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The aim of the present study is to report a case of periodontal Ehlers-Danlos syndrome (pEDS) in early childhood. A 3-year-old child, complaining of severe tooth mobility, gingival bleeding, and early loss of deciduous teeth sought the dental clinics. The patient was diagnosed with pEDS, and no other systematic health impairments were diagnosed. It was implemented a strict supragingival biofilm control, using mechanical and chemical strategies. However, during the treatment, the patient had to receive multiple dental extractions. Scaling and root planing were performed in the remaining teeth, and the patient is included in the periodontal maintenance program to prevent recurrence of the disease. It was concluded that, although rare, severe cases of periodontitis may occur in deciduous teeth. Strict supragingival biofilm control and periodontal maintenance are strongly recommended in those patients, along with familial monitoring.

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Resumo O objetivo deste trabalho foi de determinar, por meio de uma revisão sistemática da literatura, os tipos e os efeitos dos aparelhos ortodôntico-ortopédicos dentofaciais no tratamento da má-oclusão esquelética de Classe III de Angle, em pacientes em crescimento, selecionando artigos com maior impacto de evidência científica. Para se alcançar esse objetivo, realizou-se uma busca retrospectiva de 1994 a 2019, nas bases de dados eletrônicas (Pubmed). Foram pesquisados os termos "Class III malocclusion", "malocclusion, Angle Class III/therapy" e "orthopedic treatment Class III". Os critérios de seleção foram configurados para incluir apenas ensaios clínicos randomizados da plataforma Pubmed. Os artigos foram selecionados e avaliados, de forma independente, por dois autores (kappa 0,88), baseados nos critérios de inclusão e exclusão. A estratégia de busca resultou em 25 artigos, sendo 18 resultantes da plataforma Pubmed. Após a análise desses estudos, concluiu-se que o tratamento da má-oclusao de Classe III em pacientes ainda em crescimento tem como principal modalidade terapêutica o uso da máscara facial de tração maxilar. Outros aparelhos ortodôntico-ortopédicos vêm sendo utilizados, porém com respostas mais dentoalveolares. Em pacientes que já cessaram o crescimento e não optaram pela cirurgia ortognática para a correção de suas deficiências, a abordagem com mini-implantes e miniplacas vem sendo utilizada com resultados bastante positivos, gerando excelentes tratamentos e em menor quantidade de tempo, porém ainda há poucas evidências científicas que suportam a eficácia dessa modalidade terapêutica.(AU)

Abstract The aim of this study was to determine through a systematic literature review the types and effects of dentofacial orthodontic-orthopedic appliances in the treatment of Angle Class III skeletal malocclusion in growing patients, selecting articles with higher impact of scientific evidence. To reach this goal, a retrospective search from 1994 to 2019 was carried out in the electronic databases (Pubmed). The terms "Class III malocclusion", "malocclusion, Angle Class III/therapy" and "orthopedic treatment Class III" were searched. Selection criteria were set to include only randomized trials of Pubmed platform. The articles were independently selected and evaluated by two authors (kappa 0.88), based on inclusion and exclusion criteria. The search strategy resulted in 25 articles, 18 resulting from the Pubmed platform. After analyzing these studies, it was concluded that the treatment of Class III malocclusion in patients still growing has as main therapeutic modality the use of facial mask of maxillary traction. Other orthodontic-orthopedic appliances have been used, but with more dentoalveolar responses. In patients who have already ceased growth and did not chose orthognathic surgery to correct their deficiencies, the approach with mini-implants and miniplates has been used with very positive results, generating excellent treatments and in a shorter time, however there are still few scientific evidences that support the effectiveness of this therapeutic modality (AU)

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Objective: Determine the prevalence of injuries due to dislocation in the primary dentition and the associated sequelae in children treated at Pediatric Dentistry Clinic of the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará. Material and Methods: The research protocol was reviewed and approved by the Institutional Research Ethics Committee Medical School of the Federal University of Ceará, Fortaleza, Ceará, Brazil. It was conducted through a transversal retrospective observational investigation. Data were collected from the medical records from 2000 to 2014. We use the statistical analysis software SPSS (Statistical Packacge for the Social Sciences) 17.0 for Windows. Results: The sample consisted of 52 patients, totaling 75 traumatized primary teeth. The average age at injury was 37.6 months and the most affected gender was male (65.4 %). Most injuries occurred at home (57.7 %) and consequently to fall from height (73%). The most common type of dislocation for injury was intrusion (53.3 %) and color change (42.7%), pulp necrosis (37.3 %) and obliteration of the root canal (13.3%) the most frequent sequelae. Conclusion: The high prevalence of sequelae (74.7 %) shows that proper treatment should happen at right time in order to reduce the occurrence of sequelae. (AU)

