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PellGregory and Winter classifications are basic in third molar categorization; Sánchez-Torres classification is used in Mexico, but it has not been previously evaluated.To assess the degree of agreement in the radiographic evaluation of impacted mandibular third molar with the use of three classifications: PellGregory, Winter and Sánchez-Torres.Observational, descriptive, inter-observer degree of agreement study that included 10 oral and maxillofacial surgeons and 10 training residents, who recorded the radiographic categorization of third mandibular molars (left and right) according to Pell and Gregory, Sánchez-Torres and Winter classifications. Inter-observer degree of agreement was assessed with Fleiss' kappa test.Pell and Gregory classification obtained the lowest degree of agreement (kappa = 0.05 and 0.185), followed by Sánchez-Torres classification (kappa = 0.125 and 0.326); Winter had the best agreement, with kappa = 0.28 and 0.636 for oral and maxillofacial surgeons and training residents, respectively.The Winter classification showed an acceptable (moderate) degree of agreement to classify mandibular third molars by training residents.Las clasificaciones de Pell y Gregory y de Winter son básicas en la categorización de terceros molares; la clasificación de Sánchez Torres es usada en México, pero no había sido evaluada previamente.Evaluar el grado de acuerdo en la valoración radiográfica de terceros molares mandibulares impactados, con el empleo de tres clasificaciones: Pell y Gregory, Winter y Sánchez Torres.Estudio observacional, descriptivo, de concordancia interobservador, que incluyó a 10 cirujanos orales y maxilofaciales y 10 residentes en formación, quienes registraron la categorización radiográfica de terceros molares mandibulares (izquierdos y derechos) de acuerdo con las clasificaciones de Pell y Gregory, Sánchez Torres y Winter. Se evaluó el grado de acuerdo entre observadores mediante la prueba de kappa de Fleiss.La clasificación de Pell y Gregory obtuvo el menor grado de acuerdo (kappa = 0.05 y 0.185), seguida de la clasificación de Sánchez Torres (kappa = 0.125 y 0.326); el mejor valor lo obtuvo la clasificación de Winter, con kappa = 0.28 y 0.636 para cirujanos orales y maxilofaciales y residentes en formación, respectivamente.La clasificación de Winter mostró un grado de acuerdo aceptable (moderado) para categorizar terceros molares mandibulares en los residentes en formación.

The study aimed to perform a systematic scoping review with the need of exploring the actual clinical applications of the chloramphenicol-tetracycline-ZOE antibiotic paste (CTZ) as a lesion sterilization tissue repair (LSTR) therapy agent. Following a scoping framework suggested by Arksey and O’Malley, relevant articles (randomized controlled trials, literature reviews, observational studies, in vitro studies, and clinical case-series reports) published over the last 15 years (in English, Spanish, or Portuguese languages) were identified and retrieved from five internet databases: PubMed, Embase/Ovid, Cochrane Library, Google Scholar, and EBSCO. By title and abstract screening and after removing duplicates, 11 articles were finally included in the present scoping review: five randomized/non-randomized clinical trials, five in vitro studies, and one case-series report. According to the collected information, there were no differences between CTZ paste and conventional pulpectomy, antibiotic pastes, and intracanal filling materials, considering the clinical, radiographic, antimicrobial activity, and periapical tissue biocompatibility outcomes. CTZ has shown excellent rates of clinical success and good radiographic results, with adequate antimicrobial effects; however, its biocompatibility has been put into doubt. Contemporary pediatric dentists should carefully consider the CTZ paste as an alternative endodontic approach for pulpally involved primary molars, with the advantages of being simple and fast, and taking into account the limitations of instrumental pulpectomy such as the microbiological and morphological complexity of primary root canals.

Pediatricians are primary health care professionals who supervise the growth and development and treat infants and children during the first years of life. Thus, they should possess knowledge regarding oral health care, to provide anticipatory guidance, as well as dental education to parents in order to make appropriate clinical decisions. For many years, several surveys have been performed worldwide to assess the pediatricians' knowledge, awareness, and experience regarding oral health care and prevention. This work aimed to scope the existing literature and summarize the most relevant evidence about knowledge, practices, and attitudes on oral health/care among pediatricians worldwide. PubMed, Cochrane Library, Google Scholar, and DentistryOral Sciences Source were explored. Under a structured PCC question and eligibility criteria, for relevant clinical trials and observational studies, published during the last decade. Titles and abstracts were screened. Full-text articles were critically reviewed for bias risk and a data charting table was constructed. A total of 44 references were initially identified, and 37 titles remained for abstract screening after removing duplicates; then, 27 potential full-text articles were carefully reviewed. Finally, 25 relevant and most informative studies were included. The selected studies were conducted in India, Lebanon, Saudi Arabia, and Paraguay, Europe, Australia, Qatar, Iran, Turkey, United Arab Emirates, Nigeria, Brazil, Chile, Germany, Taiwan, Canada, and the USA. Through included surveys, researchers have reported different levels of knowledge, practice involvement, and attitude on children's oral health among pediatricians. In general, unsatisfactory knowledge of oral health was reported. The main impediments for a better professional involvement or practice include inappropriate education, poor auto-confidence, and lack of time. So, it has been suggested that some oral health training or clinical guidelines should be included in the current medical curricula.

The aim of this study was to characterize the morphological properties of amorphous silica nanoparticles (SiO2 NPs), their cytotoxicity and intracellular location within Human Osteoblasts (HOB). Additionally, SiO2 NPs were explored for their effectivity as carriers of CRTC3-siRNA on Human Preadipocytes (HPAd), and thus downregulate RGS2 gene expression. SiO2 NPs were synthesized using the method of Stöber at 45 °C, 56 °C, and 62 °C. These were characterized via TEM with EDS, Zeta Potential and FT-IR. Cytotoxicity was evaluated by XTT at three concentrations 50, 100 and 500 µg/mL; SiO2 NPs intracellular localization was observed through Confocal Laser Scanning Microscope. Delivering siRNA effectivity was measured by RT-qPCR. Morphology of SiO2 NPs was spherical with a range size from 64 to 119 nm; their surface charge was negative. Confocal images demonstrated that SiO2 NPs were located within cellular cytoplasm. At a SiO2 NPs concentration of 500 µg/mL HOB viability decreased, while at 50 µg/mL and 100 µg/mL cell viability was not affected regardless SiO2 NPs size. SiO2 NPs-CRTC3-siRNA are effective to down-regulate RGS2 gene expression in HPAd without cytotoxic effects. The developed SiO2 NPs-CRTC3-siRNA are a promising tool as a delivery vehicle to control obesity.

