The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.
A very rare case of bilateral supernumerary teeth in the maxillary canine region and its management through a 3-step-conservative approach and 5-year-follow up is presented in this report. A 7-year-old Caucasian boy presented with 2 erupted supernumerary primary maxillary canines (53s and 63s) and two unerupted supernumerary permanent maxillary canines (13s and 23s). The treatment was carried out in three steps. In the first step, we removed teeth 53s and 63s. As the second step, early removal of teeth 53 and 63 and cementation of a space maintenance appliance (Nance's arch) were performed. In the third step, teeth 13s and 23s were removed, and the Nance's arch was maintained until the complete eruption of teeth 13 and 23. The management of this case with a proper treatment plan enabled us to solve the problem without complex procedures.
Objective: To compare the agreement of images in white light (WL), fluorescence (FL), and digital radiographs (DR), on the diagnosis and treatment decisions for occlusal caries lesions against a micro-CT gold standard. Material and Methods: Ten extracted third molars, with enamel and/or dentin caries (ICDAS 2-4), were included. Occlusal surface images were acquired with an intraoral camera (SoproLife ® ) in WL and FL modes. DR was obtained using an intraoral X-ray and a semi-direct digital system. A total of 780 images were needed, organized in a template, to be later examined by twenty-six dentists invited to compose the study. The Generalized Estimation Equations model was used to compare the proportions of the correct answers between the three methods and the gold standard. When significant, Bonferroni posthoc test was used to identify differences (α=5%). Results: Most of the examiners were specialists (76.9%) with 14.5 years of experience. All diagnostic methods were similar and showed low agreement (DR 12.7%, WL 16.5%, and FL 16.5%) compared with gold standard caries diagnostic scores. Regarding treatment decisions, mean agreement for all diagnostic methods was higher (43.2%; p<0.001), and among all methods, WL (48.1%) and FL (51.2%) modes performed better than DR (30.4%, p<0.001). Conclusion: SoproLife ® images could help clinicians to propose rational, minimally invasive treatments for occlusal caries lesions.
Tuberous sclerosis complex (TSC) is an autosomal dominant disorder with a multisystemic character that may present alterations in multiple organ systems, including oral manifestations. This case report describes a family (mother and two sons) with TSC that underwent a multidisciplinary approach, emphasizing their oral manifestations and highlights the adequate approach taken. The children presented many and distinct features of TSC in different systems; however the family revealed similar oral manifestations. The oral findings were dental enamel pits on permanent teeth and spread gingival fibromas on both jaws. The dental planning was the same for all three patients and included guidelines on oral hygiene and dietary habits, fluoride therapy and a preventive approach through six-month reevaluations. In multisystemic disorders, early multidisciplinary action is vital to provide comprehensive care and reduce or even prevent complications from the condition, thus ensuring the patient's quality of life.
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