- Associate Professor of Paediatric Dentistry, Faculty of Health Sciences, University of Brasília, Brazil since 2004. S... moreAssociate Professor of Paediatric Dentistry, Faculty of Health Sciences, University of Brasília, Brazil since 2004. She obtained a degree in Dentistry in 1991, followed by a MSc and PhD degrees in Health Sciences from the University of Brasília in 1999 and 2003, respectively. The post-doctoral fellowship was done at the University of Wuhan, China, in 2012. In 2007 she got a certification from Oxford University, UK, in Evidence Based Dentistry. She was certificated in 2016 in "Principles and Practice of Clinical Research” from Harvard University, USA. She worked in her private practice for 23 years. From 2014 to 2016 she was responsible for training the dentists enrolled in the Brazilian Oral Health Program for the Indigenous Population, supported by the Ministry of Health, in caries detection and in the Atraumatic Restorative (ART) approach. Her current interest covers dental caries epidemiology, molar-incisor hypomineralization and minimal intervention, with emphasis on none invasive procedures and the Atraumatic Restorative Treatment.edit
The aim of the present investigation was to assess the impact of dental caries prevalence and the consequences of untreated cavitated dentine lesions on quality of life of 6- and 7-year-old Brazilian children. A total of 826... more
The aim of the present investigation was to assess the impact of dental caries prevalence and the consequences of untreated cavitated dentine lesions on quality of life of 6- and 7-year-old Brazilian children. A total of 826 schoolchildren were assessed using ICDAS and pufa (to score consequences of dental caries on soft tissues) indices. History of extraction and toothache was recorded. Oral health-related quality of life was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). A multiple logistic regression model was used to analyze the relationship between the prevalence of dentine carious lesions, pufa, history of extraction and toothache with the B-ECOHIS scores. A total of 587 questionnaires were analyzed. The prevalence of cavitated dentine lesions and pufa was 74.8 and 26.2%, respectively. Some 21.8% of children reported toothache and 9.2% had had at least one tooth extraction. The chance (OR) for children with cavitated dentine lesions, pufa ≥1, history of extraction and toothache of having higher B-ECOHIS scores than those not affected was 1.90 (95% CI: 1.18–3.06), 6.26 (95% CI: 3.63–10.83), 6.87 (95% CI: 2.75–17.16) and 3.68 (95% CI: 2.12–6.39), respectively. Children’s quality of life was negatively influenced by untreated cavitated dentine lesions and their consequences.
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We conducted a 3-year cost-effectiveness analysis on the cavitated dentine carious lesion preventive capabilities of composite resin (CR) (reference group) and atraumatic restorative treatment (ART) high-viscosity glass-ionomer cement... more
We conducted a 3-year cost-effectiveness analysis on the cavitated dentine carious lesion preventive capabilities of composite resin (CR) (reference group) and atraumatic restorative treatment (ART) high-viscosity glass-ionomer cement (HVGIC) sealants compared to supervised toothbrushing (STB) in high-risk first permanent molars. School children aged 6-7 years in 6 schools (2 per group) received CR and ART/HVGIC sealants or STB daily for 180 days each school year. Data were collected prospectively and cost estimates were made for sample data and a projection of 1,000 sealants/STB high-risk permanent molars. Although STB had the best outcome, its high implementation cost (95% of cost for supervisors visiting schools 180 days/school year) affected the results. ART/HVGIC was cost-effective compared to CR for the sample data (savings of USD 37 per cavitated dentine carious lesion prevented), while CR was cost-effective compared to ART/HVGIC for the projection (savings of USD 17 per cavitated dentine carious lesion prevented), and both were cost-saving compared to STB. Two STB scenarios were tested in sensitivity analyses with variations in caries incidence and number of supervision days; results showed STB had lower costs and higher savings per cavitated dentine carious lesion prevented than CR and ART/HVGIC. A major assumption is that both scenarios have the same high effectiveness rate experienced by STB under study conditions; however, they point to the value of further research on the benefits of adopting STB as a long-term venture in a general population of school children.