Ectopic eruption of the first permanent molar (EFUPM) is defined as its local disturbed eruptive behaviour, positioning too mesially against the distal aspect of the second upper primary molar during the developing mixed dentition. The EFUPM prevalence is up to 6% and affects both genders equally. The present study aimed to perform a scoping review to collect the most relevant studies published in the last 30 years and focused on the different strategies, traditional and novel, for treating irreversible uni- or bilateral EFUPM in children. This review also aimed to make recommendations and map the gaps in this clinical topic.An electronic and manual search was conducted in five databases according to previously established eligibility criteria, using different combinations of keywords, MeSH terms, and Boolean operators. Titles, abstracts, and full-text articles were screened and selected by pre-calibrated reviewers. A data charting was also accomplished for summarising the overview of the evidence.Paediatric dentists must learn to diagnose and treat this condition early in order to allow the prevention of future malocclusions and other clinical sequelae. Practitioners have at their disposal a variety of corrective options available for the successful resolution of EFUPM.

Secondary/persistent infections are present in teeth with previous root canal treatment, and a great variety of anaerobic microorganisms has been observed in these infections. The antibiotics prescription is occasional; however, in some cases, it is essential, particularly when the general health condition of the patient is compromised. The aims of this study were to identify the associated microorganisms in diagnosis of persistent or secondary apical periodontitis and to evaluate the susceptibility level to the antibiotics most used. Fifteen patients with persistent or secondary apical periodontitis requiring endodontic re-treatment were included. Microbiological samples were taken from the root canals and incubated in thioglycollate under anaerobic conditions. Anaerobic CDC agar (formulated by the Center for Disease Control and Prevention) was employed as a culture medium and the microorganisms were identified using the API system. The microorganisms were subjected to antibiograms with three different antibiotics. Twenty-six microorganisms were identified, the most common genus was Enterococcus (26.8%), Streptococcus (19.22%), Aerococcus (19.1%), and Clostridium (11.4%). 48% of them were susceptible to amoxicillin, with 28% of resistance. For clavulanic acid/amoxicillin, the susceptibility occurred in 32%, with 28% of resistance; and for clindamycin, the susceptibility was present in 40%, with 52% of resistance. The most frequently detected associated microorganism for secondary infections was genus Enterococcus, which exhibited high resistance to the studied antibiotics.

This study sought to evaluate the biocompatibility of Neomineral Trioxide Aggregate (Neo-MTA), MTA Repair High Plasticity (MTA-HP), and Mineral Trioxide Aggregate-Angelus white (MTA-Ang) in fibroblasts of human dental pulp.Morphology was evaluated after 24 h of incubation.Morphological changes were observed in all groups. Neo-MTA and MTA-Ang were associated with increased cell viability, and all materials induced apoptosis, with a higher percentage in the MTA-HP group than in the other groups. In the LIVE/DEAD assay, there was more damage to the cell membrane in the group of cells treated with MTA-HP than in the other groups.Neo-MTA and MTA-Ang presented similar biocompatibility, and both showed greater biocompatibility than MTA-HP. MTA-HP and MTA-Ang increased Col-1A gene expression, and Neo-MTA and MTA-Ang increased TGF

OBJECTIVE This study sought to evaluate the effect of eugenol on the cell morphology and expression of genes involved in the apoptotic process in human dental pulp fibroblasts (hDPFs) from deciduous teeth. MATERIALS AND METHODS hDPFs were cultured with 4 concentrations of eugenol (0.06 nM, 0.6 nM, 6 nM, 12 nM) and compared with a control group. After a 72 h incubation period, the cytotoxic effect on cell morphology by optical microscopy and gene expression by RT-PCR were evaluated. RESULTS At 0.06 nM and 0.6 nM eugenol concentrations, vacuolisation of the cytoplasm was observed with atypical granulation of the hDPFs, and, at 6 nM and 12 nM cytoplasmic extensions disappeared almost completely. Casp-3, Casp-9, and telomerase genes were not expressed at the concentrations evaluated nor in the control group. The relative expression responses of Bcl-2 and TGF-β genes were overexpressed at the 4 concentrations. MAKP's 0.06 nM (p

The objective of this study was to determine the age-related anatomical changes that take place at the cementodentinal junction (CDJ).Eighty-four teeth were extracted; 42 samples came from patients ranging in age from 18 to 30 years, and 42 came from patients aged from 40 to 60 years. Upper and lower and anterior and posterior teeth were included. Longitudinal slices were made, and 1% toluidine blue was used to stain all the samples prior to microscopic examination. Anatomical landmarks (apical foramen [AF], apical vertex, and cementoenamel junction) in the apical third were identified, and a pre-calibrated software package was employed to take digital measurements. Statistical analysis was performed by means of the Wilcoxon rank-sum test.The data obtained showed that there were anatomical variations in the apical third in the older patients and that these changes were related to the age of the patient. Narrower root canals and smaller CDJ diameters were found in older patients' samples.The results of this study suggest that instrumentation and obturation should take place 1 mm from the AF in older patients, and not 0.5 mm, as is usually recommended.

Caries management at the lesion level is dependent on the lesion activity, the presence of a cavitation (either cleanable or non-cleanable), and lesion depth as evaluated via radiographic examination. A variety of non-invasive, micro-invasive, and minimally invasive treatment (with or without restoration) options are available for primary and permanent teeth. Non-invasive strategies include oral hygiene instructions, dietary counseling, and personal as well as professional use of fluoridated products that reduce demineralization and increase re-mineralization. Micro-invasive procedures include the use of occlusal resin sealants and resin infiltrants, while minimally invasive strategies comprise those related to selective removal of caries tissues and placement of restorations. Deep caries management includes indirect pulp capping, while exposed pulp may be treated using direct pulp capping and partial or complete pulpotomy. The aim of the present study was to review available evidence on recommended preventive and restorative strategies for caries lesions in Latin American/Caribbean countries, and subsequently develop evidence-based recommendations for treatment options that take into consideration material availability, emphasize ways to adapt available treatments to the local context, and suggest ways in which dentists and health systems can adopt these treatments.

