Francisco Wanderley Garcia de Paula e Silva

Tooth pigmentation caused by bilirubin: a case report and histological evaluation

Systemic disorders in pediatric patients, such as congenital biliary atresia, acute liver failure, and biliary hypoplasia, may be the indications for a need of liver transplantation. One of the manifestations of these disorders is the elevated serum levels of bilirubin (hyperbiliru-binemia), a product of hemoglobin degradation, which is deposited in different tissues, including mineralized and soft tissues. When hyperbilirubinemia occurs during the period of dental development, these teeth can develop a green coloration, which remains permanently, because, after maturation, these tissues loose their metabolic activity. This case report describes a 9-year-old girl who required a liver transplant due to biliary atresia when she was three years old. Some of her pigmented teeth needed extraction and afterwards were submitted for histological analysis and compared with sound teeth.

Dental treatment in a patient with epidermolysis bullosa

Epidermolysis bullosa (EB) is a rare inherited group of genodermatoses characterized by mucocutaneous fragility and blister formation, either spontaneously or as a result of minimal mechanical trauma. The repetition of these episodes in the oral cavity leads to atrophy of the mucosa, causing microstomia, ankyloglossia, tongue denudation, and vestibule obliteration, characteristics that make dental treatment difficult. Patients with EB are at high risk for caries due to the presence of dental anomalies; they also tend to have a soft diet and difficulties with mechanical removal of the dental biofilm. This case report presents a patient diagnosed with EB and describes the difficulties faced by the clinician during dental treatment as well as the measures adopted to safely manage the patients dental care.

A Comparison Study of Periapical Repair in Dogs' Teeth Using RoekoSeal and AH Plus Root Canal Sealers: A Histopathological Evaluation

The objective of the study was to evaluate the biocompatibility of RoekoSeal sealer Roeko (Dental Products, Langenau, Germany) with the periapical tissues of dogs and compare it with AH Plus sealer (Dentsply/De Trey, Konstanz, Germany). The pulps of 32 root canals were removed, the apical cementum layer perforated, the biomechanical preparation performed, and the root canals filled by lateral condensation technique. Ninety days after the surgery, the animals were euthanized, the bone with teeth removed, and the samples prepared for histopathological analysis. In group 1 (RoekoSeal Automix), deposition of mineralized tissue was observed, with complete newly mineralized apical formed tissue in 43.8% and partial sealing in 56.2%. In group 2 (AH Plus), in 12.5% there was complete newly mineralized apical formed tissue, in 75% the sealing was partial, and in 12.5% there was no sealing (p < 0.05). There were no differences between the groups in relation to the inflammatory infiltrate; thickness of the periodontal ligament; and the resorption of dentin, cementum or bone (p > 0.05).

Kabuki make-up (Niikawa-Kuroki) syndrome: dental and craniofacial findings in a Brazilian child

This article reports the case of a Brazilian child diagnosed with Kabuki make-up syndrome (KMS), addressing the clinical features observed, with emphasis on the disease-specific oral and craniofacial manifestations. The patient had the distinctive KMS craniofacial appearance, mild delayed mental development, fingers with prominent fingertip pads and visual deficit. The dental findings included fusion of the left mandibular incisors (central and lateral), gemination of the right mandibular central incisor and congenital agenesis of the right mandibular lateral incisor, in the primary dentition, as well as absence of both permanent mandibular lateral incisors. Fusion and gemination have not been previously referred to as typical dental features in KMS. The detection of unique dental findings, such as missing teeth and dental anomalies of form in the primary dentition by means of clinical and radiographic examinations, might consist of a helpful diagnosis parameter in identifying children who may have milder forms of Kabuki syndrome.

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.