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Aim: This study aimed to investigate the prevalence of hypersensitivity in molar-incisor hypomineralization (MIH)-affected molars through a census carried out in 8-year-old schoolchildren. Methods: Examinations were conducted by a... more
Aim: This study aimed to investigate the prevalence of hypersensitivity in molar-incisor hypomineralization (MIH)-affected molars through a census carried out in 8-year-old schoolchildren. Methods: Examinations were conducted by a calibrated examiner, using the Nyvad criteria for caries diagnosis and a new criterion for MIH assessment. For hypersensitivity assessment, all MIH-affected molars were included. Nonaffected molars from the same child were used as controls. Air blast reaction was measured using the Visual Analogue Scale (VAS) and the Schiff Cold Air Sensitivity Scale (SCASS) scale, while tactile hypersensitivity was scored using VAS only. Statistical analysis was performed using the Kruskal-Wallis test followed by Dunn’s multiple comparisons test for quantitative data. χ2 was used for the comparison of categorical data. Results: In total, 631 children were assessed, of whom 102 had MIH-affected molars (16.1%). Of these, 51.7 and 8.7% presented enamel and dentin carious lesions, respectively. Regarding the number of teeth, 239 molars were MIH affected (59.8%), with 188 (78.7%) being classified as mild (opacities only), 20 (8.4%) as moderate (posteruptive enamel breakdown), and 31 (13%) as severe (posteruptive breakdown involving dentin/atypical restorations). Hypersensitivity was recorded in only one control molar, while the prevalence of hypersensitivity in MIH-affected molars was 34.7%, being of low intensity and more prevalent in moderate (55%) and severe cases (51.6 %) than in mild cases (29.8%, p = 0.008). An association between hypersensitivity and the presence of mild and moderate cases was observed. Although the same association was observed for severe cases, it was not considered a reliable information as 90% of the MIH-affected molars with posteruptive breakdown involving dentin were affected by carious lesions. It is known that dental caries is a confounding factor for the presence of hypersensitivity. Conclusions: Hypersensitivity was significantly higher in MIH-affected molars than in nonaffected molars, being associated with MIH teeth presenting opacities and posteruptive enamel breakdown.
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Early childhood caries (ECC) is a public health problem affecting young children all over the world. It is the most common reason for children hospitalisation due to oral health problems. Moreover, ECC has a negative impact on child’s... more
Early childhood caries (ECC) is a public health problem affecting young children all over the world. It is the most common reason for children hospitalisation due to oral health problems. Moreover, ECC has a negative impact on child’s quality of life, and in severer cases (sECC), it may cause difficulties in mastication, loss of appetite and weight, irritability, difficulties in sleeping, low self-esteem and poor school performance. The clinical management of ECC is complex and costly. Therefore, all efforts should be made to prevent the occurrence of the disease or to control its progression when the first signs are detected.
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Purpose: Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for ankyloglossia diagnosis: (1) the Neonatal Tongue Screening Test... more
Purpose: Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for ankyloglossia diagnosis: (1) the Neonatal Tongue Screening Test (NTST); and (2) the Bristol Tongue Assessment Tool (BTAT). Methods: This was a cohort study involving live births at the University Hospital of Brasilia, Brasilia, Brazil, from August 2017 to July 2018. The gathered data were based on clinical examinations and interviews with mothers. The Stata software program was applied to conduct the analyses using the chi-square test, Spearman's correlation and the receiver operating characteristic (ROC) curve, and sensitivity, specificity, and positive and negative predictive values. Results: A total of 972 mother-baby dyads were evaluated. The protocols showed agreement (P ≤ 0.001) for an ankyloglossia diagnosis, according to Spearman's correlation. The prevalence of ankyloglossia was 5.5 percent (NTST) and 5.1 percent (BTAT) and was greater in the male gender in both protocols. According to the ROC curve, the four cutoff point showed better sensitivity and specificity (98.4 percent and 64.2 percent, respectively). The BTAT was highly accurate in comparison with the NTST. Conclusions: Both protocols showed similar low ankyloglossia prevalence. The Bristol Tongue Assessment Tool protocol is potentially more viable as a screening instrument than the Neonatal Tongue Screening Test protocol because it is simpler and more concise.
