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The present report describes the management of a radicular cyst in a 5-year-old child. The treatment comprised extraction of the primary teeth involved followed by marsupialization. A removable appliance with a resin extension penetrating into the cystic cavity was used to help decompress the lesion. This treatment allowed rapid healing of the lesion and eruption of the permanent incisors without the need for orthodontic treatment. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth., Materials and Methods: The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations ( p < 0.05)., Results: The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts., Conclusion: A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations., Clinical Significance: Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment., How to Cite This Article: da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32., Competing Interests: Source of support: FAPESP (grant # 2012/19235-5), CNPq (grant #130717/2013-4) and CAPES (financial code #001). Conflict of interest: None, (Copyright © 2023; The Author(s).)

The present study aimed to evaluate the feasibility of developing low-cost N- and Fe-doped TiO 2 photocatalysts for investigating the mineralization of 2,4-dimethylaniline (2,4-DMA). With a single anatase phase, the photocatalysts showed high thermal stability with mass losses of less than 2%. The predominant oxidative state is Ti 4+ , but there is presence of Ti 3+ associated with oxygen vacancies. In materials with N, doping was interstitial in the NH 3 /NH 4+ form and for doping with Fe, there was a presence of Fe-Ti bonds (indicating substitutional occupations). With an improved band gap energy from 3.16 eV to 2.82 eV the photoactivity of the photocatalysts was validated with an 18 W UVA lamp (340-415 nm) with a flux of 8.23 × 10 -6 Einstein s -1 . With a size of only 14.45 nm and a surface area of 84.73 m 2 g -1 , the photocatalyst doped with 0.0125% Fe mineralized 92% of the 2,4-DMA in just 180 min. While the 3% N photocatalyst with 12.27 nm had similar performance at only 360 min. Factors such as high surface area, mesoporous structure and improved E bg , and absence of Fe peak in XPS analysis indicate that doping with 0.0125% Fe caused a modification in TiO 2 structure.

When the first cases of HIV infection appeared in the 1980s, AIDS was a deadly disease without any therapeutic alternatives. Currently, there is still no cure for most cases mainly due to the multiple tissues that act as a reservoir for this virus besides the high viral mutagenesis that leads to an antiretroviral drug resistance. Throughout the years, multiple drugs with specific mechanisms of action on distinct targets have been approved. In this review, the most recent phase III clinical studies and other research therapies as advanced antiretroviral nanodelivery systems will be here discussed. Although the combined antiretroviral therapy is effective in reducing viral loading to undetectable levels, it also presents some disadvantages, such as usual side effects, high frequency of administration, and the possibility of drug resistance. Therefore, several new drugs, delivery systems, and vaccines have been tested in pre-clinical and clinical trials. Regarding drug delivery, an attempt to change the route of administration of some conventional antiretrovirals has proven to be successful and surpassed some issues related to patient compliance. Nanotechnology has brought a new approach to overcoming certain obstacles of formulation design including drug solubility and biodistribution. Overall, the encapsulation of antiretroviral drugs into nanosystems has shown improved drug release and pharmacokinetic profile.

Objective: This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice., Design: Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100 ppm) dentifrice. The bleaching gels were applied thrice (40 min/session) at the intervals of 7 days between each application. After 21 days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined., Results: Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels., Conclusion: The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice., Clinical Relevance: The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.

Background: Dental trauma can determine the occurrence of sequelae in the deciduous tooth and due to the anatomical proximity to the germ of the successor permanent tooth, it frequently causes changes to the developing teeth., Aims: The objective of this study was to analyze clinically and radiographically traumatized primary teeth and permanent successors in children aged 0-8 years., Materials and Methods: Initially, a sample selection of medical records was made, designating the patients who fit the requirements; 247 patients were analyzed, totaling 379 traumatized primary teeth and 162 successive permanent teeth., Statistical Analysis: The results were developed using the Proportion Test and the Chi-square test at the 5% significance level., Results: Injuries to hard tissue prevailed (57%), with emphasis on coronary enamel fracture (49.1%). After clinical and radiographic examinations, 78% of traumatized primary teeth maintained pulpal vitality. At the clinical evaluation, the frequency of the developmental disorders observed in permanent successors was 10.5%, with enamel hypocalcification being the most common sequela. 17.3% of the clinical changes in the successor permanent teeth were caused by trauma to the supporting tissue, with the intrusive dislocation being responsible for the largest number of damages (37.5%)., Conclusion: Based on the results found, it was concluded that the trauma occurring in the primary dentition were recorded and monitored more precisely and about the evaluated successive permanent teeth, except for the prevalence of sequelae found, the other factors are in agreement with the findings in the literature., Competing Interests: None

