Abstract: A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32–1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3

RESUMO A Osteodistrofia Hereditária de Albrighth é uma alteração que compreende características fenotípicas de origem genética, tais como baixa estatura, obesidade e braquidactília. É uma desordem rara e está relacionada com o pseudo-hipoparatireoidismo. No âmbito da Odontologia pode estar associada à hipoplasia de esmalte e erupção tardia dos dentes. Além disto em função de problemas neurológicos estes pacientes podem impor dificuldades de comportamento no momento do atendimento. O presente estudo objetivou descrever um caso clínico de uma paciente, com o possível diagnóstico de Osteodistrofia Hereditária de Albright, apresentando sintomas e limitações ao tratamento odontológico.

ABSTRACT Albright hereditary osteodystrophy is a disorder comprising phenotypic characteristics of genetic origin, such as short stature, obesity, and brachydactyly. It is a rare disorder and is related to pseudohypoparathyroidism. Within dentistry, it may be associated with enamel hypoplasia and late eruption. Furthermore, due to neurological problems, these patients may impose behavioural difficulties during dental appointments. The present study aims to describe the case of a patient with a possible diagnosis of Albright hereditary osteodystrophy, presenting symptoms and limitations to dental management.

Abstract This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

O objetivo deste estudo foi descrever os resultados de dois anos de um programa de tratamento individualizado desenhado para controlar cáries oclusais em primeiros molares permanentes em erupção. A amostra consistiu de 145 estudantes de 5-6 anos divididos em um grupo controle (n=71) e um grupo teste (n=74). Todas as crianças do grupo teste receberam um programa preventivo básico bianual e um sistema de reconsultas de acordo com a sua atividade de doença individual. O programa básico consistiu de 3 (março) e 2 (agosto) sessões de orientação de higiene oral e escovação com gel fluoretado. A análise dos dados iniciais e de um e dois anos, apresentou uma significativa redução no número de lesões ativas no grupo teste. No grupo controle existiam inicialmente 70 lesões ativas, depois de 2 anos permaneciam 68 superfícies com doença e 24 superfícies haviam sido restauradas. As crianças do grupo teste tinham, no início do estudo, 80 superfícies com lesões ativas e depois de 2 anos permaneciam ativas apenas 3 superfícies. Das 15 lesões cavitadas, apenas 5 precisaram ser restauradas. O programa mostra que cuidados especiais individualizados a crianças com os dentes em erupção podem controlar as cáries oclusais.

The aim of this study was to describe the 2-year results of an individualized treatment program designed to control occlusal caries in erupting first permanent molars. The sample consisted of 145 five-to-six-year-old students divided into a control group (n=71) and a test group (n=74). All test children received a biannual basic preventive program and a recall system according to individual disease activity. The basic program consisted of 3 (March) and 2 (August) sessions of oral hygiene orientation and toothbrushing with fluoride gel. The analysis of the baseline and 1-2-year data showed a significant reduction in the number of active lesions in the test group. In the control group, there were initially 70 active lesions and after two years 68 surfaces remained with disease and 24 surfaces had been filled. The children in the test group had 80 surfaces with active lesions initially and after two years only 3 surfaces with disease remained. From the 15 cavitated lesions, only 5 surfaces needed to be filled. This program showed that care of erupting teeth on an individualized basis can control occlusal caries.

O objetivo do estudo foi avaliar a prevalência de cárie, gengivite e fluorose em escolares de 12 anos de Porto Alegre - RS. Foram examinados 1.000 escolares da rede de ensino público e particular da cidade. Os índices utilizados foram o ISG, CPO e o ITF. Após a coleta do ISG, a criança foi submetida à remoção da placa e secagem dos dentes para proceder-se aos exames de cárie e fluorose. A média e erro padrão do CPOD, incluindo as lesões não cavitadas, foi de 2,22 ± 0,08, o ISG foi de 19,76% ± 0,54% e a prevalência de escolares com fluorose foi de 52,9%. Em relação à severidade, 45,9% das crianças apresentaram ITF 1, 6,1%, ITF 2 e 0,9%, ITF 3. Os escolares com CPOS maior que 7 (51,2%) compreenderam 14,4% da amostra. Quanto ao sangramento gengival, observou-se que 12% das crianças apresentavam ISG > ou = 40%. O CPOD de Porto Alegre é comparável ao de países desenvolvidos, resultado provavelmente em decorrência do uso intensivo de flúor, que também está ocasionando a fluorose. A severidade da fluorose encontrada não justifica qualquer medida de saúde pública. As medidas de saúde pública de impacto populacional estão sendo efetivas, porém, existe uma parcela da população que necessita de cuidados adicionais.

The aim of the study was to evaluate the prevalence of dental caries, gingival bleeding and fluorosis in twelve-year-old schoolchildren from Porto Alegre, Brazil. One thousand students from private and public schools were examined. The indexes used were BI, DMF and TFI. The data pertaining to BI were the first to be collected. After that, the children were submitted to plaque removal and their teeth were dried prior to the examination for caries and fluorosis. The average value for DMFT, including cavitated and non-cavitated lesions, was 2.22 ± 0.08 (standard error). The average value for BI was 19.76% ± 0.54% (standard error) and the prevalence of students with fluorosis was 52.9%. Regarding the severity of fluorosis, 45.9% of the children had TFI 1, 6.1% TFI 2 and 0.9% TFI 3. A polarization of the experience of caries and gingivitis was observed in the studied population. Only 14.4% of the students had DMFS higher than 7. A small percentage of children (12%) presented with BI ³ 40%. The experience of caries and gingivitis of 12-year-old schoolchildren in Porto Alegre is comparable to that of children from developed countries. That probably results from the intense utilization of fluoride, which is also causing an increased prevalence of fluorosis. The severity of fluorosis does not justify any public health measure. The results show that the employed public health measures are effective, although part of the population still needs additional care.

