Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) is used to treat deciduous molars with necrotic pulp. The antimicrobial activity (AA) of different concentrations of the components of the CTZ paste against different microorganisms was evaluated in vitro. Thus, the medications were divided into 6 groups: P1: 250 mg of tetracycline + 250 mg of chloramphenicol + 500 mg of zinc oxide (ZO) + 0.6 ml of eugenol (original proportion), P2: 500 mg of tetracycline + 500 mg of ZO + 0.6 ml eugenol, P3: 500 mg chloramphenicol + 500 mg ZO + 0.6 ml eugenol, P4: 1000 mg ZO + 0.6 ml eugenol, P5: 0.006 ml eugenol, P6: 1000 mg of ZO + saline solution (0.85%), and evaluated against individual standard microorganisms: Streptococcus mutans, Lactobacillus casei, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Bacillus subtilis. Agar diffusion tests (ADT) and direct exposure tests (DET) were applied. The data were subjected to ANOVA and Tukey test (P<5) were applied. P1 had greater AA compared to the other groups. For the evaluation of Escherichia coli, no statistically significant difference was observed between groups P1 and P3. Direct exposure test demonstrated antimicrobial effectiveness for groups P1, P2, P3, P4 and P5 in the time intervals evaluated and ineffectiveness for P6 due to the absence of eugenol. Therefore, it can be concluded that group P1 presented the highest antimicrobial activity among groups in the ADT. DET demonstrated antimicrobial effectiveness in groups with eugenol in its composition, which suggests a bactericidal effect of this component.

Introduction: In Pediatric Dentistry, probiotics represent a new area of research focused on Bacteriotherapy. These probiotics modulate the viability and adhesion of cariogenic bacteria by competing for adhesion on dental surfaces and modifying the surrounding environment, which helps to modulate pH. Objective: To compare the effect of short-term consumption of two strains of probiotics on the count of colony-forming units of Streptococcus mutans, as well as to assess the change in salivary pH using reagent strips in pediatric patients in an in vitro study. Materials and Methods: Two strains of probiotics were administered to 10 children aged 6-12 years with caries, randomly assigned to two groups. One group consumed a probiotic tablet (Group I), while the other group took 6 drops daily (Group II) for 28 days. pH and Streptococcus mutans counts were recorded on days 0, 15, and 28, and statistically compared using Friedman and Dunn tests. Results: A significant reduction in Streptococcus mutans was observed with the application of Lactobacillus rhamnosus LGG with Lactobacillus acidophilus (p<0.0239) between day 0 and 15, along with changes in salivary pH (p<0.0008), compared to Bifidobacterium lactis BB-12 with Lactobacillus rhamnosus LGG (p<0.0085) between day 0 and 29, with no observed changes in salivary pH. Conclusions: The combination of probiotics (Bifidobacterium lactis BB-12 with Lactobacillus rhamnosus LGG) significantly reduced Streptococcus mutans in the short term, while the combination (Lactobacillus rhamnosus LGG with Lactobacillus acidophilus) helped neutralize salivary pH parameters.

Objective: This study aimed to determine the oral health status and the associated health disparities of pediatric patients with autism spectrum disorder (ASD). Methods: This non-matched, case-control study recruited 22 subjects diagnosed with ASD (cases) and 27 without ASD (controls) aged 5–18. Two calibrated dentists performed dental exams for caries and gingivitis on all subjects. Parents/caregivers completed sociodemographics and social determinants oral health questionnaires. As appropriate, between-group comparisons were performed using chi-square, Fisher’s exact test, t-test, and Mann-Whitney test. Associations between ASD and oral health indices were determined using logistic, Poisson, and linear regression models.   Results: Statistically significant differences were found for not easily finding dental services for ASD patients (p=0.014) and behavioral problems during dental visits (p=0.012). Children with ASD had significantly lower odds of caries (DMFT+dft>0) compared to children without ASD (OR=0.121; 95% CI: 0.023; 0.636). Age- and sex-adjusted models showed a significantly lower gingival index among those with ASD.   Conclusion: ASD patients had better oral health than the control subjects. The barriers to treatment for ASD patients were lack of access to dental care and living in a rural area.