The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2-3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher's LSD or Student-Newman-Keuls' tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing., (© 2020 S. Karger AG, Basel.)

Nimesulide (Nim) degradation in ultrapure water (UW) and municipal sewage (MS) via UV-ABC/H 2 O 2 was investigated. The variables included in the experimental design were time, initial Nim, and initial H 2 O 2 concentrations. Resulting decreases in Nim concentration (monitored by high performance liquid chromatography (HPLC) using a photodiode array detector operating at a maximum UV absorbance of 300 nm), mineralization (from total organic carbon (TOC) measurements), and ecotoxicity (assays employing the bioindicators Daphnia similis, Artemia salina, and Allium cepa) were also studied. Degradation rates of 90% or higher were found for 15-20 min reaction times, employing combinations of [H 2 O 2 ] = 50-150 mg L -1 and [Nim] = 8.5-15 mg L -1 prepared with MS. Mineralization rates of 70% and higher were attained within 60 min of reaction for [Nim] = 15 mg L -1 prepared in MS with [H 2 O 2 ] = 100 mg L -1 . Nim by-products were detected and possible degradation pathways proposed. Ecotoxicity evaluation using A. salina, D. similis, and A. cepa revealed that the treated samples had significantly lower toxicity. Exposure to treated samples resulted in survival rates of 79% for A. salina and over 90% for D. similis. No root growth inhibition was observed in A. cepa exposed to treated samples, whereas exposure to untreated samples inhibited root growth by 60%. Statistical analysis revealed elimination of cytotoxicity and reduction of genotoxicity against A. cepa. The results showed that the UV-ABC/H 2 O 2 process can be employed as a pre- or post-treatment method to remove Nim from contaminated wastewater., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: This study compared the clinical performance of glass ionomer cement (GIC) compared to composite resin (CR) in Class II restorations in primary teeth., Data: Literature search according to PRISMA guidelines including randomized controlled trials comparing Class II restorations performed with GIC, compared to CR, in primary teeth., Sources: PubMeb, Scopus, Web of Science, VHL, Cochrane Library, Clinical Trials and OpenGrey, regardless of date or language., Study: Ten studies were included in qualitative synthesis, and 9 in the meta-analyses (MA). Six studies were classified as low risk of bias, and 4 as "unclear". Heterogeneity ranged from null to high (0% to 73%). GIC and CR presented similar failure patterns (risk difference -0.04 [-0.11, 0.03]; p = 0.25, I 2  = 51%), and the exclusion of studies with follow-up period <24 months, or grouping according to the type of GIC (conventional or resin-modified), or according to the type of isolation (cotton roll or rubber dam), or according to the evaluation criteria applied did not affect the pattern of the results obtained. GIC exhibited significantly lower values of secondary carious lesions (SCL) than CR (SCL: risk difference 0.06 [0.02, 0.10], p = 0.008, I 2  = 0%). The materials presented similar performance (p > 0.05) regarding the overall effect, as well as for marginal discoloration, marginal adaptation and anatomical form. The superiority of GIC was maintained when resin-modified GIC and rubber dam isolation were analyzed separately., Conclusions: GIC and CR presented similar clinical performance for all criteria analyzed, except for secondary carious lesions, in which GIC presented superior performance, especially for the resin-modified GIC and with rubber dam isolation., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Introduction: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood., Aim: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers., Study Design: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits., Results: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens., Conclusion: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Objectives: This study evaluated the effect of conventional (CD, 1100ppm F) and low-fluoride (LFD, 550ppm F) dentifrices, applied in different quantities, on enamel demineralization, and on fluoride (F) concentrations in the dental biofilm formed in situ., Methods: Five combinations of dentifrices and quantities were tested: placebo (P-F-free) applied on all brush bristles; LFD applied by the transversal technique (0.3g-T1) or on all bristles (0.6g-T2); and CD applied in a pea-sized amount (0.15g-T3) or by the transversal technique (0.3g-T4), in order to produce comparable intensities (F concentration in the dentifrice×amount applied to the brush). Volunteers (n=13, 20-36 years old) wore palatal devices containing 4 bovine enamel blocks, and performed cariogenic challenges (30% sucrose solution) 6×/day, and brushing 3×/day, following a double-blind, cross-over and randomized protocol. On the 8th day, biofilm was collected 5 and 60min after brushing. The percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN) and biofilm F concentrations (solid and fluid phases) were determined. Data were analyzed by repeated-measures ANOVA, Student-Newman-Keuls test, and Pearson's correlation coefficient (p<0.05)., Results: Significantly lower ΔKHN was observed for treatments with higher intensity (T2 and T4) in comparison with the lower intensity (T1 and T3). A strong correlation was observed between ΔKHN and F concentrations in total biofilm (r=-0.71) and biofilm fluid (r=-0.72) 5min after brushing., Conclusions: The treatment intensity has a significant influence on the development of caries lesions in situ., Clinical Significance: The intensity of treatment (amount of dentifrice×concentration) during brushing seems to be a more relevant parameter of clinical efficacy than simply observing the F concentration of the product. The use of a small amount of CD significantly reduced the protective effects against enamel demineralization., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: This study evaluated the effects of fluoride varnishes containing sodium trimetaphosphate (TMP) on bovine enamel demineralization in vitro., Material and Methods: Enamel bovine discs were randomly assigned into six groups (n = 20/group): placebo, 2.5% NaF, 2.5% NaF/5% TMP, 5% NaF, 5% NaF/5% TMP, and a commercial formulation (Duraphat, 5% NaF). Varnishes were applied on all enamel discs and kept for 6 h. Loosely and firmly bound fluoride formed on/in enamel after treatment were analyzed in 10 discs from each group. The other 10 discs were subjected to a pH-cycling regimen for 7 days, and analyzed for surface (SH) and cross-sectional hardness (ΔKHN), as well as for loosely and firmly bound fluoride in/on enamel. Data were analyzed by analysis of variance (ANOVA) followed by Student-Newman-Keuls' test (p < .05)., Results: The lowest SH change and ΔKHN were observed for the 5%NaF/5%TMP varnish, which was significantly different from all the other groups. Both fluoridated varnishes containing TMP promoted significantly lower SH change and ΔKHN when compared with their counterparts without TMP. Loosely and firmly bound fluoride was significantly lower in groups treated with varnishes containing TMP., Conclusion: TMP and fluoride added to varnishes have a synergistic effect against enamel demineralization in vitro.