The local administration of analgesic combinations by means of degradable polymeric drug delivery systems is an alternative for the management of postoperative pain. We formulated a Tramadol–Dexketoprofen combination (TDC) loaded in poly(vinyl alcohol) (PVA) film. Films were prepared by the solvent casting method using three different molecular weights of PVA and crosslinking those films with citric acid, with the objective of controlling the drug release rate, which was evaluated by UV–vis spectrometry. Non-crosslinked PVA films were also evaluated in the experiments. Differential scanning calorimetry (DSC) analysis of samples corroborated the crosslinking of PVA by the citric acid. Blank and loaded PVA films were tested in vitro for its impact on blood coagulation prothrombin time (PT) and partial thromboplastin time (PTT). The swelling capacity was also evaluated. Crosslinked PVA films of higher-molecular weight showed a prolonged release rate compared with that of the lower-molecular-weight films tested. Non-crosslinked PVA films released 11–14% of TDC. Crosslinked PVA films released 80% of the TDC loaded (p

Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.

Objective. The present study aimed to compare variations in quantified tumor necrosis factor-alpha (TNF-α) levels in patients with periodontitis stage 2 grade B (POD2B) and/or type 2 diabetes (T2D) and to identify any relationships between this cytokine and these diseases. Methods. Levels of the cytokine TNF-α in gingival crevicular fluid in patients with POD2B and/or T2D were evaluated. A total of 160 subjects were distributed into four groups: those with POD2B (n=44); those with T2D (n=37); those with POD2B/T2D (n=40); and healthy subjects (n=39). Glycosylated hemoglobin (HbA1c) and blood glucose (BG) levels were quantified in each subject. Data were collected on body mass index (BMI), loss of insertion (LI), and probe depth (PD). Gingival crevicular fluid samples were collected from the most acutely affected periodontal pocket and gingival sulcus in each subject, and TNF-α was quantified by multiplex analysis. Results. Kruskal Wallis tests was used to identify differences in TNF-α levels, LI, PD, BMI, BG, and HbA1c by group. Differences (pα levels and LI or PD identified a weak but significant negative correlation of TNF-α with LI (Rho=-0199; p=0.012), and a moderately positive correlation of LI with PD (Rho=0.509; p < 0.001). Conclusions. No variation was found between TNF-α levels and the presence of POD2B, POD2B/T2D, or T2D, suggesting the absence of any direct relationship between progression of these diseases and TNF-α levels. However, a correlation was present between low TNF-α concentrations and greater LI.

The engineering of bone tissues represents an area of opportunity for the development of new polymeric compounds. In this context, the objective of this work is the generation and evaluation in vitro of supports obtained from mixtures of starch with poly (lactic acid) (PLA), treated with arginine-glycine-aspartic acid peptides (RGD). For this, non-woven fibers of PLA with different starch content (0.0, 2.5, 5.0 and 10.0%wt) were obtained using the electrospinning technique. Then the physical absorption of RGD was carried out, with the aim of increasing the cellular adhesion of the polymeric material. Subsequently, in vitro biocompatibility tests were performed, and viability (LIFE/DEAD), proliferation (MTS assay) and cell adhesion were carried out with osteoblasts incubated for 48 h. Regarding biocompatibility results, only viable cells were found for all the compositions, and the biocompatibility of the materials was validated by the morphological analysis of the cultured cells, where extended cells were observed. Proliferation assays show that osteoblasts proliferate better on the surfaces of PLA and PLA with 5.0% starch scaffolds. Therefore, it is concluded that the scaffolds obtained by electrospinning of PLA with starch and functionalized with RGD are promising for its use in the regeneration of bone tissue.

OBJECTIVE To estimate the prevalence and severity of molar incisor hypomineralization (MIH) in 8 years old children living in an endemic fluorosis area. METHODS MIH prevalence rate was determined from a study sample comprising 613 participants. They were recruited from 11 urban public schools with similar socio-economic status. Oral evaluations were performed and diagnosed MIH teeth were classified under Ghanim et al.'s criteria. Statistical descriptive and comparative analyzes were carried out. RESULTS First permanent molars were the tooth group most affected, followed by the upper central incisors, lower central incisors, lower lateral incisors, and upper lateral incisors. There was no significant statistical difference by gender and by maxillary/mandible arches (P = 0.82 and 0.26, respectively). The frequency of MIH was more in molars compared to incisors (P < 0.02). CONCLUSIONS The MIH prevalence in this study was 12.4 percent. According to the MIH severity, degree 2 was the most frequently detected (76.4 percent).

The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.

Purpose: The objective was to evaluate the antagonistic effect of Lactobacillus and Bifidobacterium recovered from five commercial probiotics on the growth of C. albicans. Study design: The Lactobacillus and Bifidobacterium strains of five commercial probiotics were recovered and grown: Probio Hp+®, ProBiseis®, Lactipan®, Liolactil®, and Lacteol Fort®; 50 mg of each was hydrated and grown in Lactobacilli MRS (De Man, Rogosa and Sharpe) broth and incubated at 37°C with stirring (120 RPM) for 24 hours. Serial dilutions of 10−1 to 10−7 were made and viability was verified and quantified. For the antagonism tests, a suspension/inoculum of Lactobacillus strains recovered from each commercial preparation (4–30 × 109) and C. albicans ATCC 90028 (1.5–8 × 108) was prepared in MRS broth and incubated for 48 hours at 36°C, then plated on Dextrose Sabouraud Agar with Chloramphenicol and Rogosa Agar and the colony-forming units (CFU) were quantified. Additionally, viability was evaluated using the LIVE/DEAD® Yeast and Bacterial Viability kit. Results: The probiotic that produced the highest acidity of the medium was Lactipan®, followed by Probiseis® and Liolactil®, while Probio Hp+® showed the least change. Probiseis® was determined to have the highest growth of probiotic bacteria and the highest inhibition on C. albicans, followed by Lactipan®; Liolactil® and ProbioHp+® showed the least effect. In fluorescence tests, ProBiseis® showed the best effect, followed by Liolactil® and Lactipan®; Probio Hp+® had less of an effect. Conclusions: Two commercial products (ProBiseis and Lactipan) whose formulations have L. acidophilus, L. casei, L. rhamnosus, L. plantarum, B. infantis, and S. thermophilus have a greater inhibitory effect on C. albicans ATCC 90028

Dental treatment for anxious or fearful intellectually disabled children/adolescents (IDCA) may present great challenges, due to deficits in cognitive, intellectual, language, and social abilities, in conjunction with limited adaptive behavior. In many cases, it is necessary for the Dentist to implement advanced behavioral control techniques. Inclusive Dentistry (ID) considers profoundly each patient’s individual interests and likes, including the social and family situations, for choosing the respective personalized plan –contemplating potential risks and benefits– for the behavior control, in order to obtain the maximal possible cooperation of the patient in the dental chair. Through ID, the Pediatric Dental Practitioner aims to alleviate the anxiety and fear of IDCA in the clinical setting, in such a way that these patients are positively motivated, on a long-term basis, for current and future oral care, both at the dental office and at home. This management approach may be a time-consuming method or require more effort by the dentist, but it reaps benefits when applied for many mild-to-moderate (and some severe) IDCA. The Practitioner must possess the knowledge, in-depth understanding, and professional training for the adequate use of ID during the behavioral management of anxious or fearful IDCA. The aim of the present report was to describe four representative clinical cases of IDCA at our Clinic, managed under the philosophical principles of ID.