For many professionals, pulpectomy in primary teeth is a challenging procedure due to the technical difficulty and complexity of the root canals. In addition, there is a wide variety of techniques and materials available. This review aims to summarize and compare the scientific evidence on pulpectomy in primary teeth. The bibliographic search was performed in the PubMed database in August 2022 and updated in June 2023. Two reviewers independently assessed studies according to the following inclusion criteria: systematic reviews with or without meta-analysis, published in the last 10 years. The certainty of the evidence (GRADE) was taken from the original article. Disagreements were resolved by a third reviewer. Two hundred and thirty-six studies were retrieved. After reading, 31 studies were evaluated for eligibility and 25 systematic reviews were included. The studies were developed in 11 countries, with Brazil (n=7) and India (n=6) accounting for most studies. The year of publication varied between 2014 and 2023, with the years 2021 (n=8) and 2022 (n=5) having the largest number of studies. The certainty of the evidence of most of the studies was which moderate to very low. This review concluded that there is still insufficient evidence to determine which of the different techniques and materials are most effective, leaving it up to the clinician to choose the clinical protocol to be used.

Introduction: Dental treatment of patients with Autism Spectrum Disorder (ASD) presents unique challenges due to the associated sensory, cognitive and behavioral alterations. Case report: This report describes the successful orthodontic treatment of a 10-year-old male patient with high-functioning ASD, who presented with severe sensory alterations and a labial suction habit. The patient had received prior sensory-behavioral adaptation to dental care. The care protocol included Tell-Show-Do techniques, audiovisual support, positive reinforcement, and the use of dark glasses to minimize sensory visual stimuli. The use of a self-regulation element of the patient was allowed. Extraction of upper lateral incisors was performed, and the crowns of the same teeth were used as temporary replacements to maintain aesthetics and avoid the feeling of tooth loss. Brackets were cemented in the central and lateral incisors to assess the patient's acceptance of fixed appliances. Result: The treatment was successful, achieving patient cooperation and ensuring continuity of treatment. Behavioral adaptation, in conjunction with a multidisciplinary team and caregiver participation, are essential to achieve therapeutic objectives and protect the patient's self-perception. Conclusion: The great challenge of caring for the patient with autism is to provide comprehensive care with a multidisciplinary team, ensuring the improvement of their quality of life and adherence over time.

Introduction: Hypomineralized second primary molar (HSPM) is an enamel defect that affects 1 to 4 second primary molars. Aim: To describe the use of the Hall Technique (HT) in rehabilitating a severely affected second primary molar in patient with HSPM and emphasize the importance of clinical monitoring in the management of fractures and caries lesions. Case report: 9-year-old boy presented esthetic issues and painful, sensitive teeth. Molar incisor hypomineralization (MIH) and HSPM were diagnozed. Preventive treatment was performed, followed by dental restoration using the HT. Recall visits were scheduled every 3 months. A recall appointment after 12 months revealed a stable treatment. His teeth were free from caries and no fracture was observed. Discussion: HT is a favorable restorative option for HSPM involving two or more surfaces. Conclusion: HT may be considered a feasible alternative to restore HSPM teeth.

Moebius syndrome represents a rare congenital disorder characterized by non-progressive unilateral or bilateral paralysis of the facial and abducens nerves. The aim of this study is to report the oral and dental manifestations of Moebius syndrome present in two Brazilian children. Clinical case 1: 9-year-old girl, diagnosed with Moebius-Poland syndrome, presented to the Baby Clinic of (omitted information) for preventive dental treatment. Clinical and radiographic examination revealed anterior open bite, unilateral crossbite, microstomia, lack of buccal elasticity, dry labial mucosa, dental fluorosis in upper and lower teeth associated with enamel hypoplasia, dental crowding, upper right canine ectopic eruption, palate ogival, micrognathism, lip sealing and adequate lingual tonus. Clinical case 2: 26-month-old girl, attended in the same service for preventive dental treatment. Clinical and radiographic examination revealed anterior open bite, microstomia, lack of buccal elasticity, high arched palate, hypotonic tongue, micrognathism, inadequate lip seal and dental caries. In both cases, episodes of dentoalveolar trauma were related by parents. Pediatric dentists play a fundamental role in the early diagnosis of oral and facial characteristics that may be present from birth and imply potential repercussions on the development of the stomatognathic system.