Introduction: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood., Aim: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers., Study Design: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits., Results: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens., Conclusion: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Purpose: This study evaluated fluoride (F) concentrations in saliva of children after brushing with dentifrices containing different F concentrations (zero, 550, and 1,100 ppm F) in different quantities (full bristles, transversal technique, and pea-sized)., Methods: Eight- to 10-year-old volunteers (N=24) were randomly assigned into nine experimental groups (dentifrice type versus amounts) following a double-blind, crossover protocol. After a one-week washout period (use of placebo toothpaste), stimulated saliva was collected prior to toothbrushing (baseline) and at five, 15, 30, 60, and 120 minutes after toothbrushing with one of the possible combinations. Centrifuged saliva was used for F analysis after buffering with TISAB III. Data were submitted to repeated-measures ANOVA followed by Student-Newman-Keuls' test (P<0.05)., Results: Salivary F peaked at five minutes after brushing, decreasing exponentially afterward. A clear dose-response relationship was seen between F concentration/amount of dentifrice applied and the mean area under the curve (AUC) of salivary F concentrations (P<0.001). The low-fluoride toothpaste applied using transversal technique or full bristles led to a significantly higher AUC than the conventional toothpaste using a pea-sized amount., Conclusions: Brushing with a low-fluoride toothpaste applied using the transversal technique delivers more fluoride to saliva compared to a conventional toothpaste in a pea-sized amount.