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AIM To develop, apply and evaluate a virtual learning object (VLO) for teaching undergraduate dental students and pediatric dentists to diagnose and to manage molar incisor hypomineralization (MIH). METHODS This controlled educational... more
AIM To develop, apply and evaluate a virtual learning object (VLO) for teaching undergraduate dental students and pediatric dentists to diagnose and to manage molar incisor hypomineralization (MIH). METHODS This controlled educational intervention included 170 undergraduate dental students and 50 pediatric dentists. The student intervention group (VLOG) was trained by the VLO; the control group of students (CG); received a synchronous virtual class and the group of pediatric dentists (PDG) was trained with the VLO. Pre-test and post-test data were analyzed with a mixed one-way and Tukey post-hoc ANOVA test (α = 0.05). The answers to the questionnaire were analyzed with the one-way ANOVA test and Tukey's posthoc (α = 0.05). RESULTS The values obtained in the pre-test were significantly lower than those obtained in the post-test for all groups. The specialists showed a higher level of knowledge before and after the MIH training compared to the students (p<0.001). Similarly, statistical differences were found in the level of knowledge, which increased after MIH training (p <0.001). There were no differences between the CG and VLOG. CONCLUSIONS The level of knowledge increased in all groups after training regardless of the method used. VLOG works similar to traditional teaching approaches.
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Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine... more
Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine carious lesions in schoolchildren from a deprived area of Brazil and to investigate the determinants of the pufa index. A sample of 835 children aged 6–7 years, from six public schools, was examined by 3 calibrated examiners. Clinical consequences of untreated dentine carious lesions in primary teeth were diagnosed using the four codes of the pufa index: ‘p’ (pulpal involvement), ‘u’ (ulceration), ‘f’ (fistulae), ‘a’ (abscess). Effects of gender, age, school, history of extraction, and toothache on the prevalence of pufa codes were tested. The prevalence of pufa codes was 23.7%. The mean pufa score was 0.4 ± 0.9. Code ‘p’ was the most prevalent (19.5%), whereas code ‘u’ was least prevalent (0.1%). Children with a history of extracted primary teeth due to caries had a 2.7 times higher chance to have a pufa code than children with no previous extraction. Children with toothache had a 5.6 times higher chance to have a pufa code than children without toothache. The prevalence of clinical consequences of untreated dentine carious lesions was moderate and the severity was low. The pufa index is an epidemiological tool complementary to existing caries indices aimed to assess dental caries. However, there appears to be no need to include code ‘u’ nor to score codes ‘f’ and ‘a’ separately.
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Different aspects should be taken into account when setting up a dental care plan than merely counting the number of (non-)cavitated carious lesions, like many clinicians usually do. In this chapter, the importance of the socioeconomic... more
Different aspects should be taken into account when setting up a dental care plan than merely counting the number of (non-)cavitated carious lesions, like many clinicians usually do. In this chapter, the importance of the socioeconomic status of the families and cultural aspects in the decision-making process is highlighted. Moreover, the validity of using caries risk assessment models for predicting new carious lesions in children is discussed. Also, instruments for detecting, diagnosing, and assessing dental caries and the definition of (severe) early childhood caries are presented. The correct understanding of these concepts is of paramount importance for deciding which are the best treatment options for individual cases, as different demands require different solutions.
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Objective To describe the caries lesion transition pattern in permanent tooth surfaces over 2 years among a convenience sample of children in a fluoridated (0.8 ppm F) low-socioeconomic community of Brazil. Material and methods One... more
Objective To describe the caries lesion transition pattern in permanent tooth surfaces over 2 years among a convenience sample of children in a fluoridated (0.8 ppm F) low-socioeconomic community of Brazil. Material and methods One hundred forty-nine schoolchildren (7–12 years) were examined for caries using Nyvad criteria at baseline and after 2 years. Descriptive analysis was used to evaluate caries lesion transition patterns. Results Less than 1% of sound surfaces and non-cavitated caries lesions at baseline progressed to cavitation stage within 2 years. 12.7% of the active non-cavitated (ANC) lesions became inactive, 34.7% regressed to sound, 48.0% remained active, and 4.6% progressed to cavitated/filled stages at follow-up. Similarly, 55.2% of the inactive non-cavitated (INC) lesions at baseline remained inactive, 33.3% regressed to sound, 8.0% progressed to cavitated/filled lesions, while only 3.5% progressed to ANC lesions. Conclusion The caries lesion transition pattern in this child population exposed to water fluoride and fluoride toothpaste showed that a low proportion of sound surfaces and non-cavitated lesions progressed to cavitation within the 2-year follow-up. Caries arrest was mainly ascribed to a high proportion of active non-cavitated lesions regressing to sound or inactive lesions. Clinical relevance Caries activity can be controlled by regular exposure to fluoridated water and fluoridated toothpaste.