Objetivo: Determinar a prevalência de lesões por luxação na dentição primária e as sequelas associadas em crianças atendidas na Clínica de Odontopediatria da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Material e Métodos: O protocolo de pesquisa foi revisado e aprovado pelo Comitê de Ética em Pesquisa Institucional da Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará. Este estudo foi realizada através de uma investigação observacional retrospectiva transversal. Os dados foram coletados dos registros médicos entre os anos 2000 e 2014. Utilizamos o software de análise estatística SPSS (Statistical Packacge for the Social Scientes) 17.0 para Windows. Resultados: A amostra foi composta por 52 pacientes, totalizando 75 dentes primários traumatizados. A idade média de lesão foi de 37,6 meses e o sexo mais atingido foi o sexo masculino (65,4%). A maioria das lesões ocorreu em casa (57,7%) e, consequentemente, a queda de altura (73%) foi o motivo mais de maior prevalência. O tipo mais comum de luxação por lesão foi a intrusão (53,3%) e alteração de cor (42,7%), necrose pulpar (37,3%) e obliteração do canal radicular (13,3%) as sequelas mais frequentes. Conclusão: A alta prevalência de sequelas (74,7%) mostra que o tratamento adequado deve ocorrer no momento adequado para reduzir sequelas.(AU)

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This study evaluated the effect of low-level laser therapy (LLLT) on bone regeneration at the midpalatal suture (MPS) after rapid maxillary expansion (RME), using cone beam computed tomography. Fourteen 8-14-year-old patients with transverse maxillary deficiency underwent RME with a Hyrax-type expander activated with one full turn after installation and two half turn daily activations until achieving overcorrection. Patients were randomly assigned to either a control group (RME alone, n = 4) or an experimental group (n = 10) in which RME was followed by 12 LLLT sessions (GaAlAs, p = 70 mW, λ = 780 nm, Ø = 0.04 cm(2)). Two tomographic images of the MPS were obtained-T0, after disjunction and T1, after 4 months. Bone regeneration was evaluated by measuring the optical density (OD) on the tomographic images using InVivo Dental 5.0 software. Data were analyzed by the paired Student's t test (α = 0.05 %). A statistically significant difference between T0 and T1 OD values was observed in the laser-treated group (p = 0.00), but this difference was not significant in the control group (p = 0.20). Intergroup comparison of OD values at T1 revealed higher OD in the laser-treated group (p = 0.05). In conclusion, LLLT had a positive influence on bone regeneration of the midpalatal suture by accelerating the repair process.

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Objetivo: O objetivo deste estudo é realizar um estudo retrospectivo dos casos de avulsão de dentes permanentes em pacientes de 12 anos do Centro de Trauma Bucodentário (CENTRAU) da da Faculdade de Odontologia da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Material e Métodos: Foi realizado um estudo retrospectivo transversal caracterizado pela observação direta de arquivos de exames dentários de uma demanda espontânea de vítimas de traumas dentários que se apresentaram ao Centro de Trauma Bucodentário (CENTRAU) durante o período entre Maio de 2001 a Maio de 2013. Resultados: A análise foi realizada em 1.104 arquivos, dentre os quais 66 pacientes reportaram ter sido vítima de avulsão dentária com 88 dentes tendo sido avulsionados, com idades variando entre 6 e 30 anos. Dentro os 88 dentes avulsionados, 59 (67,04%) foram reimplantados. Apenas 9 (15,5%) casos o reimplante foi imediato. O meio de armazenamento mais utilizado foi a cavidade oral, por 8 (30,7%) pacientes. Em 26 (39,4%) casos, a causa de avulsão foi queda. Conclusão: Nesse estudo, ficou claro que os casos de avulsão do CENTRAU corresponderam a uma baixa ocorrência dentre os casos atendidos neste centro.

Objectives: The aim of this study is to perform a retrospective study of cases of avulsion of permanent teeth in patients from 12 years of the Oraldental Trauma Center (CENTRAU) of the School of Dentistry of Faculty of Pharmacy, Dentistry and Nursing in Federal University of Ceara. Material and Methods: A retrospective transversal study characterized by direct observation of dental records was performed of a spontaneous demand sample of dental trauma victims who presented to the Oraldental Trauma Center of UFC (CENTRAU) during the period from May 2001 to May 2013. Results: The analysis was done on 1,104 records, in which 66 patients reported having been victims of avulsion with 88 avulsed permanent teeth with ages ranging between 6 and 30 years. Among the 88 avulsed teeth, 59 (67.04%) were replanted. Only in 9 (15.5%) cases replantation was immediate. The storage medium that was the most widely used was the oral cavity by 8 (30.7%) patients. In 26 (39.4 %) cases, the cause of avulsion was falling to the ground. Conclusion: In this study, it was clear that cases of avulsion in CENTRAU corresponded to a low occurrence of all cases seen in the center.

