RESUMEN

BACKGROUND: Modern management of dental caries should be more conservative and include early detection of lesions and active surveillance, in order to apply preventive measures and carefully monitor for signs of arrest or progression. Proximal slicing was suggested for nonrestorative caries treatment for primary incisors. The aim of the study was to examine the success of proximal slicing in primary maxillary incisors in arresting caries progression. METHODS: A retrospective cohort study. Data were collected from medical records of patients who had undergone proximal slicing in primary maxillary incisors with a follow-up period of at least 6 months. Treatment was considered a success when no further invasive clinical intervention was required within the follow-up period of at least 6 months. Treatment was considered a failure when further invasive clinical intervention was needed during the follow-up period (restoration, crown, or extraction). Additional variables included were the patient's gender, treated tooth, treated surface, age during their first visit to the clinic, age during slicing treatment, follow-up period, number of follow-up visits, and number of fluoride applications and additional slicing during follow-up. RESULTS: Seventy-one patients were included in the study. Proximal slicing was successful in 76% of participants with a follow-up of at least 6 months. Success was associated with older age at the first dental visit (3.5yo vs. 2.5yo, p = 0.0011) and age when proximal slicing was performed (4yo vs. 3yo, p < 0.001). CONCLUSION: Proximal slicing may successfully arrest proximal caries in primary maxillary incisors.

Asunto(s)

Caries Dental , Incisivo , Humanos , Resinas Compuestas/uso terapéutico , Caries Dental/terapia , Caries Dental/tratamiento farmacológico , Estudios Retrospectivos , Susceptibilidad a Caries Dentarias , Diente Primario

RESUMEN

Anti-NMDAR encephalitis is becoming more widely recognized as a cause of encephalopathy in both adults and children. Certain clinical features such as mood lability, movement disorders, speech dysfunction, seizures, and autonomic instability in a pediatric patient should prompt immediate concern and evaluation for autoimmune encephalitis among providers. We present the case of a pediatric patient with anti-NMDAR encephalitis in which the symptom prompting medical evaluation was insomnia. Insomnia has not previously been emphasized in the literature as a presenting feature of this disease in children and has a broad differential. Recognition of the symptoms of anti-NMDAR encephalitis and its variable presentation are key to early diagnosis and prompt initiation of treatment which may help to improve outcomes.