Robinow syndrome (RS) is a rare genetic disease that may involve cardiovascular, skeletal and urogenital systems and manifest through short limb dwarfism, defects in vertebral segmentation, hypoplastic genitalia and cranial and facial abnormalities. In this article, we hereby present a patient of a 10-year-old Brazilian boy with RS who presented with a remarkable number of classical general and dental features. Physical examination revealed disproportionate short stature with shortening limbs, syndromic face with normal hair appearance, low-set ears, macrocephaly, prominent forehead, hypertelorism and ocular prominence, nose anomalies, triangular mouth with long/short philtrum, incompetent lip seal, midface hypoplasia, retrognathia, deficient malar prominence, among others. Clinical examination revealed gingival hyperplasia, malocclusion, crowding dental, diastemas, microdontia, enamel hypoplasia, prolonged retention, dental caries, delay of dental eruption v-shaped palate, bifid tongue and ankyloglossia history. Radiographically, dental agenesis, hypertaurodontism and thick roof pulp chambers and delayed tooth eruption were observed. Preventive, restorative and rehabilitative dental procedures are being carried out. Robinow syndrome presents clinical and radiographic findings that may be present from birth and require pediatric dentistry follow-up. Furthermore, the pediatric dentist plays an essential role in developing effective planning and treatment in terms of health promotion, aesthetic rehabilitation and functional interventions in the stomatognathic system.

Mesiodens are supernumerary teeth located in the midline of the maxilla, frequently associated with alterations in dental eruption. Dentigerous cysts, on the other hand, are benign pathologies that occur in third molars and canines. The coexistence of an impacted and inverted mesiodens with a dentigerous cyst is rare, with a reported prevalence of only 5-6%. This report describes the case of an asymptomatic 8-year-old male pediatric patient who presented with absent eruption of the upper left central incisor. Clinical examination showed palatal swelling without mucosal color changes. The periapical radiography showed an inverted and impacted mesiodens with a pericoronal radiolucent image compatible with a dentigerous cyst. The lesion was confirmed by computed tomography and the diagnosis was corroborated histopathologically. Enucleation and extraction of the mesiodens was performed under local anesthesia, and the patient evolved favorably without complications. This case emphasizes the importance of early diagnosis and timely surgical treatment to prevent major complications such as malocclusion and root resorption of adjacent teeth. The particularity of this case lies in the fact that the patient is a monozygotic twin, whose brother did not present this anomaly, which makes it a relevant contribution to the literature on dental alterations in twins.

Introduction: Mucopolysaccharidoses are rare diseases related to chronic metabolic conditions caused by a genetic mutation that results in the deficiency of lysosomal enzymes responsible for the degradation of glycosaminoglycans, causing alterations in the normal functioning of the organism and oral alterations. Aim: To evaluate the physical, systemic and oral characteristics of two sibling patients with mucopolysaccharidosis type IV-A found in patients treated at the Special Patients Outpatient Clinic of the University of Ribeirão Preto - Unaerp. Cases Report: Clinical Case 1: Female patient, 34 years old; and Clinical Case 2: Male patient, 31 years old. In Clinical Case 1, the following clinical and physical characteristics were observed: respiratory difficulty, bone changes in the arms, valgus deformities of the knees, enlarged thorax, dysostosis with changes in the hands, decreased hearing, rheumatological problems, difficulty in locomotion, changes in motor coordination, short stature, shortened neck and trunk. Regarding oral changes: taurodontia in upper and lower molars, supernumerary tooth, low mandibular height, macroglossia, anterior open bite, vestibular exostoses, dental erosion on the occlusal and palatal/lingual surfaces in almost all teeth, limited mouth opening, atypical swallowing and deep palate. In Clinical Case 2, the same clinical and oral characteristics were observed, except: supernumerary tooth and vestibular exostoses. Conclusion: MPS is a rare disease that affects organs and tissues, requiring lifelong multidisciplinary health treatment, as there is no cure. However, dental treatment is important to contribute to the individual's quality of life.