The objectives of this scoping review were: first, to pose a research question; second, to identify relevant studies to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data; and finally, to collate, summarise, and report the results from selected articles on the dental management of children affected with autism.Relevant articles (randomised controlled trials, reviews, observational studies, and clinical case reports) published over an 11-year period were identified and retrieved from five internet databases: PubMed, Embase/Ovid, Cochrane Library, Google Scholar, and EBSCO.By title and abstract screening and after removing duplicates, 25 articles were finally included in the present scoping review. According to the extracted data, the following four clinical issues were found to be most important: patient behavioural control, prevalence/incidence of dental caries, adverse effects and interactions with medications, and orthodontic management. Additionally, several useful clinical recommendations are provided.Paediatric dentists should bear in mind that early diagnosis and treatment, effective communication skills, and a long-term follow-up of children with autism continue to be the best approaches for achieving enhanced patient psychological well-being and consequently a better quality of life.

Purpose Evidence exists to support the peripheral analgesic effect of local administration of ketamine (LAK) after third molar surgery. The aim of the present systematic review and meta-analysis was to determine the efficacy of LAK in the control of pain, swelling, and trismus after third molar surgery. Materials and Methods The study design was a systematic review with a meta-analysis of the effect of LAK after third molar surgery. A search in electronic databases was performed from September 2017 to February 2019. Only prospective clinical trials and randomized controlled trials that had evaluated LAK after third molar surgery were included. The meta-analysis was based on the random effects model. The outcome measures evaluated were postoperative acute pain, swelling, and trismus. The estimated overall effect size was a standardized mean difference (SMD). Results A total of 110 study subjects (men and women aged 18 to 50 years) were evaluated for the analgesic effect. The SMD showed a significant analgesic effect (postoperative pain control) favoring LAK (SMD, −1.7403; 95% confidence interval [CI], −2.45 to −1.04). Evaluation of the anti-inflammatory effect of LAK included 105 study subjects and resulted in significantly less swelling in the first postoperative day (SMD, −0.6169; 95% CI, −1.1654 to −0.0683). However, LAK did not reduce the incidence of trismus after third molar surgery (SMD, −0.7241; 95% CI, −2.2765 to 0.8284). Conclusions The use of LAK can reduce the incidence and severity of postoperative pain after third molar surgery and had an anti-inflammatory effect, although only in the first postoperative day. However, LAK had no effect on trismus reduction after third molar surgery.

The aims of this in vitro study were to synthesize, characterize, and evaluate the efficacy of a Calcium Hydroxide/Iodoform nanoparticles (CHIN) paste compared with Ultrapex as intracanal filling medication using an experimental model of bovine primary teeth. CH nanoparticle synthesis was performed via the simple hydrolysis technique of reacting calcium nitrate with sodium hydroxide. SEM–EDS and FT-IR analyses were used to characterize the obtained product. 30% of CH nanoparticles were combined with 40% of iodoform and 30% silicone oil to prepare an intracanal filling paste (CHIN). All endodontic procedures were performed on 34 uniradicular primary bovine teeth. Every root canal was instrumented with K files (up to #35) and obturated with the nanoparticle paste (experimental) or Ultrapex® (control). Three outcome variables were studied: penetration depth through the root dentinal tubules, Ca2+ ion release, and filling paste dissolution rate. The obtained data were analyzed by Student’s t test. The X-ray diffraction pattern of CH nanoparticles showed characteristic peaks at CH, as confirmed by FT-IR analyses in which an intense signal was observed at 3643 cm−1, characteristic of CH. In the morphological characterization, CH particles could be detected at the nanosize scale. When applied as intracanal filling, the CHIN paste exhibited a higher level of penetration through the root dentin tubules. The global mean penetration measures were 500 µm for the experimental paste and 380 µm for the control paste (p

The main of this study was to evaluate the inhibitory effect on the in vitro formation of the Staphylococcus aureus biofilm formed on a polyethylene (PE) surface with a nanostructured Gold (Au) coating for medical devices. An experimental in vitro study was carried out using PE discs with an Au nanoparticle coating (AuNPs) on one side (experimental group) and without coating on the other (control group); the discs were mounted in the CDC biofilm reactor adding broth of yeast-dextrose-peptone (YPD) sterile culture inoculated with S. aureus in a cell suspension (5 × 10(8) cells/ml). The specimens were evaluated at different times (6, 12, 24, 48, 72 h) and stained with the Live/Dead Bacterial Viability Kit (Invitrogen) for observation, analysis, and quantification with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). The results showed that as evaluation time passed an increasing of S. aureus biofilm formation was observed in the control group, in the experimental group, a statistically significant biofilm inhibition was observed with respect to the AuNPs uncoated specimens (p ≤ 0.05) and showed a ratio of almost 4:1 viable/nonviable in the biofilm of the uncoated surfaces, with a difference > 5 Log(10) in the CFU counts. The PE with AuNP coating showed an inhibitory effect on the biofilm formation of S. aureus.

The present study assessed cytotoxicity, cell adhesion, and apoptotic gene expression in periodontal ligament fibroblasts (PLF) treated with 2 endodontic sealers.PLF cells were obtained from nonerupted third molars and cultured. MTS and LIVE/DEAD assays were performed using different treatments and time periods. Cellular adhesion was evaluated using immunocytochemistry for integrin β1 and vinculin expression, and the gene expressions of nuclear factor kB (NF-кB), P53, and apoptotic protease-activating factor 1 (Apaf-1) were evaluated using PCR.Cell proliferation at 12, 24, and 48 h was statistically significant in the control and PLF groups receiving different treatments; PLF treated with culture medium containing non-hardened (NH) sealers showed a decrease in the number of cells. PLF treated with culture medium containing hardened (H) sealers also exhibited a decreased cell population. Integrin β1 and vinculin were expressed in both cell cultures treated with Acroseal (NH and H); however, the cell morphology changed and the cell population decreased. The gene expression of NF-kB and that of P53 were significantly different between the control group and the groups treated with the different sealers; mineral trioxide aggregate (MTA) (NH and H) inhibited Apaf-1, and PLF treated with Acroseal H exhibited increased Apaf-1 expression.Both sealers showed a certain level of cytotoxicity. The gene expression of NF-κB and P53 in PLF treated with the sealers showed significant changes compared to that of the control group, and MTA inhibited Apaf-1.

