RESUMO A cárie dentária é uma doença não infecciosa e é considerada um problema de saúde pública. Para seu diagnóstico e correto tratamento é necessário a avaliação do risco e da atividade da doença cárie. A avaliação do risco de cárie é uma maneira de formalizar o equilíbrio e desequilíbrio da doença de modo previsível para realizar o diagnóstico da doença presente. Para tanto, a avaliação do risco de cárie é realizada através de diferentes sistemas. Outro parâmetro de grande importância a ser estudado é a atividade da doença cárie, pois através dela é realizada a correta decisão de tratamento para o paciente. Assim, o objetivo do presente artigo foi informar ao leitor: os conceitos e fatores de risco de cárie; os diferentes sistemas de avaliação de risco de cárie descritos na literatura; e quais sistemas são validados. Contudo, esta revisão de literatura proporciona a identificação e avaliação dos fatores de risco e atividade das lesões de cárie afim de possibilitar uma maior objetividade no diagnóstico e facilitar as decisões de um tratamento bem-sucedido.

ABSTRACT Dental caries is a non-communicable disease and is considered a public health problem. For diagnosis and correct treatment, the study of risk assessment and caries activity is necessary. The caries risk assessment is a way to formalize the balance and imbalance of predictably disease to diagnose dental caries. Therefore, the caries risk assessment is performed through different evaluation systems. Another parameter of great importance to be studied is the activity of caries, because through it is done the correct treatment decision for the patient. The objective of this article is to inform the reader about: the concepts and caries risk factors; the different caries risk assessment systems described in the literature; and which systems are validated. In addition, this literature review provides for identification and evaluation of risk factors and activity of caries lesions in order to enable greater objectivity in the diagnosis and facilitate the decisions of a successful treatment.

A síndrome de Chediak-Higashi (CHS) é uma doença rara hereditária e fatal se não for tratada. Estas alterações estão associadas com várias doenças e síndromes que, principalmente, causa a doença periodontal assim como perda prematura de dentes. Este artigo descreve o monitoramento de perda prematura de dentes decíduos, que começou quando a criança tinha 05 anos. Na apresentação os dentes estavam com mobilidade e apresentava sangramento gengival. As radiografias panorâmicas revelaram perda óssea generalizada e grave, e os dentes sem suporte ósseo suficiente para a sua estabilidade. Foi realizada o exame de sangue para avaliar a saúde geral da criança no qual foi encontrado células gigantes com grânulos citoplasmáticos, confirmando o diagnóstico de CHS. O tratamento da doença periodontal por meio de métodos mecânicos e químicos são necessários para controle da infecção e da placa bacteriana.

The Chediak-Higashi syndrome (CHS) is a rare hereditary fatal disease, if not treated. These changes are associated with various diseases and syndromes that mainly cause periodontal disease and thus the premature loss of teeth. This paper describes the monitoring of premature loss of primary teeth that began when the child was 5 years old. On presentation his teeth were mobile and there was a history of gingival bleeding. Panoramic radiography revealed generalized and severe bone loss, and the teeth showed no bony support enough for their stability. Blood test was ordered to assess the overall health of the child and giant cells with cytoplasmic granules were found, confirming the diagnosis of CHS. The management of periodontal disease focused on the control of infection and bacterial plaque by mechanical and chemical methods.

Primary teeth are interesting models that can be used to study physiological and pathological processes involving cells and extracellular matrices in hard and soft tissues. This study investigated the expression and distribution of biglycan and decorin-the non-collagenous components of the extracellular matrix-in primary teeth tissue, during physiological root resorption. Thirty healthy human primary teeth were grouped together according to root length: Group I - two-thirds root length, Group II - one-third root length, and Group III - teeth with no root. The streptavidin-biotin-peroxidase immunohistochemical method was used with antibodies against the previously named antigens. The proteoglycans studied were found in the pulp and dentin extracellular matrix in all groups without any differences in the proteins, among the groups. Biglycan was observed mainly in predentin and in pulp connective tissue in the resorption area. In addition, decorin was observed mainly in pulp connective tissue, but near the resorption area. Biglycan and decorin were distributed differentially in the dental tissues. The present immunohistocytochemical data, combined with previously reported data, suggest that these proteoglycans could be involved in regulating the physiological resorption process in healthy primary teeth.