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O manejo clínico em Odontopediatria é individual, podendo variar nas diversas culturas mundiais. O objetivo desta revisão de literatura é reunir as principais diretrizes de diferentes países ao redor do mundo, incluindo o Brasil, visando identificar como em cada lugar o uso das técnicas de comportamento são aplicadas e sua eficiência. Inicialmente, foram selecionados os principais guias nacionais e internacionais, sendo eles retirados da Associação Internacional de Odontopediatria (IAPD) e Associação Americana de Odontopediatria (AAPD), além de artigos de diferentes países e continentes, como Argentina, Brasil, Europa e Ásia, também foram analisados se o protocolo dos principais guias estão condizentes com os protocolos do Departamento de Clínica Infantil da Faculdade de Odontologia de Ribeirão Preto - USP. Os resultados obtidos nos guias para manejo clínico odontológico brasileiro, americano, internacional e os artigos estudados recomendam inicialmente utilizar técnicas menos invasivas, com o intuito proporcionar um atendimento tranquilo e sem criar traumas para a criança, uma vez que muito do comportamento não cooperativo vem de experiências anteriores traumáticas. Entretanto, técnicas avançadas podem ser utilizadas para casos mais desafiadores. Concluímos com o estudo dos guias e artigos, que o cirurgião dentista possui diversas técnicas a serem aplicadas para que o atendimento infantil seja atraumático e restabelecer saúde ao paciente.

Clinical management in Pediatric Dentistry is individual and varies across different cultures around the world. The objective of this literature review is to bring together the main guidelines from different countries around the world, including Brazil, aiming to identify how the use of behavioral techniques are applied and their efficiency in each place. Initially, the main national and international guides were selected, taken from the International Association of Pediatric Dentistry (IAPD) and the American Association of Pediatric Dentistry (AAPD), as well as articles from different countries and continents, such as Argentina, Brazil, Europe and Asia, as well as It was analyzed whether the protocols of the main guides are consistent with the protocols of the Children's Clinic Department of the Faculty of Dentistry of Ribeirão Preto - USP. The results obtained in the guides for Brazilian, American and international dental clinical management and the articles studied recommend initially using less invasive techniques, with the aim of providing calm care and without creating trauma for the child, since much of the uncooperative behavior comes from previous traumatic experiences. However, advanced techniques can be used for more challenging cases. We conclude from studying the guides and articles that the dental surgeon has several techniques to be applied so that child care is atraumatic and restores health to the patient.

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The study aimed to compare the adherence of Brazilian and Italian pediatric dentists to the biosafety measures and operative protocols recommended by the health authorities during COVID-19 pandemic and to classify the participants according to their risk of infection. An online questionnaire with 34 questions about sociodemographic and occupational data, dental practice organization, biological risk management, and clinical operative protocols was sent to Brazilian and Italian pediatric dentists using a convenience sampling strategy. Chi-square test and multivariate analysis (two-step cluster) were performed (α = 5%). Of 641 respondents (377 Brazilians and 264 Italians), most were female (94% and 70%, respectively), aged 20-39 years (63%), with over 10 years of professional experience (58% and 49%, respectively). Based on adherence to recommended biosafety measures, participants were classified as "safer" (n = 219) or "less safe" (n = 422). Adherence to recommended protocols by the majority of participants resulted in low contagion rates (Brazilians = 5%; Italians = 12.5%). Participants with extensive professional experience in the dental setting exhibited a greater tendency to implement multiple adaptations (three or more) in their practice. Most participants (Brazilians = 92%; Italians = 80.7%) adopted the recommended minimal intervention dentistry approaches, with the use of fissure sealants and the use of non-rotary instruments for caries removal the most frequently techniques used among Brazilians (36%) and Italians (66%), respectively. Two different profiles of pediatric dentists were identified based on the biosafety protocols adopted during the pandemic. In addition, changes were implemented in the dental care provided to children, with focus on the minimal intervention dentistry.