Background Pediatric oral hemangiomas are benign vascular tumors that can be seen from birth, particularly in females. Hemangiomas are most frequent located in the lips and usually regress spontaneously, thus they do not require any type of treatment in most cases. The present scoping review pretended to synthesize the most relevant and currently available information from the international dental literature published in the last 25 years, regarding the management of pediatric oral hemangiomas. Material and Methods An exhaustive literature search was performed in four electronic databases (PubMed, Embase, Google Scholar, and Cochrane). Initially, 241 related titles and abstracts were found. After the duplication removal, screening, and assessment processes, 37 records were included for full-text reading. Finally, 20 articles in the English language were included in the scoping review for data extraction and assessment. Results We identified and subsequently discussed three fundamental issues associated to the management of pediatric oral hemangiomas: (i) clinical characteristics, differential diagnosis, and histopathological findings; (ii) evolution and complications; and (iii) current available treatment modalities. Conclusions Although these like-tumor lesions are uncommon, pediatric dentistry practitioners must be familiar with the inherent clinical characteristics, diagnosis approaches, and currently available treatment options. Nowadays, surgical removal and non-invasive medical/pharmacologic therapies are the best management modalities for pediatric oral hemangiomas. Key words:Vascular tumors, hemangioma, oral management, children, scoping review.

Background The objective of this study was to describe the bacterial communities associated with pediatric patients with endodontic infections of temporal teeth by targeting the 16S rRNA gene using pyrosequencing. Material and Methods Microbiological samples were obtained from the lower primary molars of thirteen 13 pediatric patients with dental infections. An aspiration method for microbiological sampling was used. The identification of microbiota employing the pyrosequencing method by targeting the 16S gene was performed. Results Ribosomal 16S RNA gene sequences were amplified, obtaining a total of 16,182 sequences from 13 primary infected molars (13 different individuals) by pyrosequencing. Bacteroidetes phyla (35.15%) were the most abundant followed by Firmicutes (33.3%) and Fusobacteria (10.05%); the presence of specific pathogenic bacteria was determined as well. Conclusions The infected root canal of primary teeth contains a high diversity of anaerobic bacteria, and Bacteroidetes, Firmicutes, and Fusobacteria phyla were the most abundant; Prevotella and Streptococcus genera were the most prevalent. Key words:Pyrosequencing, deciduous teeth, oral bacterial microbiota, 16S rRNA, taxonomy.

Pediatric clinical research on new drugs and biomaterials involves children in order to create valid and generalizable knowledge. Research on vulnerable populations, such as children, is necessary but only admissible when researchers strictly follow methodological and ethical standards, together with the respect to human rights; and very especially when the investigation cannot be conducted with other population or when the potential benefits are specifically for that age group. Clinical research in Pediatric Dentistry is not an exception. The aim of the present article was to provide the bioethical principles (with respect to the child/parents' autonomy, benefit/risk analysis, and distributive justice), and recommendations, including informed consent, research ethics committees, conflict of interest, and the “equipoise” concept. Current and future worldwide oral health research in children and adolescents must be conducted incorporating their perspectives in the decision-making process as completely as possible. This concept must be carefully considered when a dental clinical study research is going to be planned and conducted, especially in the case of randomized controlled trials, in which children will be recruited as participants.

Objective: The objective of this study was to evaluate the effects of pit and fissure sealant mixed with silver nanoparticles on dental caries, by means of monthly measurement of fluorescence with DIAGNOdent over six months. Study Design: This study was divided in two phases: experimental and clinical. In the experimental phase, the adhesion and microleakage of the pit and fissure sealant experiment were evaluated. Two groups of 10 teeth, without serious carious lesions, were included. Conventional (group A) and silver nanoparticles (group B) were added to the pit and fissure sealant. For the clinical phase, a split-mouth study was performed on 40 children aged 6-10 years old with healthy, erupted permanent first molars. A conventional pit and fissure sealant or a silver nanoparticle-mixed sealant was randomly placed. Repeated measures analysis was performed. Results: Conventional sealant presented an average microleakage of 30.6%, and the silver nanoparticle-mixed sealant showed 33.6% (P=NS). A three times greater reduction in fluorescence was found in the silver nanoparticles group compared to the conventional group (P

Objective: The aim of the study was to determine the eugenol concentrations at which toxicity occurs in human dental pulp fibroblasts of primary teeth. Study design: Samples of primary dental pulp tissue were taken. Tissue samples were seeded by means of explant technique and used in the 4th–5th pass. Single Cell Gel Electrophoresis (Comet), phenazine MeThoSulfate (MTS), LIVE/DEAD® Cell Viability/Toxicity and trypan blue assays for evaluation of the cytotoxicity of increasing concentrations of eugenol (0.06 to 810 μM) were performed. Results: The results of toxicity tests showed toxic effects on dental pulp fibroblasts, even at very low concentrations of eugenol (0.06 μM). Very low concentrations of eugenol produce high toxicity in human dental pulp fibroblasts. Conclusions: All of the concentrations of eugenol that we evaluated produced high toxicity in human dental pulp fibroblasts of primary teeth.

The two aims of this article were to conduct a scoping review of current knowledge regarding laser treatment of ankyloglossia in children and to report a case of a male paediatric patient with ankyloglossia treated with laser surgery.A comprehensive literature search was carried out on the following electronic databases: PubMed; Embase; Google Scholar; The Cochrane Library, and Dentistry and Oral Science Source (EBSCO).The initial search identified 278 references. After the process of title/abstract screening, 61 articles received a full-text reading; finally, 17 articles were selected. According to this scoping literature review, lingual frenulectomy managed with laser surgery provides a more efficient and comfortable treatment for both the paediatric patient and the dentist compared with conventional scalpel/blades/suturing techniques. Nevertheless, further high-quality studies on the clinical efficacy of laser devices for lingual frenulectomy in paediatric populations are required.Early diagnosis and treatment of ankyloglossia are fundamental for the adequate functional oral development of paediatric patients. Laser surgery for lingual frenulectomy provides a more efficient and comfortable treatment for both the child and the paediatric dentist compared to traditional scalpel/blade methods.