This in vitro study investigated the effect of sodium trimetaphosphate (TMP), added to toothpaste containing 250 p.p.m. fluoride, on enamel demineralization. Bovine enamel blocks (n = 96) were subjected to five pH cycles over a 7-d period and treatment with suspensions of toothpastes containing 0, 250, 500, and 1,100 p.p.m. fluoride (as sodium fluoride), as well as with 250 p.p.m. fluoride containing TMP at 0.25, 0.5, 1.0, and 3.0%. Treatment with toothpaste suspensions was performed under agitation twice a day, for 1 min. Surface and cross-sectional hardness, and fluoride firmly bound to enamel, were quantified. Data were subjected to one-way anova, followed by Tukey's test. Low-fluoride toothpastes containing TMP at 0.25-1.0% resulted in enamel mineral loss similar to that seen for the toothpaste containing 1,100 p.p.m. fluoride. Also, the addition of TMP to the toothpaste containing 250 p.p.m. fluoride promoted enamel fluoride concentrations similar to those obtained for the 500 p.p.m. fluoride group. The toothpaste containing 250 p.p.m. fluoride and 0.25% TMP led to the lowest mineral loss among all groups. It was concluded that the addition of as little as 0.25% TMP to a toothpaste containing 250 p.p.m. fluoride can reduce enamel demineralization to levels similar to those seen for a conventional toothpaste containing 1,100 p.p.m. fluoride, in vitro., (© 2016 Eur J Oral Sci.)

Unlabelled: Low-fluoride dentifrices (LFD) have been recommended for young children aiming to minimize excessive fluoride intake during tooth brushing. Given the uncertainties surrounding the clinical efficacy of such formulations, alternatives to increase their anticaries effect have been investigated., Objectives: This double-blind, randomized controlled trial assessed the clinical efficacy of LFDs supplemented with Calcium Glycerophosphate (CaGP) or Sodium Trimetaphosphate (TMP) on the progression of dental caries in the deciduous dentition., Methods: Children (average age 48 months old) from two Brazilian cities (Araçatuba and Fernandópolis) were randomly assigned into 3 groups, according to the dentifrice to be used: 500ppm F plus 1% TMP ("500TMP", n=206), 500ppm F plus 0.25% CaGP ("500CaGP, n=201) and 1100ppm F ('1100F', n=193). Clinical exams (dmfs) were performed at baseline and 18 months after dentifrices started to be used, and the increment in the number of carious lesions (final dmfs - initial dmfs) was calculated. Data were analyzed by multivariate linear regression analysis to verify the influence of city, gender, previous caries experience and type of dentifrice on dmfs increment (p<0.05)., Results: Mean caries increment observed for 500TMP (0.26) was significantly lower when compared with 1100F (0.74), while values found for 500CaGP (0.54) were not significantly different from 1100F. Caries increment was significantly higher in children from Araçatuba and in those with previous caries experience., Conclusion: The results indicate that clinical efficacy of LFDs supplemented with TMP is superior to that observed for a conventional formulation (1100F), while the addition of CaGP leads to similar efficacy when compared to 1100F., Clinical Significance: Children brushing with 500ppm F toothpastes containing phosphate salts developed fewer caries lesions when compared with those using a 1100ppm F dentifrice. The tested toothpastes can be regarded as a safe alternative to conventional formulations for children under 6 years of age, based on risk-benefit considerations., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the effect of a low-fluoride (F) toothpaste supplemented with sodium trimetaphosphate (TMP) on enamel remineralization in situ., Design: Bovine enamel blocks were selected on the basis of their surface hardness (SH) after caries-like lesions had been induced, and randomly divided into 4 treatment groups, according to the toothpastes used: without F or TMP (placebo); 500 ppm F; 500 ppm F plus 1% TMP; and 1,100 ppm F. The study design was blinded and crossover and performed in 4 phases of 3 days each. Eleven subjects used palatal appliances containing 4 bovine enamel blocks which were treated 3 times per day during 1 min each time, with natural slurries of saliva and toothpaste formed in the oral cavity during toothbrushing. After each phase, the percentages of surface (%SHR) and subsurface hardness recovery (%ΔKHNR) were calculated. F, calcium (Ca), and phosphorus (Pi) contents in enamel were also determined. Data were analyzed by 1-way, repeated-measures ANOVA, followed by the Student-Newman-Keuls test (p < 0.05)., Results: Toothpaste with 500 ppm F + TMP and 1,100 ppm F showed similar %SHR and %ΔKHNR as well as enamel F, Ca, and Pi concentrations., Conclusion: The addition of TMP to a low-fluoride toothpaste promoted a similar remineralizing capacity to that of a standard (1,100 ppm F) toothpaste in situ., (© 2016 S. Karger AG, Basel.)