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PURPOSE Using the ICDAS (International Caries Detection and Assessment System), to assess caries experience in the primary dentition of preschool children living in a socioeconomically poor area with a nonfluoridated water supply, and to... more
PURPOSE Using the ICDAS (International Caries Detection and Assessment System), to assess caries experience in the primary dentition of preschool children living in a socioeconomically poor area with a nonfluoridated water supply, and to compare the stages of caries manifestation between children from private and public schools. MATERIALS AND METHODS This census included all children aged 3 to 5 years from public and private schools from Teixeira, Brazil. Clinical examinations were carried out by two calibrated examiners using ICDAS, the results of which were converted into components of dmf-s and dmf-t. RESULTS The majority of children had caries; the prevalence of enamel and dentin lesions was 81.7%. The prevalence of dentin lesions alone was 62.1%. The mean values of the d2mf2-s/d2mf2-t indices (enamel and dentin lesions) and d3mf3-s/d3mf3-t indices (dentin lesions) were 13.5 ± 14.9/6.8 ± 5.8 and 7.4 ± 10.9/3.0 ± 3.6, respectively. There was no significant difference between the dmf-s/dmf-t indices of children from private vs public schools (p > 0.05). CONCLUSION Caries was highly prevalent in the primary dentition of this Brazilian population, and the presence of noncavitated lesions was the most prevalent condition. Children from private and public schools showed similar caries experience.
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Oral health promotion and positive reinforcement play an important role in the maintenance of a good oral health condition once the dental treatment is completed. Based on this premise, some aspects such as the importance of diet control,... more
Oral health promotion and positive reinforcement play an important role in the maintenance of a good oral health condition once the dental treatment is completed. Based on this premise, some aspects such as the importance of diet control, oral hygiene, the child’s caries risk profile, and the establishment of individualized recall dental visits should be emphasized with parents. The compliance of the family to these recommendations is the key element to the success of the dental treatment, as the restorative treatment has a therapeutic effect without intervening with the etiological aspects of the disease, which are fundamental to its control. Therefore, it is paramount that a good communication channel between the family and the professional is established, as the younger the child is, the most he/she needs their assistance in maintaining a good oral health status.
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OBJECTIVE The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications. METHODS Twenty-one... more
OBJECTIVE The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications. METHODS Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity. RESULTS There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG. CONCLUSIONS Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials. CLINICAL SIGNIFICANCE This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties.
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Aim: The aim of this study was to compare the caries experience of children with and without molar-incisor hypomineralisation (MIH). Methods: A case-control study was designed in which 130 children aged between 7 and 13 years with MIH... more
Aim: The aim of this study was to compare the caries experience of children with and without molar-incisor hypomineralisation (MIH). Methods: A case-control study was designed in which 130 children aged between 7 and 13 years with MIH (cases) were matched with 130 children without the condition (controls) according to age, sex, and school. Dental caries and MIH were assessed using the Caries Assessment Spectrum and Treatment (CAST) and European Academy of Paediatric Dentistry (EAPD) criteria, respectively, by three examiners. CAST was converted into DMFT/dmft; the Kruskal-Wallis test was performed to analyse whether dmft/DMFT was influenced by the severity of MIH. Associations between MIH and dental caries were analysed at child and tooth levels: between and within subjects, respectively. To correlate MIH severity and the occurrence of dental caries, the Cochran-Armitage test was used. Results: The mean age of the children was 9.63 ± 1.29 years. The mean dmft for cases was 1.23 ± 1.99 and for controls 1.71 ± 2.22 (p &gt; 0.05). For the DMFT, the mean scores for cases and controls were 0.45 ± 0.90 and 0.07 ± 0.25, respectively (p &lt; 0.001). The between-subject analysis showed no difference in relation to enamel carious lesions; however, the prevalence of dentine carious lesions was significantly higher in children with MIH than in those without the condition. The same pattern was seen for the within-subject analysis. It was observed that the increase in MIH severity resulted in more teeth being affected by dentine carious lesions (p = 0.0003). Conclusion: Children with MIH presented a higher experience of caries in the permanent dentition than those without the condition. MIH was considered a risk factor for caries development.