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OBJECTIVES: To identify 1) factors of the evidence-practice gap (EPG) in Japan and Brazil as perceived by dentists and compare these factors between two countries, and 2) mechanisms to close this EPG. METHODS: The study employed a cross-sectional design by administering a web-based questionnaire to 136 Japanese and 110 Brazilian dentists. The survey queried dentists' reports of which factors possibly cause an EPG, using a newly developed 20-item questionnaire. RESULTS: An international comparison of 20 items related to factors of the EPG between Japan and Brazil revealed that "Dentists' own experiences are sometimes given priority over evidence" and "Dentists' own thoughts are sometimes given priority over evidence" were common factors to both countries, with over 80 % agreement. In logistic regression, "Insufficient opportunity to learn about evidence in dental education at universities", "Evidence-based treatments are sometimes not covered by the dental insurance system", and "Insufficient evidence which helps dentists choose an appropriate treatment for a patient after careful consideration of his/her own background" were significantly associated with the EPG in Japan (p < 0.05). In Brazil, "Insufficient case reports in which evidence-based dentistry (EBD) is applied to clinical practice" and "Image-based information and devices used for diagnosis vary depending on individual dentists" were significantly associated with the EPG (p < 0.05). CONCLUSIONS: This study suggests that EPG could be improved in Japan: by promoting EBD education at universities, improving the dental insurance system, and accumulating evidence according to patient background; and in Brazil: by promoting EBD case reports and standardizing diagnostic information and devices. CLINICAL SIGNIFICANCE: Two factors of EPG common to Japan and Brazil, namely the prioritization of dentists' own "experiences" and "thoughts" over evidence, are urgent issues for improving EPG. In addition, it will be necessary to address the country-specific factors of EPG that were identified in this study.

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BACKGROUND: The acceptability and preference for clear aligner therapy (CAT) has been increasing among orthodontists, but there is still a lack of consensus regarding CAT best practices. Consequently, this study aimed to investigate CAT practices among orthodontists practicing in Canada. METHODS: The survey was conducted among orthodontists practicing in Canada using a modified previously published survey. Sixty orthodontists participated (6.1% response rate). It consisted of 11 sections with open and closed questions related to demographic information and particularities about using or not using CAT. The survey responses were exported from REDCap to a Microsoft Excel (Microsoft, Redmond, Wash) spreadsheet, then statistically analyzed using SPSS software (SPSS for Windows, version 21.0; IBM Inc., Armonk, NY, USA). The comments were categorized under themes and subthemes. Data were organized in descriptive statistics, expressing frequencies and percentages. RESULTS: Almost 30% of the orthodontist's annual caseload was treated with CAT, most frequently prescribed to adult patients. Case complexity and patient cooperation were the factors that most influenced the decision to prescribe CAT. Almost half of orthodontists reported sometimes combining CAT with adjunctive fixed appliances. CONCLUSIONS: Most orthodontists prescribe CAT, and its use is based on the malocclusion's complexity. Orthodontists who do not prescribe CAT believe that fixed appliance therapy has superior treatment outcomes.

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INTRODUCTION: The removal of residual resins is a routine procedure in orthodontic clinics and of great importance to the final result of the treatment. OBJECTIVE: To evaluate the main methods of residual resin removal used by orthodontists, and the main reasons for choosing these methods. METHODS: A questionnaire consisting of 21 questions: 6 relating to demographic data and the other 15 relating to two methods used to remove residual resins (drills or pliers) was sent by e-mail to orthodontists registered with the Regional Councils of Dentistry of São Paulo and Rio de Janeiro (Brazil) within April and June, 2023. Questionnaires were sent back by 153 professionals. RESULTS: Residual resin removal is always carried out with high speed drill for 44.7% of the sample, and with low speed drill for 28.7%; 61.3% use irrigation. The multi-laminate carbide bur is used by 82.5% of orthodontists. Pliers are always used by 12.4%. Resin-removing pliers with Widia are used in 39% of cases. The use of high speed was justified by the shorter working time, and the choice of pliers was justified by the smaller damage to the tooth enamel. CONCLUSION: The most used residual resin removal method was the multi-laminate carbide bur at high speed with irrigation, justified the by shorter working time.