Molar incisor hypomineralization (MIH) is a defect in the tooth enamel of systemic origin and may affect one or all four first permanent molars frequently associated with the permanent incisors. This case reports a 7-year-old child with severe MIH in the permanent molars associated with tooth decay and intense pain. In the first stage of treatment, therapy was performed with fluoride varnish and restoration with glass ionomer cement (GIC). After 6 years of clinical and radiographic follow-up, the restorations presented wear and fractures on the margins, indicating their replacement with composite resin. Severe cases of MIH in the early permanent molars can be treated with varnish and GIC to restore the patient's comfort and strengthen the hypomineralized dental structures. The clinical and radiographic monitoring frequently indicated when the restoration with composite resin should be performed.

Objectives: This study aimed to evaluate the fluoride concentration in the fingernails and toenails of children aged 18-30 months during use of fluoride-containing toothpastes supplemented with calcium glycerophosphate (CaGP) or sodium trimetaphosphate (TMP)., Methods: According to the toothpaste used, children (n = 56) were randomly assigned into three groups: 500 μg F/g with 1% TMP, 500 μg F/g with 0.25% CaGP, and 1100 μg F/g. Fingernails and toenails were collected monthly over a period of 330 days, from the beginning of toothpaste use. Fluoride concentration in the water consumed by the volunteers and fluoride intake from diet and toothpaste were also determined. Fluoride analyses were performed with the electrode after hexamethyldisiloxane-facilitated diffusion or by the direct method, according to the samples. Data passed normality and homoscedasticity tests and were analyzed by 2-way analysis of variance (anova) and 1-way anova followed by Student-Newman-Keuls test (P < 0.05)., Results: Fluoride levels in the fingernails and toenails as well as fluoride intake from toothpaste were similar for the groups treated with 500 μg F/g with 1% TMP and 500 μg F/g with 0.25% CaGP toothpastes, but significantly lower than the 1100 μg F/g group (P < 0.05). No significant differences were noted among the groups regarding fluoride intake from diet and that by water consumed by the volunteers (P > 0.05)., Conclusion: The results of the longitudinal study suggest that the level of fluoride present in nails was lower with the use of toothpastes with a low fluoride concentration., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Condyloma acuminata caused by human papilloma viruses, (HPV) is a sexually transmitted disease (STD) appearing most frequently as soft, pink cauliflower like growths in moist areas, such as the genitalia, mouth and other places. The disease is highly contagious, can appear singly or in groups, small or large. In children, the isolation of a sexually transmitted organism may be the first indication that an abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist., Case Presentation: The authors report the clinical case of a five-year-old Caucasian male with lesions located in the dorsal surfaces of the posterior tongue and palate. Both lesions had a firm consistency, reddish appearance and presence of whitish areas and regions of ulceration. During the interview, the mother reported that the boy had been sexually abused., Conclusion: Sexually transmitted disease may occur during sexual abuse. Dentists as well as pediatricians have a role to play in identifying and treating these children. The diagnosis is essentially clinical (anamnesis and physical examination), but also the use of cytology eventually resorts to biopsy of the suspicious lesions for histological examination. The therapeutic option was the excision of the lesions.

