RESUMO O objetivo deste trabalho é fornecer embasamento científico para condução do tratamento endodôntico em gestantes através de uma revisão de literatura e série de casos clínicos conduzidos em sessão única no projeto de extensão Atenção Odontológica Materno-infantil da Faculdade de Odontologia da Universidade Federal de Pelotas. As bases científicas abordam as principais dúvidas do profissional na condução do pré-natal odontológico: uso do exame radiográfico, anestésico local, prescrição de medicamentos, entre outros fatores essenciais no atendimento da gestante. As gestantes assistidas procuraram atendimento apresentando dor de origem dentária. Em dois casos foi diagnosticado pulpite irreversível sintomática, enquanto um terceiro se travava de periodontite apical aguda. Os procedimentos endodônticos foram realizados sob condições controladas e padronizadas, sob supervisão de um professor de Endodontia. O preparo dos canais radiculares foi realizado em sessão única, através de instrumentação mecanizada de cinemática reciprocante (Wave One® Gold Primary (Dentsply Sirona), sendo o comprimento dos canais determinado por meio de localizador foraminal FinePex (Schuster). A obturação dos canais foi realizada pela técnica do cone único com cones do sistema Wave One®. Após o tratamento endodôntico foi realizada blindagem coronária com resina composta cor A2 Z350 XT (3M ESPE). Os cuidados relacionados à condição gestacional estão destacados, sendo que as pacientes permanecem em acompanhamento no projeto. Conclui-se que o uso de localizadores foraminais e da instrumentação mecanizada, utilizando limas reciprocantes associadas à técnica de obturação com cone único padronizado para cada sistema representam avanços para a realização do tratamento endodôntico em pacientes gestantes devido ao menor tempo clínico e maior conforto do procedimento.

ABSTRACT The aim of this paper is to provide a scientific basis for conducting safe root canal treatment in pregnant women, illustrating with case reports treated in the extension project Maternal-Child Dental Care at the Federal University of Pelotas. The scientific bases address the main doubts of professionals when performing prenatal dental care: use of radiographic examination, local anesthetics, prescription of medications, among other essential factors in the care of pregnant women. The assisted pregnant women sought care with dental pain. In two cases symptomatic irreversible pulpitis was diagnosed, while a third was experiencing acute apical periodontitis. Endodontic procedures were performed under controlled and standardized conditions. The root canals were prepared in a single session, using mechanical instrumentation with reciprocating kinematics (Wave One® Gold Primary - Dentsply Sirona), and the root canal length was determined by an electronic apex locator FinePex (Schuster). Root canal filling was performed by the single cone technique with Wave One® gutta-percha points. After endodontic treatment, coronal sealing was performed with composite resin A2 Z350 XT (3M ESPE). The care related to the gestational condition is highlighted, and the patients remain under monitoring. It is concluded that the use of apical locators and mechanical instrumentation, using reciprocating files associated with the single cone obturation technique with a standardized cone for each system, represents advances for the accomplishment of endodontic treatment in pregnant patients due to the shorter clinical time and greater comfort of the procedure.

Abstract The purpose of this study was to investigate the association between maternal factors and dental visits of children within their first year of life. This study used data from the 2015 Pelotas Birth Cohort and included pregnant women and their children at 12 months of age, followed-up between May 2014 and December 2015. Socioeconomic and demographic data, information on the use of dental services during the last year, and information on dental fear were collected by interviewing the mothers. Information regarding dental caries and periodontal disease were collected during the mother’s clinical examination. The date of each child’s first visit to the dentist was recorded. Crude and adjusted Poisson regression models with robust variance were used. The sample comprised 2,287 mother-child dyads, of which 10.1% of children visited the dentist during the first year of life. Children whose mothers visited the dentist within the last year for preventive reasons (RR: 1.51; 95%CI: 1.12–2.03) or curative reasons (RR: 1.47; 95%CI: 1.08–2.01) were more likely to have visited the dentist during the first year of life compared to those whose mothers had not used dental services during this period. Maternal tooth loss was inversely associated with a child’s visit to the dentist during the first year of life (RR: 0.69; 95%CI: 0.54–0.89). Considering the mother’s history of using dental services, as well as their dental caries history, is necessary to understand and improve patterns of dental health care utilization and implement public oral health policies for young children.

Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Abstract This study aimed to investigate the influence of specific maternal-factors on caries prevalence in offspring. This cross sectional study was conducted in Pelotas, Brazil nested in a cohort of adolescent mothers with children aged 24–42 months. A questionnaire was administered to collect information in relationship to socio-economic, demographic, and behavioral maternal variables. The outcome (children’s dental caries prevalence – dmfs > 0) was collected from clinical examinations. Bivariate and multivariate analyses were conducted. A total of 538 mother/child dyads were evaluated and 15.1% of the children exhibited caries. Adjusted multivariate analysis showed children from mothers living without partners (p < 0.027) had more caries than those living with partners. Maternal perception of a child’s oral health was associated to occurrence of caries, particularly when mothers classified their child as poor and these children had a higher level of caries. In addition, mothers accurately evaluated their child’s teeth when associated with caries occurrence. Maternal oral health care practices were associated with children’s caries prevalence. Our results demonstrated mothers accurately evaluated the oral health of their offspring.