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Brazil's public healthcare system (SUS) offers specialized oral health services to Brazilians, but the productivity of specialists, such as Pediatric Dentists, has not been characterized. Therefore, the objective of this study was to characterize the outpatient dental procedures (ODPs) carried out by Pediatric Dentists within the SUS. An epidemiological study with an ecological, longitudinal, retrospective, and quantitative approach was conducted. The ODPs carried out by Pediatric Dentists within the SUS were characterized based on type of procedure, complexity level, and circumstance (urgent or elective). Data were analyzed using a descriptive and analytical approach, considering a significance level of 5%, as well as the impact of the COVID-19 pandemic (the 2020-2022 years were not included in secondary analyses). In the last 15 years, 29,234,972 ODPs were carried out by Pediatric Dentists within the SUS. Clinical procedures were the majority (55.4%), significantly more frequent than all other types of procedures (all p <0.05). Among these, restorative and periodontal procedures were the most common (30.7% and 21.0%, respectively). From 2008 to 2019, excluding COVID-19 pandemic years, the trend over the last 15 years was constant for all types of procedures (all p >0.05). In addition, low complexity ODPs were the majority (90.1%), significantly more frequent than medium (9.7%) and high complexity procedures (0.1%) (both p <0.05). At last, most ODPs were not characterized by circumstance in the outpatient production reports (96.9%). Therefore, it was possible to conclude that Pediatric Dentists carried out diverse ODPs within the SUS over the past 15 years, although there was a dominant pattern of type and complexity.

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A hemofilia por deficiência do fator XIII é uma doença que possui inúmeros riscos em cirurgia ou procedimentos invasivos, sendo o maior deles, a hemorragia. Na odontologia, para o profissional realizar procedimentos cirúrgicos em pacientes hemofílicos precisa estar capacitado com conhecimento teórico-prático de como realizar o pré, trans e pós-operatório, a fim de amenizar possíveis riscos e trazer segurança para o paciente e para ele. O presente estudo visa relatar uma exodontia em um paciente portador de hemofilia com deficiência do fator XIII, na Clínica Escola de Odontologia do Instituto Esperança de Ensino Superior (IESPES), objetivando trazer informações relacionadas à essa disfunção sanguínea e a conduta do cirurgião-dentista para um bom manejo odontológico neste grupo de pacientes.

Factor XIII hemophilia is a disease that poses several risks in surgery or invasive procedures, the greatest of which is hemorrhage. In dentistry, for the professional to perform surgical procedures in hemophilia patients need to be trained with theoretical and practical knowledge of how to perform the pre, trans and postoperative, in order to mitigate possible risks and bring safety for the patient and for him. The present study aims to report an exodontia in a patient with hemophilia with factor XIII deficiency in the Clínica Escola de Odontologia do Instituto Esperança de Ensino Superior (IESPES), aiming to bring information related to this blood dysfunction and the dental surgeon's conduct for a good dental management in patients affected by this pathology.

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O tratamento endodôntico de dentes com rizogênese incompleta requer uma atenção especial, uma vez que o tratamento convencional é inviável e devemos evitar a perda dos dentes permanentes. Na maioria das vezes, as causas que interrompem a formação radicular são os traumatismos dentários e as cáries extensas, que podem atingir a polpa coronária, podendo levar, inclusive, à necrose pulpar. Atualmente, esses casos têm sido tratados por meio da apicificação, apicogênese e da revascularização pulpar, com uso de medicações a base de hidróxido de cálcio, antibiótico e MTA (Agregado trióxido mineral). Nessas técnicas, a intenção é induzir o desenvolvimento radicular completo ou o fechamento apical por tecido duro calcificado. O objetivo deste trabalho foi realizar uma breve revisão de literatura, utilizando artigos científicos disponíveis nas plataformas Café (UFF), Scielo e PubMed, a fim de descrevermos os conceitos de apicificação, apicogênese e revascularização, expondo as suas indicações e condutas clínicas ideais para a realização destes tratamentos. Pode-se concluir que são procedimentos clínicos simples e de conhecimento extremamente importantes para qualquer cirurgião-dentista, uma vez que são tratamentos emergenciais bastante comuns no dia a dia. Além disso, sabe-se da necessidade de manter um dente permanente sadio na boca, que pode evitar grandes problemas no futuro.

Endodontic treatment on teeths with incomplete rhizogenesis requires special attention, since conventional treatment is infeasible and we must avoid the loss of permanent teeth. Most often, the causes that interrupt root formation are dental trauma and extensive caries, which can reach the coronary pulp and may even lead to pulpal necrosis. Currently, these cases have been treated through apexification, apexogenesis and pulpal revascularization, with the use of calcium hydroxide, antibiotic and MTA (Aggregate mineral trioxide) base medications. In these techniques, the intent is to induce complete root development or apical closure by calcified hard tissue. The objective of this work was to carry out a review of literature, using scientific articles available on the Café platform (UFF), Scielo and PubMed, in order to describe the concepts of apexification, apexogenesis and revascularization, exposing their indications and ideal clinical procedures for the realization of these treatments. It can be concluded that they are simple clinical procedures and of knowledge extremely important for any dentist, since they are emergency treatments that are quite common day by day. In addition, it is known that one needs to maintain a permanent healthy tooth in the mouth, which can avoid major problems in the future.