In order to include appropriate informed decisions on dental therapeutic or preventive procedures in children, Pediatric Dentists should apply the fundamentals of “Evidence-Based Dentistry” (EBD). This oral health approach assists clinicians in understanding and applying the most relevant research published on evidence in the clinical setting when treating their patients. One of the crucial steps of EBD is to critically appraise and use the primary articles about therapy or prevention, namely, Randomized Clinical Trials (RCT), the study design that best addresses the questions related with these clinical areas. The aim of the present paper was to provide the basic concepts and an example of how to critically read and understand articles on RCT studies in Pediatric Dentistry employing the CONSORT statement, a process that involves assessing the reliability of results, risk of bias (internal validity), and applicability of reported clinical findings (external validity).

Objective.The present study aimed to compare levels of matrix metalloproteinase-9 (MMP-9) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) from subjects with controlled and noncontrolled Type 2 Diabetes Mellitus (T2D), with and without stage 2 grade B periodontitis (POD2B) versus healthy (H) subjects.Methods.The levels of both enzymes, from 80 GCF samples collected with PerioPaper strips, were analyzed by a Multiplex/Luminex assay. Five groups were formed, all current patients at the Institutional Dentistry Service, and distributed as follows: two groups of diabetics (one controlled and one poorly controlled); two groups with the previous conditions and diagnosed with POD2B; and one H group.Results.The highest concentration of MMP-9 corresponded to the H group, while the lowest corresponded to the T2D controlled group. Regarding MPO levels, the highest levels were associated with the T2D controlled with POD2B group and the lowest with the T2D controlled group.Conclusions.No apparent relationship between the elevation of MMP-9 and MPO levels was observed among subjects with T2D, with and without POD2B, compared to H subjects.

A case report is a useful type of publication to describe information on unusual clinical diseases or syndromes, new management techniques, potential risk factors/oral disease associations, and uncommon side effects or responses to traditional dental treatments. In the practice of Dentistry and Medicine, the publication of case reports has the purpose of sharing new clinical experiences and knowledge with interested colleagues. Case reports in the field of Evidence-Based Pediatric Dentistry convey unique contributions to the clinical practice and help improve the process of clinical decision making in the form of a brief written communication. Additionally, case reports are potential resources of new hypotheses for more complex methodological designs in clinical research studies and are one of the best ways to get started in scholarly writing. The purposes of the present report were to comment on the role, relevance, and main limitations of case reports in Clinical Pediatric Dentistry, to describe the reasons for writing a case report and some recommendations for critically reviewing a published case report, and finally, to provide the fundamentals of preparing a case report, and finally, to provide the fundamentals of preparing a case report manuscript in a structured manner.

OBJECTIVE To summarize the clinical/radiographic outcomes from the evidence of studies published since 1988 on different DPC agents applied on vital pulp-exposed primary teeth. METHODS The following electronic databases were searched: PubMed, Embase, Cochrane Library, Dentistry and Oral Science Source, and Google Scholar. Inclusion criteria were randomized controlled trials (RCTs) published between January 1988 and December 2019, with at least 6 months of follow-up, comparing the clinical and radiographic success rates of two or more DPC agents applied in primary teeth with cariously and non-cariously exposed pulp. RESULTS Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Sixty-four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. Finally, 12 of these articles were included in the systematic review. Low and moderate risks of bias were observed. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. CONCLUSIONS For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. There is no evidence that justifies discarding the judicious use of DPC procedures in primary teeth.

This study aimed to identify the aerobic and anaerobic causal microorganisms of odontogenic infections and their antibiotic sensitivity. Purulent exudates were taken from patients with odontogenic infections by transdermal puncture, and aerobic and anaerobic microorganisms were identified using biochemical tests. Susceptibility to antibiotics was tested using the Kirby-Bauer method; the inhibition halos were measured according to NCCLS, and based on the results, the microorganisms were classified as susceptible, intermediate or resistant to each antibiotic. Frequencies of species and percentages of resistance were calculated. The microorganisms associated with odontogenic infections were principally anaerobic (65.3% anaerobic vs. 35.7% aerobic), and the susceptibility to antibiotics was higher in anaerobic than in aerobic microorganisms. The majority of isolated microorganisms (82%) showed susceptibility to amoxicillin/clavulanic acid. The causal agents of odontogenic infections were anaerobic microorganisms, which exhibited high resistance to antibiotics.

To perform a systematic review of articles related to the clinical efficacy of topical fluoride varnishes/gels, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and other remineralisation agents of white spot lesions (WSL) in primary teeth.Electronic and manual searches were conducted through diverse electronic databases. The search was limited to randomised, clinical, controlled trials, and quasi-experimental papers in full-text version. Suitable individual studies were evaluated through a previously reported quality system, their data extracted and carefully analysed.The search identified 298 citations, and 95 were chosen and reviewed in full text. Nine relevant citations met the eligibility criteria for inclusion in the systematic review. Pair comparisons were made between fluoride varnishes, CPP-ACP, dental lasers, and control interventions.Clinicians are encouraged to discuss more high-quality studies in order to provide sufficient evidence and to confirm the clinical utility of remineralisation agents of WSL in primary teeth.

The aim of this study was to compare the efficacy of preoperative and postoperative dexketoprofen trometamol for pain control after third molar surgery. Sixty subjects indicated for impacted mandibular third molar surgery were randomly assigned to two groups: preoperative (group 1, n = 30) and postoperative (group 2, n = 30) administration. Group 1 received 25 mg of dexketoprofen trometamol 30 min before surgery and 1 placebo capsule (same color and size with active drug) immediately after surgery. Group 2 received the placebo capsule 30 min before surgery and 25 mg of dexketoprofen trometamol immediately after surgery. Pain intensity was assessed using a numeric rating scale (NRS) during the first 8 h. The time of the need for a second dose of dexketoprofen trometamol, after the first administration, was recorded. The data were analyzed using mixed-model repeated-measures (MMRM), Wilcoxon rank-sum, and Kaplan–Meier analysis. After the 8 h period, no statistically significant difference was observed in the intensity of pain (MMRM, p = 0.41); and no significant difference in the time for a second dose (p = 0.956). In conclusion, preoperative administration of dexketoprofen trometamol is a reasonable clinical approach that is as effective as conventional postoperative pharmacological treatment, with the advantage of allowing early analgesia before pain develops. (ClinicalTrials.gov: NCT02380001 ).

