.05). One sample of each cycle was characterised through Raman spectroscopy analysis. It can be concluded that LF was effective in detecting the first demineralisation on enamel; however, the method did not show any effect in monitoring lesion progression after three cycles of in vitro demineralisation.
Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/patologia , Progressão da Doença , Fluorescência , Lasers , Análise de Variância , Animais , Bovinos , Esmalte Dentário/patologia , Dureza , Humanos , Análise Espectral Raman , Propriedades de Superfície , Desmineralização do DenteRESUMO
AIM: This was to assess and compare risk factors for traumatic dental injury (TDI) among children/adolescents with and without autism spectrum disorders (ASD). METHODS: The study consisted of 122 children and adolescents (98 males, 24 females), 61 with ASD (study group) and 61 without ASD (control group, CG). Dental injuries were determined according to Andreasenss classification. The cause, location and type of activity at the time of trauma were recorded from patient/carer recollection. RESULTS: Subjects with ASD presented higher percentages of TDI in routine activities (P = 0.003), falling while walking and episodes of self-harm (P = 0.007) in the individual's own residence (P = 0.036). TDI prevalence in the ASD group was higher (39.3%) than in the CG (26.2%) though not significant, (P = 0.123). Girls with ASD presented a significantly higher TDI percentage (50.0%) compared with girls from the CG (8.3%) (P = 0.024). Enamel fracture was the most frequent type of TDI for both groups (P = 0.292). The teeth most commonly affected were #11 and #21 for both groups. CONCLUSIONS: Children and adolescents with ASD exhibit different risk factors for TDI compared with those without ASD, and girls with ASD are more prone than boys.
Assuntos
Transtorno do Espectro Autista/complicações , Traumatismos Dentários/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Incisivo , Masculino , Fatores de Risco , Fatores SexuaisRESUMO
This study aimed to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, LF; DIAGNOdent pen, LFpen, and VistaProof fluorescence camera, FC) in detecting demineralization and remineralization on smooth surfaces in situ. Ten volunteers wore acrylic palatal appliances, each containing 6 enamel blocks that were demineralized for 14 days by exposure to a 20% sucrose solution and 3 of them were remineralized for 7 days with fluoride dentifrice. Sixty enamel blocks were evaluated at baseline, after demineralization and 30 blocks after remineralization by two examiners using LF, LFpen and FC. They were submitted to surface microhardness (SMH) and cross-sectional microhardness analysis. The integrated loss of surface hardness (ΔKHN) was calculated. The intraclass correlation coefficient for interexaminer reproducibility ranged from 0.21 (FC) to 0.86 (LFpen). SMH, LF and LFpen values presented significant differences among the three phases. However, FC fluorescence values showed no significant differences between the demineralization and remineralization phases. Fluorescence values for baseline, demineralized and remineralized enamel were, respectively, 5.4 ± 1.0, 9.2 ± 2.2 and 7.0 ± 1.5 for LF; 10.5 ± 2.0, 15.0 ± 3.2 and 12.5 ± 2.9 for LFpen, and 1.0 ± 0.0, 1.0 ± 0.1 and 1.0 ± 0.1 for FC. SMH and ΔKHN showed significant differences between demineralization and remineralization phases. There was a negative and significant correlation between SMH and LF and LFpen in the remineralization phase. In conclusion, LF and LFpen devices were effective in detecting demineralization and remineralization on smooth surfaces provoked in situ.
Assuntos
Esmalte Dentário/patologia , Desmineralização do Dente/diagnóstico , Remineralização Dentária , Adulto , Animais , Cariogênicos/efeitos adversos , Cariostáticos/uso terapêutico , Bovinos , Dentifrícios/uso terapêutico , Feminino , Fluorescência , Fluoretos/uso terapêutico , Dureza , Humanos , Lasers , Masculino , Microscopia de Polarização , Variações Dependentes do Observador , Fotografação/métodos , Reprodutibilidade dos Testes , Sacarose/efeitos adversos , Adulto JovemRESUMO
This study aimed to assess the performance of International Caries Detection and Assessment System (ICDAS), radiographic examination, and fluorescence-based methods for detecting occlusal caries in primary teeth. One occlusal site on each of 79 primary molars was assessed twice by two examiners using ICDAS, bitewing radiography (BW), DIAGNOdent 2095 (LF), DIAGNOdent 2190 (LFpen), and VistaProof fluorescence camera (FC). The teeth were histologically prepared and assessed for caries extent. Optimal cutoff limits were calculated for LF, LFpen, and FC. At the D (1) threshold (enamel and dentin lesions), ICDAS and FC presented higher sensitivity values (0.75 and 0.73, respectively), while BW showed higher specificity (1.00). At the D (2) threshold (inner enamel and dentin lesions), ICDAS presented higher sensitivity (0.83) and statistically significantly lower specificity (0.70). At the D(3) threshold (dentin lesions), LFpen and FC showed higher sensitivity (1.00 and 0.91, respectively), while higher specificity was presented by FC (0.95), ICDAS (0.94), BW (0.94), and LF (0.92). The area under the receiver operating characteristic (ROC) curve (Az) varied from 0.780 (BW) to 0.941 (LF). Spearman correlation coefficients with histology were 0.72 (ICDAS), 0.64 (BW), 0.71 (LF), 0.65 (LFpen), and 0.74 (FC). Inter- and intraexaminer intraclass correlation values varied from 0.772 to 0.963 and unweighted kappa values ranged from 0.462 to 0.750. In conclusion, ICDAS and FC exhibited better accuracy in detecting enamel and dentin caries lesions, whereas ICDAS, LF, LFpen, and FC were more appropriate for detecting dentin lesions on occlusal surfaces in primary teeth, with no statistically significant difference among them. All methods presented good to excellent reproducibility.