Purpose: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience., Materials and Methods: Eighty children, aged 6-8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months., Results: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent., Conclusion: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience.

Background: Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged., Case Presentation: The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted., Conclusion: This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Background: Generalized aggressive periodontitis (GAP) in primary teeth is a rare periodontal disease that occurs during or soon after eruption of the primary teeth. An association with systemic diseases is a possibility., Case Report: A 4-year-old Brazilian girl presented with GAP involving the entire primary dentition. The patient and her parents and sister were subjected to microbiological testing to identify the microorganisms involved in the disease. The patient underwent tooth extraction to eradicate the disease and received a prosthesis for the restoration of masticatory function. After the permanent teeth erupted, fixed orthodontic appliances were place to restore dental arch form and occlusion., Conclusions: The results show the importance of an early diagnosis of GAP and of a multidisciplinary approach involving laboratory and clinical management to treat the disease and to restore masticatory function, providing a better quality of life for patients., (© 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.)

Background: The application of CPAP has been used to minimize postoperative pulmonary complications after lung resection surgery. The aim of this study was to quantify both the CPAP effects upon lung function and functional capacity in early postoperative lung resection, as well as to evaluate if CPAP prolongs air leak through the chest drain., Methods: Thirty patients in the postoperative period of lung resection were allocated into 2 groups: an experimental group, consisting of 15 patients who underwent a 10 cm H(2)O CPAP, and a 15 patient control group, who performed breathing exercises. Arterial blood gas analysis, peak expiratory flow (PEF), respiratory muscle strength, spirometry, and 6-min walk test (6MWT) were assessed in the preoperative period, and repeated postoperatively on the first and on the seventh day (6MWT was repeated only on the seventh day)., Results: Significant increases in PEF, muscle strength, and FEV(1) between the first and seventh postoperative day were observed, both in the experimental and in the control group, whereas FVC and P(aO(2)) increased significantly between the first and seventh postoperative day only in the experimental group. The average loss in 6-min walk distance (6MWD) from preoperative to postoperative day 7 in the experimental group was significantly lower than in control group. When comparing the 2 groups, only 6MWD was statistically different (P < .001). There was no air leakage increase through the drain with the early use of CPAP., Conclusion: When compared to breathing exercises, CPAP increases the 6MWD in postoperative lung resection patients, without prolonging air leak through the chest drain.

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Child temperament has been studied in various researches and may be useful to predict how a child responds to dental treatment, especially very young children. The purpose of the present longitudinal study was to evaluate the behavioral manifestation of children aged 0 to 3 years, considering different types of dental situation. A total of 169 children were selected and the following data were collected: the age of the child, gender, age of the mother, number of dental visits and their respective dates, stimuli offered to the child, and behavioral response to these stimuli. The children and their respective behaviors were divided into five groups according to the dental situation offered: control, missed visits, fluoride varnish, restoration, and dental trauma. The data were submitted to descriptive and inferential analysis using the chi-square test, with the level of significance set at 5%. Analysis of the different situation offered to infants during routine dental care revealed a predominance of collaborating and partially collaborating behavior, and age at the time of dental care influenced the behavior of the infants, irrespective of the stimulus group. The different types of dental situation provoked changes in the behavioral response of the children of certain age groups, especially in the dental trauma group.

'When' and 'how' the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP), were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.

Aim: The purpose of this study is to evaluate the developmental disturbances in permanent teeth as a result of luxation injuries in the primary teeth predecessors., Materials and Methods: A total of 5330 records, corresponding to 10 years attendance at the Emergency Center of Baby Clinic, Londrina State University, Brazil, were analyzed. Three hundred and eighty nine children were involved in this study, totaling 620 traumatized primary teeth. Clinical and radiographic examinations were carried out in the permanent successor teeth., Results: In total, 623 permanent teeth were examined and developmental disturbances were detected in 126 teeth (20.2%). The white or yellow-brown discoloration of enamel was the clinical disturbance most observed (78.0%) and the crown alteration most detected through radiographic analysis was hypoplasia (86.0%). Root alterations were rare; root dilaceration was observed in only one case. The age of the children when their primary teeth received damage varied between 6 and 36 months (P = 0.000325). Intrusive luxation and avulsion were related with most of the cases of sequelae in the successor permanent teeth (P = 0.000001)., Conclusion: The results of the present investigation emphasize the special attention required for children who suffered dental trauma at an early age, especially in cases of intrusive luxation and avulsion.