Objective: The purpose of the present study was to evaluate the clinical and radiographic effectiveness of zinc oxide–eugenol (ZOE) as the only pulp capping agent in pulpotomies carried out on decayed primary molars after a follow-up period of 24 months. Study design: In total, 60 pulpotomies were performed on 38 patients aged 3 to 11 years. Pulpotomy treatment consisted of the removal of the coronal pup tissue, subsequent hemostasis, irrigation with saline solution, drying and pressure with sterile cotton pellets, and placement of a thick regular ZOE base with a minimal amount of eugenol directly over the vital radicular pulp. Additionally, a histopathologic study was carried out on some of the molars treated. Results: After a 24-month follow-up, we considered 51 procedures to be successful and 9 failures using clinical and radiographic criteria; most of the failures occurred between the 12th and 18th month. Conclusions: Results suggest that the proposed pulpotomy treatment with ZOE as the only capping agent may be considered as an alternative technique in the pulp treatment of primary molars.

Objective To conduct a systematic review and meta-analysis to assess the findings on the clinical efficacy of intracanal irrigants employed during pulpectomy of primary teeth. Methods A systematic search was performed in electronic databases and peer-reviewed paediatric dentistry journals to find relevant studies. Titles, abstracts, and full-text papers were located, screened, and assessed independently by two reviewers, and a meta-analysis was performed. Results The search identified a total of 775 records; 46 were selected and reviewed in full text. After screening, seven studies met the eligibility criteria for inclusion. Three studies compared the 2% chlorhexidine and saline solutions, but no analysis could be performed because of the heterogeneity between these; two of the studies reported non-comparative methodologies and results when compared, and were not analysed. Finally, two studies compared a mixture of tetracycline isomer, an acid, and a detergent (MTDA) or oxidative potential water (OPW) to sodium hypochlorite (NaOCl), without showing significant heterogeneity; therefore, their combined outcomes were included. Both fixed and random mixed models resulted in a non-significant weighted mean difference between treatments, according to a forest plot. Conclusions More studies are required with adequate quality, as well as a full-result report, including summary measurements of both response variables and effect size, to determine the most effective irrigant agents for use in pulpectomies.

Background and Objective.Pain evaluation in children can be a difficult task, since it possesses sensory and affective components that are often hard to discriminate. Infrared thermography has previously been used as a diagnostic tool for pain detection in animals; therefore, the aim of this study was to assess the presence of temperature changes during dental extractions and to evaluate its correlation with heart rate changes as markers of pain and discomfort.Methods. Thermographic changes in the lacrimal caruncle and heart rate measurements were recorded in healthy children scheduled for dental extraction before and during the procedure and compared. Afterwards, correlation between temperature and heart rate was assessed.Results. We found significant differences in temperature and heart rate before the procedure and during the dental extraction (mean difference 4.07°C,p<0.001, and 18.11 beats per minute,p<0.001) and no evidence of correlation between both measurements.Conclusion. Thermographic changes in the lacrimal caruncle can be detected in patients who undergo dental extractions. These changes appear to be stable throughout time and to possess very little intersubject variation, thus making them a candidate for a surrogate marker of pain and discomfort. Future studies should be performed to confirm this claim.

Objectives The aim of this study was to evaluate the putative association between the presence of the COL1A2 gene A/C polymorphism and the severity of dental fluorosis in a sample exposed to high concentrations of fluoride. Methods A cross-sectional study was carried out that included 80 children residing in a community with high concentrations of fluoride in the drinking water. To determine whether the presence of this polymorphism and dental fluorosis are associated, the presence of the dental fluorosis was considered to be a response variable, while fluoride concentration in water and urine was designated as independent variables. In addition, the children's parents completed questionnaires with general information about drinking and cooking with tap water, consumption of milk and soft drinks, and other putative risk factors. Results Individuals with the polymorphism had nonsignificant odds (OR = 2.24; 95% CI = 0.55–9.02) of having dental fluorosis at higher exposures to fluoride. This finding was similar in individuals without the polymorphism (OR = 1.65; 95% CI = 0.44–6.17). Conclusions The presence of polymorphism in the COL1A2 gene was not associated with the severity of dental fluorosis.

Oral mucositis (OM) is a painful and inflammatory ulcerative lesion occurring as an adverse effect during chemotherapy in children with acute lymphoblastic leukemia (ALL). This condition may cause significant systemic anomalies such as malnutrition, opportunistic infections, and delay in the chemotherapy course. This report aims to describe a case series of 11 ALL patients treated with methotrexate as chemotherapy agent.Each patient was carefully followed-up and orally examined for 14 days after their chemotherapy session. OM occurred in all children. Then, the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO) management protocol for OM was applied to them. The mean time of the lesion total resolution was 3.7 days.It is necessary to emphasise the importance of early detection of OM through a close clinical oral examination of children and adolescents with ALL undergoing methotrexate chemotherapy. Pain/infection control and the maintenance of good levels of oral hygiene are fundamental during the management of OM. Therefore, paediatric dentists need to be part of the oncology care team, and thus contributing and helping with ALL treatment.

To perform a scoping review of the existing literature in order to gather the most relevant information in the paediatric dentistry field related to the oral management of children affected by Henoch-Schönlein Purpura and associated Glomerulonephritis (HSPG).Using scoping review methodology for the screening and selection of valid articles, the steps of this review were the following: first, to pose a research question; second, to identify relevant studies; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarise, and report the results from the included articles. Relevant articles published over a 25-year period, up to July 31, 2017, were identified and retrieved from four Internet databases: PubMed; EMBASE/Ovid; Ebsco/DentistryOral Science Source, and the Cochrane Collaboration Library.By title and abstract screening and after removing duplicates, four articles were finally included in the scoping review. According to the extracted data, the following are the most important clinical issues to be considered: (1) the disease can appear as a consequence of a dental treatment, such as those indicated for oral infectious processes; (2) children with HSPG are highly susceptible to dental caries and apical periodontitis, and (3) in affected children, oral infectious foci must be exhaustively eradicated in order to avoid the dissemination of the infection.Paediatric Dentists should be aware of HSPG, because the disease can be triggered or worsen subsequent to dental treatment. Adequate treatment of oral active infectious processes, together with an exhaustive oral preventive programme and long-term patient screening, are the best management approaches for children with HSPG.

