Fabrício Kitazono de Carvalho

E-cadherin abnormalities resulting from CPG methylation promoter in metastatic and nonmetastatic oral cancer.

This study aims to compare the alterations in the methylation profiles of E‐cadherin in oral cancer, especially in tumors with lowest metatastic potential.

Oral aspects in celiac disease children: clinical and dental enamel chemical evaluation

OBJECTIVE The aim of this study was to evaluate the oral manifestations of celiac disease (CD), the chemical composition of dental enamel, and the occurrence of CD in children with dental enamel defects (DEDs). STUDY DESIGN In the study, 52 children with CD and 52 controls were examined for DEDs, recurrent aphthous stomatitis (RAS), dental caries experience, and salivary parameters. In addition, 10 exfoliated primary enamel molars from each group were analyzed by energy dispersive x-ray spectroscopy and Fourier transform infrared spectroscopy. Fifty children with DEDs were submitted to CD diagnosis. RESULTS Among the children with CD, a higher prevalence of DEDs (P = .00001) and RAS (P = .0052), lower caries experience (P = .0024), and reduction of salivary flow (P = .0060) were observed. Dental enamel from the children with CD demonstrated a lower calcium-to-phosphorus ratio (P = .0136), but no difference in the carbonate-to-phosphate ratio (P = .5862) was observed. In the multivariate analysis, CD was a protective factor for caries (OR = 0.74) and a risk factor for RAS (OR3.23). CONCLUSIONS The children with CD presented with more RAS, DEDs, reduction of salivary flow, and chemical alterations in the enamel.

Stress and Anxiety in Children After the Use of Computerized Dental Anesthesia

The aim of this study was to evaluate the transitory stress levels and the anxiety state in children submitted to conventional and computerized dental anesthesia. Twenty children (7 to 12 years) were randomly assigned to receive conventional and computerized dental anesthesia. To investigate the hypothesis that transitory stress could be lower after using computerized anesthesia compared to conventional anesthesia, cortisol levels in saliva were measured before and after each technique. Anxiety was also evaluated individually by answering the State-Trait Anxiety Inventory for Children (STAIC). Numerical data were analyzed statistically by the Mann-Whitney non-parametric test (5% significance level). Salivary cortisol levels increased in 8 (40%) patients after conventional anesthesia and in 9 (45%) patients after computerized anesthesia, with no statistically significant difference between the two types (p=0.34). In the same way, no statistically significant difference was found between the techniques (p=0.39) related to the psychological analysis based on the STAIC scores. Local anesthesia using either conventional anesthesia or a computerized delivery system produced similar level of stress/anxiety in pediatric patients, using both quantitative and qualitative analyses.

Biological Restorations as a Treatment Option for Primary Molars with Extensive Coronal Destruction - Report of Two Cases

This article reports the cases of two young children aged 4 and 5 years, in whom biological restorations using tooth fragments were placed in primary molars with severely damaged crowns due to extensive carious lesions. After radiographic and clinical evaluation, tooth fragments obtained from extracted teeth in stock were autoclaved, adjusted to the prepared cavity and bonded to the remaining tooth structure with either adhesive system (Case 1) or dual-cure resin-based cement (Case 2) over a calcium hydroxide layer and a glass ionomer cement base. Occlusal adjustment was performed and topical sodium fluoride was applied to tooth surface. Periodical clinical and radiographic controls were carried out and the restored teeth were followed up for 4 and 3 years, respectively, until exfoliation. In these two reports, the technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed primary molars are discussed.

Assessing the proposed association between DED and gluten-free diet introduction in celiac children: ASSOCIATION BETWEEN DED AND GLUTEN-FREE DIET

A strong association between celiac disease (CD) and dental enamel defects (DEDs) have been extensively reported, however, the nature of this relationship is still unclear. The aim of this study was to evaluate DEDs phenotype in CD individuals according to the time they were introduced to a gluten-free diet (GFD). Forty-five CD individuals were examined by a pediatric dentist. DEDs were classified according to the type of affected teeth. CD individuals were classified into two groups (with or without DEDs) and the differences between these groups were tested using chi-square or Fisher´s exact tests and t-test to compare differences between means. The Pearson coefficient test was used to evaluate the degree of the correlation between the age of GFD introduction and number of affected teeth. Individuals with MIH were introduced earlier to the GFD (p = 0.038). An association was also observed for molar DED (p = 0.013). In conclusion, our study suggested an association between a specific type of DED and the time that CD individuals were introduced to a GFD.

Alveolar Fracture Caused by Tooth Extraction at Home

Injuries to the teeth and surrounding structures are relatively common. Although traumatic injuries caused by falls or activities related to sports are widely discussed, the same cannot be said regarding accidents arising from non-professional extraction of primary teeth. The present study reports a 6-year-old male child who underwent mandibular alveolar bone fracture during non-professional extraction of his central lower left incisor at home, performed by his 30-year-old aunt. The root of the tooth was with an irregular physiological resorption, which acted as a lever component for the mechanical force applied, leading to bone fracture. Although not common, the possibility that dental roots with irregular resorption can act as a possible risk factor for accidents if the parents or guardians of children during the period of transitional dentition try to perform intentional extraction of primary teeth should be highlighted. Parents should always consult a professional, preferably a pediatric dentist, for monitoring this period of transitional dentition.

Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA) was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.