JOURNAL OF DENTISTRY FOR CHILDREN最新文献

Purpose: To discuss the transplantation of a maxillary premolar to replace a maxillary central incisor in a seven-year follow-up period.
Methods: An avulsed permanent maxillary central incisor was reimplanted by a pediatric dentist but it presented progressive external root resorption. Transplantation of the maxillary right first premolar was planned, as the patient presented a Class II malocclusion with increased overjet that would be treated with extractions of the maxillary premolars.
Results: The transplanted tooth did not present any negative symptoms other than discoloration, which was treated with bleaching for three years. At the end of a three- year follow-up period, a full ceramic restoration was done to improve translucency properties to provide better esthetics. The transplanted tooth presented healthy periapical and periodontal tissues in both clinical and radiographic examinations at the end of the seven-year follow-up period.
Conclusions: Autotransplantation of maxillary premolars can be a viable alternative to provide adequate physiologic and esthetic components for avulsed and reimplanted permanent incisors that presented unsuccessful results.

Purpose: To evaluate the impact of malocclusion and dental caries on oral health- related quality of life (OHRQoL) in adolescents and the differences between adoles- cents' self-reports and caregiver's proxy reports. Methods: A population-based cross-sectional study was conducted with 1,612 Brazil- ian adolescents and 1,168 caregivers. Adolescents completed the Child Perceptions Questionnaire and caregivers completed the Parental-Caregiver Perceptions Question- naire. Malocclusion (dental esthetic index) and dental caries (DMFT) were documented. Multiple Poisson regression was conducted. Results: A self-reported model demonstrated that adolescents with malocclusion had an impact on emotional (PR=1.14; 95 percent confidence interval [95% CI=1.03 to 1.26) and social domains (PR=1.35; 95% CI=1.20 to 1.50). Dental caries had an impact on the emotional domain (prevalence ratio [PR]=1.34; 95% CI=1.21 to 1.48). The caregiver model showed that malocclusion had an impact on oral symptoms (PR=1.12; 95% CI=1.03 to 1.21), functional limitations (PR=1.18; 95% CI= 1.05 to 1.33), and emotional (PR=1.23; 95% CI=1.10 to 1.54) and social domains (PR=1.22; 95% CI=1.02 to 1.45). Those with dental caries felt an impact on oral symptoms (PR=1.09; 95% CI=1.01 to 1.19), functional limitations (PR=1.18; 95% CI=1.05 to 1.33) and social domains (PR=1.24; 95% CI=1.04 to 1.45). Conclusions: Adolescents reported a negative impact on OHRQoL both in relation to dental caries and malocclusion. Caregivers observed the impact of oral conditions on more domains than the adolescents reported.

Purpose: To present a patient interaction teaching tool for synchronous teledentistry visits following concepts in critical thinking and report on the viability, assessment and implementation of the tool in an academic pediatric dentistry clinic.
Methods: A teaching tool was derived from interviews with pediatric dental residents and clinicians. The tool contained six main sections and 26 steps. The main sections included: greeting, medical, dental and behavioral histories; airway assessment; treatment recommendations; behavioral modalities of treatment; and follow-up. A faculty member assigned each interviewer dichotomous values of yes and no for implementation of each step of the teaching tool.
Results: Six pediatric dentistry residents participated in a tool use demonstration with 21 patients. The purpose of each interview was to gain information for procedural treatment at the first onsite visit. All pediatric dental residents completed over 90 percent of the steps in each section. The interview duration ranged from eight to 29 minutes (median: equals 18 minutes). Eighteen of the 21 patients were scheduled for follow-up visits.
Conclusions: The emulation model for provisional treatment planning is viable for teledentistry. Pilot results showed students consistently completed over 90 percent of skillset steps and that this teaching tool serves as a framework for teledentistry appointments.

Purpose: To evaluate the factors associated with longitudinal changes in the caries activity profile of high caries risk children.
Methods: The sample consisted of clinical records of children who had undergone dental care in a public setting during a one-year period. Patients with active carious lesions (non-cavitated and/or cavitated) at the initial examination and who completed treatment were considered for the analysis. A caries-controlled profile was set as the main outcome based on arresting active carious lesions. Poisson regression was used to evaluate the association of patient- and treatment-related factors with the outcome ( P <0.05).
Results: The analysis included 130 caries-active children (7.8±2.4 [standard deviation - SD] years), with a mean missing and filled teeth index score of 8.3±4.4 SD. Patients with lower caries experience (prevalence ratio [PR]=0.93; 95 percent confidence interval [95% CI]=0.87 to 0.99) who received more appointments focused on oral health promotion based on dietary and oral hygiene instructions (PR=1.28; 95% CI= 1.03 to 1.58) had a greater rate of moving to caries-controlled status. The number of invasive treatments was not associated with a shift from caries-active to caries-controlled status (PR=0.98; 95% CI=0.87 to 1.11).
Conclusion: A preventive regimen focused on dental and diet guidance may play an important role in arresting active carious lesions in high caries risk children.

