Objetivos: Conocer técnicas de apoyo no convencionales para el manejo de conducta en niños. Esta revisión se realizó mediante revistas indexadas de los últimos 10 años. A pesar que las técnicas tradicionales utilizadas en odontopediatría pueden ser satisfactorias, en la actualidad existe controversia sobre el uso de algunas de ellas. El rechazo por parte de los padres, así como las diversas implicaciones éticas y legales han llevado a que se revalúen muchas actitudes y técnicas, especialmente aquellas de tipo aversivo, lo cual ha conducido a intensificar la investigación en este campo con el fin de buscar nuevas alternativas. La musicoterapia es un tipo de sugestión en la que el niño es animado a la fantasía, evocando sentimientos placenteros para el paciente llevándolo a un estado de relajación. Con la aromaterapia se crea un ambiente cálido para el paciente, volviéndolo menos predispuestos a sentir dolor, disminuye su ansiedad y está más complacido con el servicio. En la distracción audiovisual (técnica que dio mejores resultados) la concentración de los niños, auditiva y visual, queda atrapada en la película que estén viendo desconectándose parcialmente del ambiente odontológico. Se concluye, que son necesarias nuevas técnicas en el manejo de conducta del paciente pediátrico que deben estar acordes a los avances tecnológicos de nuestra era y que promuevan la salud.
El enfoque de riesgo de caries dental aplicado a individuos y poblaciones se viene empleando einvestigando mucho en las últimas décadas. En este artículo se describe la importancia y limitacionesde la evaluación de riesgo cariogénico, los predictores de riesgo más utilizados, como son,experiencia pasada de caries, hábitos dietéticos, control de placa, suposición del profesional,pruebas bacteriales, estado sociodemográfico, saliva, historia médica y uso de flúor, incluyendola evidencia disponible acerca de su valor y poder predictivo, y las características que deben tenerlos modelos de predicción de caries dental.
The aim of this multicenter randomized clinical trial was to evaluate the pulp vitality and survival rate of adhesive restorations performed on posterior deciduous teeth after non-selective (NSCR) or selective (SCR) carious tissue removal over 33 months. One hundred and seven children (average age 4–8 years, SD 1.4) with at least two active moderate cavitated lesions in dentin were included. Teeth were randomized and submitted to NSCR or SCR before composite resin restoration. Restorations were clinically and radiographically assessed at baseline, 6, 12, 18, 24, and 33 months by a blinded, trained, and calibrated operator in each center. The characteristics of the restorations were recorded according to FDI criteria and were considered as restorative failures when scores 4 or 5 were presented. Pulp vitality was measured by clinical and radiographic examinations, and those teeth that presented any signs or symptoms of irreversible pulpitis or pulp necrosis were considered as failure. Data were analyzed by a Cox regression model with shared frailty, considering two outcomes: pulp and restorative. A total of 278 restorations (137 after NSCR and 141 after SCR) were performed at baseline in four different centers and there was no loss in the follow-up period. Survival rate was 97.1 and 87.1% for pulp and for restorative outcome, respectively. The overall annual failure rate was 7%. There were no differences in the failure risk according to the treatment group, center, and all the clinical and demographic variables, regardless of outcome. Composite restorations of active moderate deep carious lesions performed on posterior primary teeth show satisfactory survival for restorative and pulp outcome after a 33-month follow-up, regardless of the technique executed for carious tissue removal.
,dRev Estomatol Herediana. 2014 Abr-Jun;24(2):91-7. Caries risk and its relationship with clinic, systemic and behavioral features of infant patients RESUMEN Objetivos: Determinar las características clínicas, sistémicas y conductuales; y su relación con el riesgo de caries de pacientes infantes atendidos por estudiantes de 5to. año de la Facultad de Estomatología, Universidad Peruana Cayetano Heredia, de enero del 2009 a abril del 2013. Material y métodos: Fue un estudio de corte transversal retrospectivo. La recolección de datos se realizó de las historias clínicas de pacientes infantes de 0 a 36 meses de edad. Se obtuvieron datos de: riesgo de caries, enfermedad sistémica, alteración de la estructura dental, frecuencia de higiene, frecuencia de consumo de azúcares extrínsecos, transmisión vertical, lactancia materna, lactancia artifi cial con edulcorante y amamantamiento nocturno. Se revisaron 170 historias clínicas de pacientes de 0 a 36 meses de edad. Resultados: Se encontró riesgo de caries alto en el 54,12% de ellos, riesgo de caries moderado en el 22,35% y riesgo de caries bajo en el 22,53%. Conclusiones: Existió relación estadísticamente signifi cativa entre riesgo de caries dental y los factores: frecuencia de higiene bucal, frecuencia de consumo de azúcares extrínsecos, amamantamiento nocturno y transmisión bacteriana.
Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines.
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