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A má oclusão de Classe III, de acordo com o sistema de classificação preconizado por Angle, muito embora seja uma das menos prevalentes, é considerada a de maior complexidade quanto ao tratamento. A abordagem terapêutica pode ser instituída durante o crescimento facial, por meio de aparelhos ortopédicos, preferencialmente entre o final da dentição decídua e o início da dentição mista. Entretanto, antes e após esta fase, os movimentos ortopédicos dos ossos são acompanhados pelos movimentos dentários, considerando o apoio dentário superior. A ancoragem esquelética, por meio de miniplacas, tem sido sugerida como dispositivos que potencializam a força ortopédica nos casos com retração de maxila. A corticotomia tem sido utilizada como meio de favorecer o movimento dentário, com pouca indicação para o movimento esquelético, sobretudo, na protração da maxila com máscara facial. O objetivo desse trabalho é apresentar um caso clínico de uma menina tratada na dentição permanente com má oclusão de Classe III, com mordida cruzada anterior e retração de maxila por meio de máscara facial conectada a miniplacas instaladas na região lateral à cavidade nasal. A corticotomia bilateral horizontal foi realizada previamente à tração. Após seis meses de tratamento, houve a correção da má oclusão com avanço de maxila e melhora do perfil facial. A abordagem ortopédica de tração reversa associada à ancoragem esquelética e corticotomia mostrou-se efetiva e rápida.

Angle’s Class III malocclusion, although it is considered the malocclusion with the lowest prevalence, it is the most complex regarding treatment. Therapeutic approach may be instituted during facial growth through orthopedic appliances, preferably between the end of primary teeth and early mixed dentition. However, before and after this phase, the orthopedic bone movements are accompanied by tooth movements, considering the upper dental support. Skeletal anchorage using miniplates, has been suggested as a device that may enhance orthopedic force in cases with jaw retraction. Corticotomy has been used as a method to perform tooth movement, with little indication for skeletal movement, especially in maxillary protraction with facial mask. The aim of this paper is to present a clinical case of a girl treated in the permanent dentition with Class III malocclusion with anterior cross bite and jaw retraction through a face mask connected to mini-plates installed in the lateral nasal cavity. The horizontal bilateral corticotomy was performed before traction. After six months of treatment, the correction of malocclusion with maxillary advancement and improvement of facial profile was achieved. The approach of orthopedic protraction associated with skeletal anchorage and corticotomy has proven to be effective and fast.

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Os índices normativos são ferramentas de diagnóstico e de avaliação terapêutica muito importantes, pois possuem grande valia para o planejamento ortodôntico e a compreensão dos resultados obtidos. Dentre os índices validados, o Dental Aesthetic Index (DAI) pode avaliar a necessidade de tratamento ortodôntico e seus resultados, o qual aborda componentes estéticos e da oclusão dentária. Os indivíduos com má oclusão de Classe II, 1ª divisão, em crescimento, ocupam o primeiro lugar em busca do tratamento ortodôntico-ortopédico, parte com protrusão maxilar. O aparelho extraoral tem mostrado, ao longo dos anos, uma boa opção devido à possibilidade de promover alterações esqueléticas corrigindo o posicionamento da maxila, como o aparelho de Thurow modificado. Este estudo retrospectivo avaliou, por meio do Índice Dental Estético, as mudanças oclusais em 15 casos tratados por meio do aparelho de Thurow modificado. Houve uma diminuição significativa da severidade da má oclusão com a redução do escore DAI 4 de 87% para 0% do total de casos tratados. Conclui-se que o aparelho modificado de Thurow é eficiente no tratamento da má oclusão de Classe II, 1ª divisão, principalmente pela redução do overjet e melhoria da relação molar.