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The aim of this study was to establish the face and content validity of the Caries Assessment Spectrum and Treatment (CAST) index. This hierarchical epidemiological index consists of 10 codes covering the spectrum of carious lesion... more
The aim of this study was to establish the face and content validity of the Caries Assessment Spectrum and Treatment (CAST) index. This hierarchical epidemiological index consists of 10 codes covering the spectrum of carious lesion progression and describing conditions ranging from the absence of carious lesions to the presence of sealants and restorations, the presence of lesions in enamel and dentine, and the presence of advanced stages of carious lesion in pulpal tissue and tissue surrounding the tooth. Using the RAND modified e-Delphi consensus method, a set of 17 statements related to the content, including the codes and descriptions used, and suitability of the CAST index were scored on a scale of 1-9 by 15 senior epidemiologists from 15 countries over three rounds of assessment. Agreement of ≥ 75% was required to indicate consensus on a statement. Consensus was reached on 14 statements in the first round, none in the second and on the remaining three statements in the third round. To obtain feedback on the initial validation of the index and to test its external validity, 41 epidemiologists from 24 countries were requested to assess the validated statements. Minor changes to 10 of the 17 statements&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; content and descriptions were suggested; this necessitated the resubmission of the modified CAST index to the original 15 epidemiologists. Consensus of ≥ 80% was reached on all 10 statements regarding codes and their descriptions. After a total of four rounds with the panel members and one round with the feedback group, the CAST index was approved for face and content validity. External validity was obtained. The participating epidemiologists found the RAND modified e-Delphi consensus method to be a suitable instrument for reaching consensus.
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RESUMO A capacidade olfativa como instrumento de diagnóstico não deve ser ignorada por aqueles que trabalham na área da saúde. O objetivo do trabalho foi apresentar um modelo de avaliação organoléptica do odor bucal e avaliar a presença... more
RESUMO A capacidade olfativa como instrumento de diagnóstico não deve ser ignorada por aqueles que trabalham na área da saúde. O objetivo do trabalho foi apresentar um modelo de avaliação organoléptica do odor bucal e avaliar a presença de gengivite, ...
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Purpose: To evaluate the effect of silver diamine fluoride (SDF) application on the microshear bond strength (MBS) of glass-ionomer cements (GIC) to caries-affected dentin (Part 1) and dentin cleaning methods to reduce SDF's potential... more
Purpose: To evaluate the effect of silver diamine fluoride (SDF) application on the microshear bond strength (MBS) of glass-ionomer cements (GIC) to caries-affected dentin (Part 1) and dentin cleaning methods to reduce SDF's potential effect on MBS (Part 2). Methods: For Part 1, 56 extracted human teeth were randomly divided into eight groups with GIC, 38% SDF application and dentin substrate. Samples of artificial caries-affected human dentin were treated or not with 38% SDF and restored with conventional or resin-modified GIC. The same procedures were performed in sound dentin tested for MBS test after 24 hours. In Part 2, different dentin cleaning agents (water, aluminum oxide, and pumice slurry) were tested after SDF application. The procedure was performed on the group that presented the worst values for MBS in Part 1. Fracture mode was evaluated under scanning electron microscope. Data were statistically analyzed by ANOVA. Results: MBS was affected by the presence of caries and the type of material, with the conventional GIC the most affected (P< 0.05). Pumice slurry was superior in comparison to the other agents in cleaning SDF-treated dentin. Fracture evaluation showed more mixed failures in all the groups. Clinical significance: Clinicians should have caution when selecting the glass-ionomer cement (GIC) for restorations in silver diamine fluoride (SDF)-treated dentin. The mechanical properties of conventional GIC restorations were more affected than resin-modified GICs. Pumice slurry was the most effective cleaning method to minimize the negative effect of SDF on dentin.
