Objective: To evaluate an imaging protocol for use as a diagnostic and calibration tool for dentists before and after practical activity. Material and Methods: Thirty photos of children's teeth with or without changes in dental enamel were selected and evaluated by a group of experienced dentists previously calibrated to establish the diagnosis defined as the gold standard. After instructions, the images were shown to a group of postgraduate dentists for free identification of dental changes. Subsequently, a lecture on molar incisor hypomineralization (MIH) was carried out, and, at 14 days and all calibration was performed using the criteria previously. The retest was performed at 28 days. After experience in clinical activity in the following two weeks, the post-test was performed at 49 days. Data were analyzed using Cohen's kappa coefficient. Results: Theoretical learning on the subject showed low inter-examiner agreement when the diagnosis of defects was made from images obtained from intraoral photographs. After clinical practice, there was greater intraexaminer agreement. After theoretical training, dentists started to identify different types of enamel alteration, although with low agreement between them. Conclusion: Clinical experience in theoretical and imaging training favored the identification of defects. However, it is necessary to improve the protocol to establish a reliable and viable diagnostic method for calibration in MIH.
Dentinogenesis imperfecta (DI) is a hereditary developmental disorder of dentin formation that can occur associated with osteogenesis imperfecta (type I), isolated (type II), or in a specific isolated resident group of Brandywine, in southern Maryland (type III). This work aims at reporting a clinical case of DI type II in childhood with a 34-year follow up. The child at issue was taken to the dental health service at a very young age, which favored an appropriate treatment, avoiding complications, and portending a favorable long-term prognosis, besides safeguarding the patient physical and mental well-being. The clinical aspects of this condition are teeth with short crowns and gray-brown coloration, and an altered consistency of affected dental elements. Radiographically, the teeth present bulbous crowns, cervical constriction, thin roots, and early obliteration of the root canal and pulp chambers due to excessive dentin production. Rehabilitation treatment included the use of stainless-steel crowns for reconstructing deciduous molars and composite resin restorations on the anterior deciduous teeth. As for permanent dentition, it consisted of aesthetic-functional rehabilitation using metal crowns on the first molars and ceramic crowns and facets on the anterior teeth. Endodontic, prosthetic and restorative treatment was performed on other posterior teeth. Preventive measures were instituted. DI may cause serious changes in dentin structure, affecting function and aesthetics in both dentitions. The sooner it is administered, the more promising the multidisciplinary dental treatment will be in promoting health and minimizing damage to affected individuals.
A Deus, pela dádiva da vida, com todos as perdas, conquistas, desafios e superações que me permitem evoluir a cada dia.À Cláudia Cristina Santos Silva (in memoriam), por me escolher como irmã, me incentivar, me guiar no caminho da verdade e consolidar a minha fé, mesmo diante de sua partida pela Covid-19.Aos meus pais, Getúlio Vieira e Glaci Aparecida Orsini Vieira, pelo apoio que me deram para a conclusão de mais esta etapa.À tia Glacy Orsini, que nos momentos mais difíceis de sua vida se faz amorosamente presente na minha. Aos meus padrinhos, Theodomiro de Oliveira (in memoriam) e Vanda Carvalho de Oliveira (in memoriam) pois tudo é por eles, que continuam eternamente presentes em minha vida, memória e coração. AGRADECIMENTOS ESPECIAIS À Prof. a Dra. Léa Assed Bezerra da Silva, pelo meu aceite como sua orientada e pela oportunidade de realização deste trabalho. Sua dedicação à vida acadêmica é um exemplo a ser seguido. Tê-la como orientadora é uma honra que levarei para sempre, com orgulho, em minha trajetória. Jamais esquecerei a magnitude de suas aulas! À Prof. a Dra. Raquel Assed Bezerra Segato, que, desde o primeiro contato, demonstrou sua receptividade e compreensão, sempre disposta a solucionar os percalços do caminho acadêmico com placidez. Seu comprometimento e dedicação ao Ensino e à Pesquisa refletem sua excelência profissional. Sua sensibilidade ao lidar com as mais diversas questões expressa sua grandiosidade! À Prof. a Dra. Marília Pacífico Lucisano Politi, pelo auxílio, orientação e atenção em todos os momentos que precisei. Seu respeito, carinho, educação e dedicação aos colegas e pacientes demonstram a riqueza de sua alma! Ao Prof. Dr. Francisco Wanderley Garcia de Paula e Silva, pela prestatividade, presença e orientação durante todo o curso. Sua proatividade e sabedoria é, para mim, motivo de grande admiração. Um exemplo de atenção ao humano e amor à ciência! À pós-doutoranda Dra. Carolina Maschietto Pucinelli, pela adorável convivência e ajuda nas análises. Com certeza, seu empenho e entusiasmo determinarão seu sucesso na carreira acadêmica! À amiga Ana Carolina Fernandes Couto, pelo auxílio abnegado para a execução deste trabalho, além de toda a atenção e cuidado comigo. Sua preocupação em não desvincular humanidade e ciência demonstram a qualidade de uma pessoa que fez, faz e fará diferença na vida de todos que, como eu, tiverem o privilégio de sua presença.
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