This article reports a longitudinal follow-up of a 15-month-old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14-year clinical and radiographic follow up of the case is presented.

Reimplantation of primary teeth has been the subject of various clinical and histological studies, but very little is known about the effect of this treatment on primary teeth. The aim of the present study was to histologically evaluate the biological response of dog primary teeth after immediate reimplantation. Twelve dogs were divided into two groups according to postoperative time: 1 week and 3 weeks. Twenty-one upper and lower intermediate incisors were extracted and submitted to endodontic treatment, reimplantation and splinting. The 21 homologous teeth not submitted to treatment served as controls. The animals were killed after the respective experimental periods, and the obtained specimens were processed for histological analysis. Most dogs of the 1-week group exhibited the following alterations: gingival epithelium was inserted in the cemento-enamel junction, with a small number of chronic inflammatory cells being observed in the gingival corium; the periodontal ligament was partially reestablished, with a more expressive chronic inflammatory infiltrate being observed in the apical third; small root resorption was observed on the palatine/lingual side in the apical third. In contrast, in 3-week animals, gingival epithelial insertion was predominantly absent on the buccal side, and a moderate chronic inflammatory infiltrate was present; the periodontal ligament generally showed no bone-cementum reinsertion especially on the palatine/lingual side, with an expressive inflammatory infiltrate in the apical region, and large root resorption was mainly observed on the palatine and lingual sides. In conclusion, reimplantation causes histological alterations in the tooth and its supporting periodontal structures that suggest the impossibility of its maintenance.

Ankyloglossia is a developmental anomaly of the tongue characterized by a short lingual frenum, resulting in restricted movement of the tongue. Its etiology is undefined and there is no gender preference. Few studies are available in the literature and the diagnosis and management of ankyloglossia in infants remains controversial. We report two cases of infants submitted to lingual frenectomy, emphasizing the management of ankyloglossia and its implications in breast-feeding.

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

Regional odontodysplasia (RO) is a rare developmental anomaly involving both mesodermal and ectodermal dental components in a group of contiguous teeth. It affects the primary and permanent dentitions in the maxilla and mandible or both jaws. Generally it is localized in only one arch. The etiology of this dental anomaly is uncertain. Clinically, affected teeth have an abnormal morphology, are soft on probing and typically discolored, yellow or yellowish-brown. Radiographically, the affected teeth show a "ghostlike" appearance. This paper reports the case of a 5-year-old girl presenting this rare anomaly on the left side of the maxillary arch, which crossed the midline. The primary maxillary left teeth (except for the canine) and the primary maxillary right central incisor were missing due to previous extractions. The permanent teeth had a "ghostlike" appearance radiographically. The treatment performed was rehabilitation with temporary partial acrylic denture and periodic controls. In the future, the extraction of affected permanent teeth and rehabilitation with dental implants will be evaluated. The presentation of this case adds valuable information to pediatric dentists to review special clinical and radiographic features of RO, which will facilitate the diagnosis and treatment of patients with this condition.