Principais tumores não odontogênicos que acometem a cavidade bucal de crianças: [revisão]

O objetivo deste trabalho e descrever as caracteristicas clinicas, radiograficas e histologicas, assim como aspectos relacionados ao tratamento e prognostico das patologias tumoriformes nao odontogenicas mais comumente encontradas na cavidade bucal de criancas. Dentre elas estao o papiloma, o hemangioma, o linfangioma, a epulide congenita do recem-nascido, o granuloma piogenico, as lesoes perifericas e centrais de celulas gigantes e o fibroma ossificante periferico. (AU) The aim of this review is to relate the clinical, radiographical and histological aspects, the treatment andprognostic of non odontogenic tumors commonly found in the oral cavity of children. Beside these tumors are the papilloma, hemangioma, lymphangioma, neonatal congenital epulis, pyogenic granuloma, peripheral and central giant cell lesions, and peripheral ossifying fibroma. (AU)

Microleakage of Sealants after Phosphoric Acid, Er: YAG Laser and Air Abrasion Enamel Conditioning: Systematic Review and Meta-Analysis

PURPOSE The aim of this systematic review and meta-analysis is to answer the focused question: Does the application of phosphoric acid, Er:YAG laser and air abrasion enamel conditioning methods previous to the oclusal sealant application in human permanent molars influence the microleakage? STUDY DESIGN A literature research was carried out in the Pubmed Medline, Web of Science, Scopus and Cochrane databases using with the MeSH terms and keyword search strategy. A supplemental hand search of the references of retrieved articles was also performed. Inclusion criteria comprised ex vivo studies (extracted teeth) with permanent human teeth that used chemical (phosphoric acid) or mechanical (Er:YAG laser and air abrasion) conditioning methods previous the sealant application. The studies should evaluate microleakage as an outcome. Meta-analysis pooled plot were obtained comparing the microleakage after pre-treatment with phosphoric acid, Er:YAG and air abrasion enamel conditioning for sealant application using RevMan software. RESULTS The search resulted in 164 articles, 55 records were excluded because they were duplicated. The analysis of titles and abstracts resulted in the exclusion of 105 studies. Four studies were included in the systematic review and the meta-analysis. According to the risk of bias evaluation, the four studies were considered low risk of bias. The meta-analysis showed that phosphoric acid had lower microleakage than Er:YAG laser (p < 0.001) and air abrasion (p < 0.001), with heterogeinity of I2 = 0% and I2 = 71%, respectively. It was not found statistical difference when compared phosphoric acid and phosphoric acid combined with Er:YAG laser and air abrasion (p > 0.05). CONCLUSION The evidence supports that the pretreatment with phosphoric acid leads lower microleakage in oclusal sealants than Er:YAG laser and air abrasion.

Large apical periodontitis healing following root canal dressing with calcium hydroxide: a case report

OBJETIVO: O objetivo deste trabalho e relatar o caso clinico de um paciente que apresentava lesao periapical cronica decorrente de necrose de pulpar e o sucesso a longo prazo de uma terapia endodontica utilizando o hidroxido de calcio como curativo de demora. DESCRICAO DO CASO: O paciente, do genero masculino, com 20 anos de idade, compareceu a Clinica Odontologica para tratamento de rotina. Por meio de exames radiograficos observamos uma area radioluscente extensa, lateralmente ao incisivo lateral superior direito, com possibilidade de comunicacao com o periodonto lateral, sugestivo de lesao periapical. Devido a presenca de reabsorcao radicular externa, foi utilizado um curativo de demora a base de hidroxido de calcio (Calen®), trocado a cada 15 dias, por um periodo de 2 meses. A obturacao do canal radicular foi realizada com cones de guta-percha pela tecnica de condensacao lateral ativa. O acompanhamento radiografico realizado apos 19 anos do tratamento endodontico indicou um periodonto em condicoes de normalidade, com integridade da lamina dura. CONCLUSAO: O hidroxido de calcio e um material adequado para ser usado como curativo de demora em dentes com lesao periapical, uma vez que a avaliacao a longo prazo demonstrou resultados clinicos satisfatorios apos o tratamento endodontico.

Tratamento odontológico em paciente com trissomia do cromossomo 9: relato de caso

The present work relate a case of partial trisomy of chromosome 9, in 10 year-old patient. This is a rare genetic condition which presents as main characteristics microcephaly, facial asymmetry, thin hair, short neck, hypertelorism, hands asymmetry, cyanotic feet and hands, dysplasic nails, cardiac anomalies, enamel hypoplasy, palatine fissure, and micrognathy. During clinical exam was observed the presence of white stains in the teeth and caries lesions. Dental treatment was applied using common techniques of behavior management. Clinical procedures constituted of preventive orientations, application of fluoridated varnish and sealants, composite resin restoration, and dental avulsion. Attending was made in ambulatory environment without sedation or physical restriction of movements. Key-words: trisomy of chromosome 9, dental treatment, special patient