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OBJECTIVES: This study was designed to: 1) evaluate and compare the evidence-practice gap (EPG) in minimal intervention dentistry (MID) in Japan and Brazil by measuring concordance between dentists' clinical practice and published evidence; and 2) identify dentists' factors associated with the EPG in both countries. METHODS: We performed a cross-sectional study using a web-delivered questionnaire among 136 Japanese and 110 Brazilian dentists. The questionnaire consisted of three questions concerning "restoration diagnosis and treatment," "deep caries diagnosis and treatment," and "caries risk assessment" regarding MID. A chi-square test was used to analyze differences in concordance among clinical practice and evidence from the literature between Japanese and Brazilian dentists. Logistic regression analyses were performed to analyze dentists' factors associated with overall concordance for all three questions. RESULTS: Overall concordance was significantly higher in Brazil (55%) than in Japan (38%) (p<0.01). Concerning how evidence was obtained, textbooks, nonacademic journals, and seminars and workshops were used as information sources more frequently by Japanese than Brazilian dentists (p<0.001), whereas scientific journal articles in English were used more frequently by Brazilian dentists (p<0.001). On logistic regression analysis, overall concordance was higher for Japanese dentists who frequently obtained evidence from scientific journal articles in English (p<0.05), whereas Brazilian dentists who frequently obtained evidence from the Internet were associated with lower overall concordance (p<0.05). CONCLUSIONS: Because overall concordance was significantly higher in Brazil than in Japan, Japan may have a greater EPG in MID practice. Specific characteristics of Japanese and Brazilian dentists showed significant associations with overall concordance.

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A ansiedade é uma reação do organismo, considerada como uma emoção de alarme que se encontra associada a sensações de angústia medo. O atendimento em odontopediatria é rodeado de desafios, sendo necessária a preparação psicológica da criança pelo cirurgião dentista, seus assistentes e os responsáveis pelo paciente. A presente revisão de literatura teve como objetivo relatar as principais técnicas de manejo comportamental para facilitar a colaboração da criança com o tratamento odontológico. Esta é uma revisão narrativa da literatura realizada através do levantamento bibliográfico utilizando os descritores Odontopediatria; Comportamento infantil; Manejo comportamental nas bases de dados PubMed, LILACS e SciELO. Foram encontrados artigos nas línguas portuguesa e inglesa, entre o período de 2010 e 2020. As técnicas de manejo de comportamento são mecanismos disponíveis para o cirurgião-dentista. A escolha do método deve levar em consideração o estágio de desenvolvimento da criança, e efetividade do método e aceitação dos pais. Normalmente a técnica mais utilizada é o controle pela voz, falar-mostrar-fazer e distração, sendo esses dois últimos mais aceitos pelos pais, e o método com maior rejeição é o mão-sobre-a-boca. Para obter a colaboração das crianças durante os procedimentos odontológicos, é necessário o profissional conhecer e respeitar cada fase do desenvolvimento da criança e aplicar cada técnica de acordo com a necessidade individual do paciente e adequada a cada situação.

Anxiety is a reaction of the body, considered as an alarm emotion that is associated with feelings of fear anguish. The care in pediatric dentistry is surrounded by challenges, being necessary the psychological preparation of the child by the dentist, his assistants and those responsible for the patient. This literature review aimed to report the main behavioral management techniques to facilitate the collaboration of the child with dental treatment. This is a narrative review of the literature performed through the bibliographic survey using the descriptors Pediatric Dentistry; Childish behaviour; Behavioral management in PubMed, LILACS and SciELO databases. Articles were found in Portuguese and English between 2010 and 2020. Behavior management techniques are mechanisms available to the dentist. The choice of method should consider the stage of development of the child, and effectiveness of the method and acceptance of parents. Usually, the most used technique is voice control, talk-show-do and distraction, the latter two being more accepted by parents, and the method with greater rejection is hand-over-the-mouth. In order to obtain the collaboration of children during dental procedures, it is necessary for the professional to know and respect each phase of the child's development and apply each technique according to the individual needs of the patient and appropriate to each situation.

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