Purpose: To compare the clinical and radiographic success rates of indirect pulp treatment (IPT) in primary molars using mineral trioxide aggregate (MTA) with and without two percent chlorhexidine gluconate (CHX).
Methods: A blinded, randomized, controlled clinical trial was performed in a split-mouth desi gn. Eighty primary molars in 40 subjects from four to eight years of age were randomly allocated so that each subject had one tooth treated with MTA and CHX and the other tooth treated with MTA alone. Study teeth had deep caries without signs and symptoms of pulpal inflammation or necrosis. All teeth were restored with stainless steel crowns. Follow-up was done at 12 months to evaluate the teeth clinically and radiographically.
Results: At the follow-up, one tooth from each group had failed. Upon the clinical and radiographic evaluations, the overall success rate for both groups was 97 percent. No statistically significant difference was found in the success rate between the two groups.
Conclusions: IPT in primary molars using MTA with or without CHX demonstrated satisfactory clinical and radiographic outcomes in a period of 12 months.

Molar-incisor malformation (MIM) is a newly described dental developmental anomaly that predominantly affects primary second molars, permanent first molars, and, in some cases, permanent central incisors. Diagnosis is usually made upon radiographic examination. The molars usually present with significant cervical constriction, flattened pulp chambers, and absent or thin, short, and narrow roots, whereas the incisors usually exhibit coronal dilaceration. Loss of these compromised teeth in the long term may be inevitable. Thus, clinicians should be aware of this condition and the factors to consider to advise their patients as early as possible. The purpose of this paper is to present two cases of MIM and discuss the factors clinicians should take into consideration to make a care plan in these cases.

Purpose: To evaluate the effectiveness of lingual frenectomy, as a standalone treatment or in association with myofunctional therapy, on the general and functional aspects of six- to 12-year-old children with anomalies in the lingual frenulum.
Methods: This randomized controlled clinical trial involved 40 children diagnosed with altered lingual frenulum. Children who received a frenectomy were evaluated 15 and 30 days after the procedure. After 15 days, the children were randomized into two groups: a group that received isotonic tongue exercises (Study Group [SG]) and a group that did not receive isotonic tongue exercises (Control Group [CG]). The outcome evaluator was blinded to group assignment. Statistical tests were used to compare between and within groups (P <0.05).
Results: There were 20 children in each group. SG children improved significantly when compared to CG subjects regarding tongue mobility (P =0.016), maximum mouth opening (MMO; P =0.024), and MMO with the tip of the tongue touching the incisive papilla (P =0.026).
Conclusion: Frenectomy associated with myofunctional therapy benefitted tongue mobility.

Idiopathic gingival fibromatosis (IGF) is a rare, benign, slow-growing proliferation of the gingival tissues involving both maxillary and mandibular gingiva. It is exacerbated during the eruptive phase of both primary and permanent dentitions. The purpose of this article is to report the case of a 10-year-old boy who presented with IGF whose gingival enlargement covered the occlusal surfaces of many teeth and displaced the erupting dentition, compromising the patient's cosmetics, function, speech and development. The treatment involved gingivectomy and gingivoplasty, combining both surgical and laser methods. The case showed remarkable esthetic and functional im provement, without signs of recurrence one year post-treatment.

Localized scleroderma (LoS) or morphea is a rare group of inflammatory disorders resulting in excessive collagen deposition and subsequent sclerosis of the skin and subdermal tissues. Linear scleroderma (LiS) or linear morphea is the most common subtype of LoS in children and primarily affects the face and extremities. This case report details the three-year follow-up of a five-year-old girl with LiS of the left upper lip and adjacent oral mucosal tissue. She also presented with a concurrent developmental root defect of the permanent maxillary left central incisor. Intralesional corticosteroids were considered as a first-line treatment; however, parents declined it. Decision was made to biopsy when the lesion showed signs of progression. At subsequent reviews, the affected mucosal surface appeared to have stabilized but progressive notching of the upper lip was noted. In the long term, after cessation of disease activity, the patient will require aesthetic intervention to surgically correct her upper lip.

Purpose: To assess the impact of pulp necrosis on the oral health-related quality of life (OHRQoL) of children with early childhood caries and their caregivers.
Methods: A cross-sectional study was performed with a consecutive sample of children who were divided into three groups: (1) caries-free children; (2) with untreated carious lesions and without pulp necrosis; and (3) with untreated carious lesions and at least one tooth with pulp necrosis. Data were collected using a sociodemographic questionnaire, the Early Childhood Oral Health Impact Scale (ECOHIS) and a dental clinical examination using the International Caries Detection and Assessment System index. Descriptive statistics, Kruskal-Wallis tests, Mann-Whitney tests and Poisson regression were performed (P <0.05).
Results: A total of 532 children and their legal guardians participated in the study. Children with pulp necrosis had a greater negative impact on the OHRQoL versus those with untreated carious lesions without pulp necrosis (ratio of unadjusted and adjusted rates [RR] = 1.59; 95 percent confidence interval [95% CI] = 1.36 to 1.86; P <0.001), as measured by the total ECOHIS score. in Group 3, four- and five-year-old children had a greater negative impact on the OHRQoL than two- and three-year-old peers (RR = 1.36; 95% CI = 1.08 to 1.72; P <0,001).
Conclusion: The presence of pulp necrosis increased the negative impact on OHRQoL of children with untreated carious lesions and their guardians.