OBJETIVO: Determinar a relação entre o nível socioeconômico e a prevalência de cárie dentária, gengivite e fluorose em escolares brasileiros. MÉTODOS: Foram examinados mil escolares de 12 anos de idade provenientes das redes particular e pública de ensino. Os índices utilizados foram: Índice de Dentes ou Superfícies Cariadas, Perdidas e Obturadas (CPOD ou CPOS), Índice de Sangramento Gengival (ISG) e Índice de Thylstrup e Feyerskov (ITF). O nível socioeconômico foi determinado pela renda per capita e pelo nível educacional dos pais. RESULTADOS: O nível educacional dos pais apresentou forte correlação de Pearson com a renda per capita. Correlações extremamente fracas, quase nulas, foram observadas entre o nível educacional dos pais e os eventos examinados. Foram observadas diferenças nos eventos examinados (p<0,05) separando-se a amostra em escolares das redes particular e pública. O CPOD na rede particular foi de 1,54±2,02 e na pública foi de 2,48±2,51; o ISG foi de 14,7%±12,7% na rede particular e de 21,7%±17,9% na pública; e a prevalência de fluorose foi de 60,8% e 49,9%, respectivamente. Os indivíduos com maior número de superfícies com experiência de cárie e os de maior número de superfícies sangrantes situaram-se nas escolas públicas. CONCLUSÕES: Não se observou correlação das variáveis do nível socioeconômico com os eventos estudados. Outras variáveis socioeconômicas podem estar contribuindo para as diferenças observadas nos escolares das redes particular e pública.

OBJECTIVE: To determine the relationship between the socioeconomic status and dental caries, gingivitis and fluorosis among Brazilian school children. METHODS: One thousand students aged 12 from private and public schools were examined. The indexes used were DMFT or S (Decayed, Missing and Filled Teeth or Surfaces Index), BI (Bleeding Index), and TFI (Thylstrup and Feyerskov Index). The socioeconomic level was determined according family income and parents' educational level. RESULTS: Parents' educational level data revealed a strong Pearson's correlation with income. No correlation was observed between dental caries prevalence, gingivitis and fluorosis and the studied social economic variables. The DMFT in private schools was 1.54±2.02, and in public schools was 2.48±2.51. BI was 14.7%±12.7% in private schools and 21.7%± 17.9% in public ones. The prevalence of fluorosis was 60.8% and 49.9%, respectively). These differences were statistically significant (p<0.05). Individuals with a larger number of decayed surfaces and the ones with a larger percent of bleeding surfaces were seen in public schools. CONCLUSIONS: The socioeconomic level variables, income and parents' educational level, did not correlate with the events analyzed in the study. Other socioeconomic variables probably contributed to the observed differences between students from private and public schools.

OBJETIVO: Determinar a relação entre o nível socioeconômico e a prevalência de cárie dentária, gengivite e fluorose em escolares brasileiros. MÉTODOS: Foram examinados mil escolares de 12 anos de idade provenientes das redes particular e pública de ensino. Os índices utilizados foram: Índice de Dentes ou Superfícies Cariadas, Perdidas e Obturadas (CPOD ou CPOS), Índice de Sangramento Gengival (ISG) e Índice de Thylstrup e Feyerskov (ITF). O nível socioeconômico foi determinado pela renda per capita e pelo nível educacional dos pais. RESULTADOS: O nível educacional dos pais apresentou forte correlação de Pearson com a renda per capita. Correlações extremamente fracas, quase nulas, foram observadas entre o nível educacional dos pais e os eventos examinados. Foram observadas diferenças nos eventos examinados (p<0,05) separando-se a amostra em escolares das redes particular e pública. O CPOD na rede particular foi de 1,54±2,02 e na pública foi de 2,48±2,51; o ISG foi de 14,7%±12,7% na rede particular e de 21,7%±17,9% na pública; e a prevalência de fluorose foi de 60,8% e 49,9%, respectivamente. Os indivíduos com maior número de superfícies com experiência de cárie e os de maior número de superfícies sangrantes situaram-se nas escolas públicas. CONCLUSÕES: Não se observou correlação das variáveis do nível socioeconômico com os eventos estudados. Outras variáveis socioeconômicas podem estar contribuindo para as diferenças observadas nos escolares das redes particular e pública.

OBJECTIVE: To determine the relationship between the socioeconomic status and dental caries, gingivitis and fluorosis among Brazilian school children. METHODS: One thousand students aged 12 from private and public schools were examined. The indexes used were DMFT or S (Decayed, Missing and Filled Teeth or Surfaces Index), BI (Bleeding Index), and TFI (Thylstrup and Feyerskov Index). The socioeconomic level was determined according family income and parents' educational level. RESULTS: Parents' educational level data revealed a strong Pearson's correlation with income. No correlation was observed between dental caries prevalence, gingivitis and fluorosis and the studied social economic variables. The DMFT in private schools was 1.54±2.02, and in public schools was 2.48±2.51. BI was 14.7%±12.7% in private schools and 21.7%± 17.9% in public ones. The prevalence of fluorosis was 60.8% and 49.9%, respectively). These differences were statistically significant (p<0.05). Individuals with a larger number of decayed surfaces and the ones with a larger percent of bleeding surfaces were seen in public schools. CONCLUSIONS: The socioeconomic level variables, income and parents' educational level, did not correlate with the events analyzed in the study. Other socioeconomic variables probably contributed to the observed differences between students from private and public schools.