Objectives: The aim of this study was to verify the anticariogenic effect of acidulate solutions with low NaF concentration, using pH-cycling model and bovine enamel., Material and Methods: Enamel blocks were submitted to the surface microhardness (SMH) test and randomly divided in 12 experimental and one placebo groups. The blocks were submitted to pH cycling for 7 days, with daily applications once/day of 0.05% NaF and 0.1% NaF and twice/day of 0.02% NaF solutions. Four different pH: 4.0, 5.0, 6.0 and 7.0 were used. Next, SMH test was again used to determine the surface microhardness percentage change (%SMH). Data obtained for %SMH were homogeneous and passed through variance analyses and Tukey's test (5%) as far as fluoride concentrations and pH., Results: The results showed that pH influenced %SMH in 0.02% NaF and 0.05% NaF solutions with pH 4.0, which had less mineral loss compared to pH 7.0 (p<0.05). The 0.02% NaF - pH 4.0, and 0.05% NaF - pH 7.0 groups showed similar results (p>0.05). A dose-response relationship was observed among the tested solutions, with better anticariogenic effect for the 0.1% NaF solution., Conclusion: The results suggest that the addition of citric acid to acidulate mouth rinses reduce mineral loss.

The aims of this study were to analyze the histomorphology of developing permanent teeth whose primary teeth had suffered traumatic intrusion, as well as to compare the influence of immediate extraction of the intruded tooth to passive re-eruption. Nine dogs from 45 to 50 days old were submitted to the intrusion of the maxillary central and lateral primary incisors using a force applicator adapted to the teeth incisal cuspids. The right side intruded teeth were kept in their sockets and the ones on the left side were extracted 30 min later. After a postoperatory periods of 30 and 60 days, four (group 1) and five (group 2) dogs, respectively, were killed by perfusion. The histological evaluations showed that, in group 1, alterations had occurred in the odontoblastic layer and deposition of the enamel matrix had taken place in some specimens while in group 2, a portion of non-mineralized matrix was observed. We concluded that the morphological changes were because of the immediate trauma of intrusion. No differences were found between the groups where the primary tooth was immediately extracted or left to passively re-erupt.

Dentigerous cysts are benign odontogenic cysts associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. The purpose of this case report was to describe the management of 2 dentigerous cysts in children. The treatments instituted were the extraction of the deciduous tooth involved followed by marsupialization in the first case and enucleation in the second one. Both treatments allowed rapid healing of the lesion and eruption of the permanent teeth without the need for orthodontic treatment.

Objective: In the present investigation, the anticariogenic effect of fluoride released by two products commonly applied in infants was evaluated., Methods: Bovine sound enamel blocks were randomly allocated to each one of the treatment groups: control (C), varnish (V) and diamine silver fluoride solution (D). The blocks were submitted to pH cycles in an oven at 37 degrees C. Next, surface and cross-sectional microhardness were assessed to calculate the percentage loss of surface microhardness (%SML) and the mineral loss (deltaZ). The fluoride present in enamel was also determined., Results: F/Px10(-3) (ANOVA, p<0.05) in the 1st layer of enamel before pH-cycling were (C, V and D): 1.61; 21.59 and 3.98. The %SMH (Kruskal-Wallis, p<0.05) were: -64.0, -45.2 and -53.1. %deltaZ values (ANOVA, p<0.05) were: -18.7 feminine, -7.7 and -17.3 feminine., Conclusion: The data suggested that the fluoride released by varnish showed greater interaction with sound enamel and provided less mineral loss when compared with silver diamine solution.

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

The aim of this study was to establish methodologies for verification of the fluoride solution dose-response relationship using bovine enamel and pH-cycling models. Six models of the cariogenic challenge were performed, varying the time of demineralization and pH, time of remineralization, composition of de- and remineralization solutions, frequency and time of application of treatment solutions and pH-cycling duration. For the evaluation of the fluoride effect on caries dynamics, two proposed models provided for improvement in standardization of methods leading to a higher level of precision, demonstrating a dose response between treatments with regard to surface microhardness and DeltaZ. For the evaluation of the fluoride effect on enamel remineralization, the addition of fluoride to the de- and remineralization solutions and the reduction of frequency and time of application of fluoride solutions led to a more suitable pH-cycling model., (Copyright 2005 S. Karger AG, Basel.)

This case report documents the trauma and follow-up care of lateral luxation associated with extrusion of the lower central incisors in an 8-month-old patient. The teeth were repositioned by digital pressure and stabilized using proximal sutures. Clinical and radiographic follow-up 40 months after the injury showed alterations in both incisors, but both remained functional and free of pathology.