Research Interests: Materials Science, Dentistry, Fluoride, Medicine, Pubmed, and 3 moreDentin, Slurry, and Glass Ionomer Cement
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To determine whether the frequency of microleakage at the margin of the tooth-restoration interface in primary molars restored with high-viscosity glass-ionomer cement (HVGIC) differs from that of primary molars restored with amalgam. The... more
To determine whether the frequency of microleakage at the margin of the tooth-restoration interface in primary molars restored with high-viscosity glass-ionomer cement (HVGIC) differs from that of primary molars restored with amalgam. The HVGIC restorations were performed according to the ART method. A total of 19 naturally exfoliated primary molars (10 amalgam and 9 ART/HVGIC) with clinically assessed intact restorations fulfilled the inclusion criteria. SEM analyses using replicas were performed to assess the microgap presence and size of the tooth-restoration interface The depth of a microgap was measured from histological sections after infiltration of 50% (w/v) AgNO3 solution. Independent variables were restorative material, age of restoration, and number of tooth surfaces. Data analyses included Fisher&#39;s Exact version of the chi-squared test, independent t-test and one-way ANOVA. More ART/HVGIC than amalgam-restored teeth were gap free (p = 0.14). The mean gap size for teeth with a gap between amalgam (322.0 µm) and ART/HVGIC (201.0 µm) restorations did not differ statistically significantly. AgNO3 infiltration was not influenced by restorative material or age of restoration. Infiltration in multiple-surface was higher than in single-surface restorations (p = 0.02). The occurrence of marginal microleakage in primary molars restored by ART/HVGIC is no different from that observed in primary molars restored with amalgam. Microleakage was deeper in multiple-surface than in single-surface restorations. Despite the presence of microleakage, restoration functionality up to exfoliation is secured, reinforcing the importance of biofilm removal and behavioral education of patients.
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In many countries around the world, the prevalence and severity of dental caries have decreased during the last three decades. This outcome should not come as a surprise as dental caries is a preventable disease. During these decades,... more
In many countries around the world, the prevalence and severity of dental caries have decreased during the last three decades. This outcome should not come as a surprise as dental caries is a preventable disease. During these decades, many studies have been carried out to investigate which factors keep healthy teeth healthy and which cause tooth surfaces to demineralise. This great focus on oral health makes it difficult to accept that untreated carious cavities in permanent teeth are the number one prevalent condition out of 291 medical diseases and conditions investigated over the period 1990–2010 (Marcenes et al. 2013). The same condition, but in primary teeth, was the tenth most prevalent condition over the same period. The global economic impact of all dental diseases amounted to US$442 billion in 2010 (Listl et al. 2015). This is an astronomically high figure considering that the two major dental diseases, dental caries and periodontal diseases, are largely preventable.
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Purpose: To assess children's oral health-related quality of life (OHRQoL) three years after implementation of three treatment protocols for managing cavitated carious dentine lesions in primary molars by parent proxy report with the... more
Purpose: To assess children's oral health-related quality of life (OHRQoL) three years after implementation of three treatment protocols for managing cavitated carious dentine lesions in primary molars by parent proxy report with the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) and to assess the level of agreement between the children's self-reporting and the parents' reporting of the children's OHRQoL. Materials and methods: Schoolchildren aged 6 to 7 were included in a clinical trial that compared three treatment protocols for managing cavitated carious dentine lesions: CRT (Conventional Treatment); ART (Atraumatic Restorative Treatment) and UCT (Ultraconservative Treatment). Before treatment (baseline), the OHRQoL of 273 children was assessed by B-ECOHIS using the parents'/caregivers' proxy report. Three years later, 147 parents/caregivers filled in the questionnaire while the children, ages 9 to 10, were interviewed. The t-test and one-way ANOVA were used for statistical analysis. Results: No difference was observed between treatment protocols in regard to the children's OHRQoL (p = 0.41). A significant reduction in the parent distress domain was observed when baseline and parents'/caretakers' responses after three years (p = 0.01) were compared. The level of agreement between the parents'/caregivers' and children's scores was low. Children scored lower on the impact of oral health on their quality of life than their parents/caregivers did (p < 0.0001). Conclusion: The use of UCT, a largely non-restorative protocol, leads to a perception of OHRQoL by parents/caregivers that is similar to the ART and CRT protocols after three years. Parent distress decreased over time. Children and parents/caregivers disagreed about children's OHRQoL.