Assuntos
Cárie Dentária/diagnóstico , Lasers , Dente Decíduo/patologia , Área Sob a Curva , Testes de Atividade de Cárie Dentária , Fluorescência , Humanos , Técnicas In Vitro , Dente Molar , Curva ROC , Radiografia Interproximal , Sensibilidade e EspecificidadeRESUMO
This study aimed to evaluate the influence of professional prophylactic methods on the DIAGNOdent 2095, DIAGNOdent 2190 and VistaProof performance in detecting occlusal caries. Assessments were performed in 110 permanent teeth at baseline and after bicarbonate jet or prophylactic paste and rinsing. Performance in terms of sensitivity improved after rinsing of the occlusal surfaces when the prophylactic paste was used. However, the sodium bicarbonate jet did not significantly influence the performance of the fluorescence-based methods. It can be concluded that different professional prophylactic methods can significantly influence the performance of fluorescence-based methods for occlusal caries detection.
Assuntos
Cárie Dentária/diagnóstico , Profilaxia Dentária/métodos , Lasers , Fotografia Dentária/métodos , Coroa do Dente/patologia , Área Sob a Curva , Cárie Dentária/patologia , Esmalte Dentário/patologia , Dentina/patologia , Fluorescência , Corantes Fluorescentes , Humanos , Curva ROC , Rodaminas , Sensibilidade e Especificidade , Bicarbonato de Sódio/uso terapêutico , Fatores de Tempo , Cremes Dentais/uso terapêutico , Água/administração & dosagemRESUMO
Congenital epulis (CE) of the newborn is a rare benign soft tissue tumor that presents at birth. It occurs usually as a single mass with various sizes, although some multiple lesions have also been reported. The lesion is more common in female neonates and normally affects the maxillary alveolar ridge. Rare recurrence and no malignant alteration have also been reported. This condition may interfere with respiration, feeding or adequate closure of the mouth. A decisive diagnosis is made by histopathologic analysis as other newborn lesions can be incorrectly diagnosed as CE. This article presents a case report of a female infant who presented a fibrotic mass in the primary lateral incisor and canine region of the maxillary alveolar ridge. The lesion was not causing feeding or respiratory problems. After a watchful waiting procedure and no spontaneous regression, the lesion was excised under local anesthesia and confirmed by histopathologic analysis as CE.
Assuntos
Neoplasias Gengivais/congênito , Neoplasias Gengivais/patologia , Feminino , Neoplasias Gengivais/cirurgia , Humanos , Lactente , Maxila , Conduta ExpectanteRESUMO
A evolucao dos metodos para avaliacao da maturidade pulmonar fetal tem possibilitado um melhor seguimento das gestacoes de alto risco. A relacao lecitina-esfingomielina e o teste de Clements ocuparam por longo tempo o papel mais importante nesta propedeutica obstetrica. A presenca de um outro fosfolipide, o fosfatidilglicerol (FG), tem sido considerada por nos como o parametro mais importante na avaliacao da maturidade pulmonar fetal. A sua presenca no liquido amniotico nos assegura maturidade em 100% dos casos (ausencia de falso positivo). Ja a sua ausencia esta relacionada com a sindrome de angustia respiratoria em 80% dos casos (um reduzido indice de falso negativo). Importante torna-se ressaltar tambem que o resultado do exame nao sofre alteracoes mesmo na presenca de sangue ou meconio no liquido amniotico. A tecnica usada para a pesquisa do FG e a cromatografia em camada delgada. Assim, os autores propoem uma rotina pratica e mais segura para orientar aqueles casos em que se indica uma interrupcao prematura da prenhez