Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia.

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie¯ gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo¯, and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie¯ is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method.

AIM: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. METHODS: An observational study was carried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean's Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. RESULTS: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). CONCLUSIONS: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

JUSTIFICATIVA E OBJETIVOS: As queixas de sintomas otológicos podem estar associadas a quadros de disfunção temporomandibular (DTM). A placa miorrelaxante é uma alternativa de tratamento para a DTM, pois oferece oclusão ideal para o paciente, atuando nos sintomas de dor. Considerando as características conservadoras e reversíveis da terapia de suporte com placa miorrelaxante, o objetivo deste estudo foi avaliar seu impacto na frequência de alterações otológicas em pacientes com DTM. MÉTODO: Realizou-se estudo de intervenção em 35 pacientes com sintomas otológicos associados à DTM. Foram considerados portadores de DTM aqueles que apresentassem pelo menos três sinais e três sintomas da morbidade, sendo um deles otalgia, zumbido, sensação de hipoacusia, sensação de plenitude auricular ou tontura. Os pacientes foram submetidos a exame clínico, orientações e confecção de placa miorrelaxante maxilar em resina acrílica termoplastificável. Ajustes da placa e avaliação dos sintomas foram realizados quinzenalmente. Utilizou-se o teste Exato de Fisher para análise estatística da diferença entre a prevalência de sinais e sintomas antes (AN) e após (AP) a terapia, com nível de significância de 5% (p < 0,05). RESULTADOS: Dezenove pacientes concluíram o tratamento. Observou-se redução na prevalência de sinais e sintomas otológicos: zumbido (AN = 14; AP = 6; p = 0,009), otalgia (AN = 13; AP = 4; p = 0,003), sensação de plenitude auricular (AN = 12; AP = 4; p = 0,006), tontura (AN = 11; AP = 4; p = 0,009) e de hipoacusia (AN = 10; AP = 2; p = 0,001). CONCLUSÃO: A placa miorrelaxante é uma terapia conservadora e reversível que mostrou ser capaz de melhorar os sintomas otológicos associados à DTM.

BACKGROUND AND OBJECTIVES: Otological symptoms complaints may be associated to temporomandibular joint disorders (TMJD). Occlusal splint is an alternative to treat TMJD because it provides ideal occlusion to patients, acting on painful symptoms. Considering the conservative and reversible characteristics of supportive therapy with occlusal splints, this study aimed at evaluating its impact on the frequency of otological changes in TMJD patients. METHOD: An intervention study was carried out with 35 patients with TMJD-associated otological symptoms. TMJD patients were considered those with at least three signs and three symptoms of morbidity, being one of them earache, tinnitus, sensation of hypoacusis, ear fullness or dizziness. Patients were submitted to clinical evaluation, orientations and fabrication of maxillary occlusal splint in thermoplastic acrylic resin. Splint adjustments and symptoms evaluation were performed fortnightly. Fisher Exact test was used for statistical analysis of the prevalence of signs and symptoms before (BE) and after (AF) therapy with significance level of 5% (p < 0.05). RESULTS: Nineteen patients have finished the treatment. There has been decrease in the prevalence of otological signs and symptoms: tinnitus (BE = 14; AF = 6; p = 0.009), earache (BE = 13; AF = 4; p = 0.003), ear fullness (BE =12; AF = 4; p = 0.006), dizziness (BE = 11; AF = 4; p = 0.009) and hypoacusis (BE = 10; AF = 2; p = 0.001). CONCLUSION: Occlusal splint is a conservative and reversible therapy able to improve TMJD-related otological symptoms.

O tumor odontogênico cístico calcificante (TOCC) com proliferação ameloblastomosa é uma variante rara entre os cistos maxilares. Este trabalho objetiva apresentar o relato clínico de um paciente do sexo masculino, 18 anos de idade, que apresentava aumento de volume extra e intraoral do lado esquerdo da maxila, firme à palpação, de característica normocrômica e indolor. A conduta consistiu em realização de tomografia Cone Beam, biópsia incisional, remoção completa da lesão, curetagem e fixação maxilar. O paciente encontra-se em acompanhamento clínico e radiográfico sem recidiva após doze meses. Dessa forma, ressalta-se a importância do diagnóstico precoce, a conduta clínica empregada e o acompanhamento periódico.

Calcifying cystic odontogenic tumors (CCOT) with proliferative ameloblastoma are a rare variant among maxillary cysts. This study aims to present a clinical report of an 18-year-old male patient with extra and intra oral swelling of the left maxilla, firm to touch, with normochromic characteristics and painless. The clinical approach comprised cone-beam tomography, incisional biopsy, complete removal of the lesion, curettage and maxilla fixation. His clinical and radiographic follow-up has revealed no relapse after 12 months. Hence, this study corroborates the importance of early diagnosis, clinical approach and periodical follow-ups.