Background: Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as Tracheo-Esophageal Fistula (TEF). Case report: A 7-year-old male with TEF referred by a Pediatric Cardiologist, with the principal complaint of “severe and generalized tooth wearing”. Considering that the patient was systemically stable, it was decided to perform the oral procedures under local anesthesia and rubber-dam isolation with an antimicrobial prophylaxis regimen. The treatment consisted of the extraction of all maxillary primary incisors and canines and both first molars; in the mandibular arch, only the lower second right molar was extracted, and a distal shoe was placed. Pulpotomies were performed and preformed metallic crowns were placed on the remaining second primary molars, on both lower first molars, and on lower canines and lateral incisors. Finally, a fixed prosthesis was positioned in the upper arch, and cemented through orthodontic bands adapted to both crowned second molars. The patient has been maintained under close medical and dental control. The child showed satisfactory oral conditions, and the vomiting episodes had decreased significantly. Conclusions: Dentists can learn and then participate in the integral health management of infants and young children affected with EA/TEF, particularly those with dental erosion.

Introduction. Factors that contribute to swelling and trismus are complex, and they are originated by surgical trauma. The aim of the present study was to determine whether clinical and radiographic factors could predict the level of swelling and trismus after lower third molar surgery, through longitudinal approach. Methodology. A prospective longitudinal trial was carried out. Forty-five patients of both genders with clinical and radiographic diagnosis of asymptomatic mandibular impacted third molar and with no intake of analgesic or anti-inflammatory drugs 12 h prior to surgery were recruited and evaluated in a 72 h follow-up period. A mixed repeated measures model and backward and restricted maximal likelihood methods were used to analyze the data. Results. Male gender, body mass index (BMI), the relation to the lingual and buccal walls, and age were determinants for predicting postoperative swelling and for exerting a significant influence (P<0.05). Conclusions. This study suggests the association of male gender, the relation to lingual and buccal walls, BMI, and age with measurement of swelling.

AIM To evaluate the effectiveness of a Video Eyeglasses/Earphones System (VEES) as distracting device in reducing anxiety in children during dental procedures carried out under local anaesthesia.In this crossover clinical trial, 36 Frankl scale II and III children aged 5-8 years received different dental procedures in two sessions, with and without the VEES system. In the control visit, they were not exposed to this distraction stimulus, but traditional non-aversive behaviour management was applied. Each dental session was divided into four phases (explanation, anaesthetic injection, rubber-dam/clamp placement, and high-speed hand piece work for 5 min). Pain in each treatment phase was assessed by the following measurements: the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Pulse rate, and oxygen saturation measurements were employed to evaluate the state of anxiety. Comparison of the outcomes of two interventions were statistically analysed through the Wilcoxon Signed-rank Test.There were no statistical differences between the results of the two interventions (VEES vs. no VEES/behavioural management) during the four treatment phases on assessment by any of the measurements employed.The VEES method was not more effective than traditional non-aversive behavioural techniques for reducing anxiety and pain perception in children undergoing dental treatment.

This study evaluated the influence in the biocompatibility of human periodontal ligament (hPDL) mesenchymal stromal cell onto poly lactic-acid (PLA) films and PLA fiber membrane. Fiber scaffold was prepared via air jet spinning (AJS) from PLA solutions (6, 7, and 10%) and analyzed using SEM, AFM and FTIR. Biocompatibility was evaluated by adhesion, proliferation and cell-material interaction. PLA film exhibited a smooth and homogenously surface topography in comparison with random orientation of PLA fiber with roughness structure where diameter size depends on PLA solution. Moreover, cell adhesion; proliferation and cell-material interaction has the best respond on random orientation nanofiber of 10, followed by 7, and 6% of PLA in comparison with PLA films. It could be concluded that AJS is an attractive alternative technique for manufacture fiber scaffolds with a tunable random orientation geometry of fibers that allow to produce interconnected porous formed by nanometric fiber diameter structures that could be a potential scaffold for periodontal tissue engineering applications.

Background Craniosynostosis (CS) is a complex condition consisting of the early fusion of one or more cranial sutures in the intrauterine stage. The affected infant exhibits abnormal head shape at time of birth or shortly thereafter. It can be observed in normal individuals (non-syndromic CS or NSCS) or as a part of a multisystem syndrome. The purposes of the present article were to carry out a scoping review on Non-Syndromic CS and to discuss the most important findings retrieved. Material and Methods The steps of this scoping review were as follows: first, to pose a research question; second, to identify relevant studies to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles. Relevant articles published over a 20-year period were identified and retrieved from five Internet databases: PubMed; EMBASE; Cochrane Library; Google Scholar, and EBSCO. Results Fourteen articles were finally included in the present scoping review. The following four most important clinical issues are discussed: (i) normal cranial development, clinical manifestations, and pathogenesis of NCSC; (ii) clinical evaluation of NCSC; (iii) treatment and post-surgical follow-up; and (iv) additional considerations. Conclusions NSCS may be present with associated head shapes. Multiple early surgical reconstructive options are currently available for the disorder. Pediatric Dentistry practitioners must be familiarized with this condition and form part of a multi-approach health team as those responsible for the opportune oral health care of the affected child. Key words:Craniosynostosis, cranial development, children, scoping review, dental management.

The purpose of this study was to evaluate the clinical and radiographic outcomes of a bioactive tricalcium silicate [Ca3SiO5]-based dentin substitute and a light-activated calcium hydroxide [Ca(OH)2]-based liner as indirect pulp treatment (IPT) interventions for vital primary molars with carious lesions approaching the pulp.Eighty children, aged four to eight years old, with 160 bilateral primary teeth without signs or symptoms of irreversibly inflamed or degenerative pulp tissue were treated in a split-mouth design trial comparing IPT using Ca3SiO5 or Ca(OH)2. The teeth were treated and restored with a preformed crown in a single session and assessed clinically and radiographically for one, three, six, and 12 months.Sixty patients with 120 treated molars completed the 12-month evaluations. The combined clinical and radiographic success rates were 98.3 percent (59 out of 60) for Ca3SiO5 and 95 percent for Ca(OH)2 (57 out of 60). No significant differences were found for success rates between the two study groups (P0.05). The combined success rates for both groups was 96.7 percent.These results suggest that the indirect pulp treatment procedure with either a bioactive Ca3SiO5-based dentin substitute or a Ca(OH)2-based material may be considered a suitable treatment to achieve acceptable therapeutic results when applied on deeply carious primary teeth without degenerative symptoms.