Normative indexes are very important diagnostic and therapeutic evaluation tools, since they have great value in orthodontic planning and understanding of orthodontic treatment results. Among the validated indexes, Dental Aesthetic Index (DAI) can evaluate the need for orthodontic treatment and its results, using occlusal and aesthetic components. Class II division 1 malocclusion cases, in growing patients, are the first in search for orthopedic-orthodontic treatment, of them with maxillary protrusion. Over the years the extraoral appliance has proved to be a good option due to the possibility of promoting skeletal changes by correcting the positioning of the bone bases, likewise, the Modified Thurow Extraoral Appliance. This retrospective study has evaluated, through the Dental Aesthetic Index, occlusal modifications in 15 cases treated with modified Thurow’s appliance. There was a significant reduction in malocclusion severity, with a modification of DAI score reducing from 87% to 0% of DAI score 4. It was concluded that modified Thurow’s appliance is efficient in Class II division 1 malocclusion, mainly in overjet reduction and improvement of molar relationship.

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AIM: To evaluate the clinical and radiographic success of endodontic treatment in human primary teeth with necrotic pulp with and without radiographically visible furcal/periapical lesion treated with a calcium hydroxide (CH) and chlorhexidine (CHX) intracanal dressing. The tested hypothesis was that there is no difference in the clinical and radiographic success in primary teeth medicated with CH pastes prepared with polyethylene glycol (PEG) or CHX. METHODS: Thirty-two teeth with necrotic pulp were used in this randomized clinical study: 12 without and 20 with lesion. Canals were prepared and medicated with CH pastes with polyethylene glycol (CH/PEG) (n=16) or 2% CHX gel (CH/CHX) (n=16). Definitive filling was done after 30 days. The teeth were clinically and radiographically examined during 12 months to determine the success of the endodontic therapy. Data from clinical and radiographic examination of the initial condition and 12 months after treatment were compared using the Z test (α = 0.05). RESULTS: There was no significant difference (p>0.05) in the success rate of teeth with and without lesion medicated with CH/PEG or CH/CHX. No significant difference (p>0.05) was found between the pastes regardless of the presence of lesion. CONCLUSIONS: Combination of CHX and CH was not more effective than the CH/PEG paste, as similar clinical and radiographic success rate was observed in teeth medicated with either type of intracanal dressing.

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Dentoalveolar ankylosis is described as the direct union between root cementum/dentin and alveolar bone. Its etiology is unknown, and conflicting opinions have been presented to explain it. Late detection of ankylosed primary teeth may cause serious problems to the occlusion and generally demands a more complex treatment approach. The purpose of this report is to present an unusual case of severe infraocclusion of the primary maxillary right second molar associated with a posterior crossbite in a 6-year-old child. The initial treatment option was tooth extraction, but the tooth resumed eruption spontaneously. After correction of the posterior crossbite and a 1-year follow-up, the tooth remained in occlusion and the permanent successor was developing without problems. From this unusual outcome, it may be concluded that further investigation of this anomaly of eruption is needed.

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A necrose pulpar representa a cessação dos processos metabólicos do tecido pulpar, desestruturação e concomitante perda de suas defesas naturais. A partir da necrose pulpar, a cavidade pulpar torna-se progressivamente colonizada por vários micro-organismos habitantes da cavidade bucal e sistemas interligados. Assim, os dentes com necrose pulpar e áreas radiolúcidas periapicais apresentam inúmeros morfotipos microbiológicos no sistema de canais radiculares. Não obstante, de longa data, tem sido questionada a sobrevivência de micro-organismos nos granulomas periapicais. Nesta revisão, verificou-se que na atualidade, pela técnica da cultura microbiológica ou por métodos moleculares, cocos, bacilos e filamentosos, gram-negativos e positivos, predominantemente anaeróbios estritos, identificados no sistema de canais radiculares, também são recuperados na região periapical. Esses micro-organismos também são identificados pela coloração de Brown e Brenn ou pela microscopia eletrônica de varredura no ápice radicular e na estrutura da lesão, numa frequência que oscila de 4% a 100%. Estruturalmente, organizam-se num material amorfo, iodoso, de composição polissacarídica - os biofilmes periapicais.

Starting from the pulp necrosis the pulp cavity becomes progressively colonized by several microorganisms' inhabitants of the oral cavity and interconectives systems. Thus, the teeth with pulp necrosis and radiolucencies periapical areas present countless microbiological morfotypes in the root canal system. Nevertheless, of long date, the survival of the microorganisms in the periapical granuloms has been questioned. In this review it was verified that currently, by culture or molecular methods that the coccus, bacilli and filamentous, gram-negative and positive, predominantly strict anaerobes, identified in the root canal system also are recovered in the periapical lesions. Such microorganisms are also identified for the coloration of Brown and Brenn or for the scanning electronic microscopy in the root apex and in the structure of the lesion, in a frequency that oscillates from 4% to 100%. Structurally, they are organized in an amorphous material, muddy, of polysaccharide composition- the periapical biofilms.