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AIMS: To perform a systematic review and meta-analysis compiling data on the prevalence of bruxism in children and adolescents with cerebral palsy. METHODS AND RESULTS: Searches were carried out in PubMed/Medline, Web of Science, and Scopus databases to identify the articles published by February 2023. Two independent reviewers, and in duplicate, employed a two-stage process to select publications. The same two reviewers performed the data extraction. Studies were included when the following eligibility criteria were met: performed in children and/or adolescents with cerebral palsy and reporting bruxism. Potentially eligible studies were read in full and excluded that: not presented numerical data on the prevalence of bruxism; not reported how the bruxism was assessed; not reported data about the cerebral palsy; and not an observational study. The risk assessment of bias was assessed by the Newcastle- Ottawa Scale. After reading the titles and abstracts of the 358 identified articles, eight articles from 1966 to 2020 were included. The main reason for not including the studies was not to report data about bruxism (59.3%), and 44.5% were excluded for not reporting data from patients with cerebral palsy. The studies were carried out in schools, university hospitals, or centers for patients with special needs (Brazil, the United States, and Egypt). The pooled prevalence of bruxism in children and adolescents with cerebral palsy was 46% (95%CI: 0.38-0.55) after removing one study. CONCLUSION: The pooled prevalence of bruxism in children with cerebral palsy can be considered high since almost half of the studied population is affected by this condition. PROSPERO #CRD42021225781.

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Aim: To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars. Materials and methods: Cross-sectional study consisting of 30 cone-beam computed tomography (CBCT) images of primary maxillary and mandibular first molars, with crown, and root integrity. The wall dentin thickness of each canal was measured in three axial views, divided into distal (D), mesial, lingual/palatine, and buccal surfaces. Results: The smallest dentin wall thickness of the maxillary molar was located on the mesial surface of the mesiobuccal (MB) canal apical third (mean 0.55 ± 0.04 mm). The buccal and palatal (P) surfaces of the distobuccal (DB) and P canals showed the smallest dentin thickness on the cervical third (0.62 ± 0.02 mm). On the mandibular molar, we found the smallest dentin thickness on the apical third [lingual surface of the MB canal and buccal surface of the mesiolingual (ML) canal] with a mean of 0.41 ± 0.07 mm. Additionally, the dentin thickness is average of the D canal was about 0.67 ± 0.11 mm. Conclusion: It is essential to understand the primary first molar's anatomy to reduce possible complications in pediatric patients from instrumentation during root canal treatments. Clinical significance: Pulpectomy is among the most challenging procedures in pediatric dentistry and the knowledge of the root anatomy of primary teeth allows the professional to make better clinical decisions and reduce possible risks during root canal treatment. How to cite this article: Justiniano-Navarro C, Caballero-García S, López-Rodriguez G, et al. Evaluating the Thickness of the Root Canal Dentin Wall in Primary First Molars using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2023;16(S-2):S122-S127.

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Se presenta el caso de 02 recién nacidas gemelares, pre-términos tardíos, producto de gestación monocoriónica - biamniótica con presencia de dientes natales, los cuáles requirieron evaluación odontológica para definir la mejor conducta a seguir y con ello evitar riesgos o desenlaces fatales como la aspiración hacia bronquios. La evaluación evidenció escasa movilidad de piezas dentarias en ambos casos, por lo que se recomendó mantener los dientes; del mismo modo, se dio consejería a los padres sobre la higiene y cuidado de la salud bucal de sus hijas con control ambulatorio a los 3 meses.

We present the case of 2 twin newborns, late preterm, who were a product of monochorionic - diamniotic gestation and presented with natal teeth, which required a dental evaluation to define the best management strategy and thereby avoid risks or fatal outcomes such as bronchial aspiration. The evaluation showed little mobility of teeth in both cases, so it was recommended to keep the teeth. The parents were counseled on proper oral health care and hygiene for their daughters and scheduled for an outpatient follow-up at 3 months.

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Abstract Evaluate the shaping ability and preparation time using a pediatric motor-driven rotary instrumentation compared to other systems in resin prototypes of primary molars. Methods: Thirty specimens were scanned in micro-CT and divided into three groups according to the instrumentation type: pediatric motor-driven Sequence baby File (SBF); conventional motor-driven (Sequence Rotary File - SRF); manual K file. Instrumentation time was timed. After preparation, the specimens were scanned again. The pre- and post-instrumentation images were superimposed to measure the amount of root canal deviation and the resin remnant thickness. ANOVA followed by the Tukey test analyzed the comparisons between groups (p<0.05). Results: No statistically significant differences occurred in root canal deviation among groups (p>0.05). There were statistically significant differences in the comparison among root thirds (p<0.001) but without significant differences in the interaction group vs. root third (p>0.05). Both motor-driven instrumentations showed statistically greater weariness than manual instrumentation (p<0.001), without significant significant differences between SBF and SRF. Motor-driven instrumentation had a shorter working time than manual instrumentation (p<0.001). Conclusion: Pediatric motor-driven instrumentation demonstrated good outcomes in relation to root canal deviation and amount of remnant structure, with shorter instrumentation time. SBF can be a suitable alternative for endodontic instrumentation in primary molars.

Resumo Objetivo: Avaliar os resultados da instrumentação endodôntica e o tempo de preparo de lima odontopediátrica ativada por motor (Sequence Baby File- SBF) em canais de molares decíduos prototipados. Métodos: Trinta espécimes foram escaneados em micro-CT e divididos em três grupos de acordo com o tipo de instrumentação: mecanizada odontopediátrica (SBF); mecanizada convencional; lima K manual. O tempo de instrumentação foi cronometrado. Após o preparo, os espécimes foram escaneados novamente. As imagens pré e pós-instrumentação foram sobrepostas e a quantidade de desvio do canal radicular e a espessura de resina remanescente foram mensurados. Para as análises de comparações entre os grupos foram realizados teste ANOVA seguido do teste de Tukey (p<0,05). Resultados: Não ocorreram diferenças estatisticamente significativas entre os grupos no desvio do canal radicular (p>0,05). Houve diferenças estatisticamente significativas na comparação entre terços radiculares (p<0,001), mas sem diferenças significativas na interação grupo vs. terço radicular (p>0,05). A instrumentação mecanizada apresentou desgaste estatisticamente maior do que a instrumentação manual (p<0,001), sem diferenças estatísticas entre a SBF e a lima mecanizada convencional. A instrumentação mecanizada teve menor tempo de trabalho quando comparado a instrumentação manual (p<0,001). Conclusão: A instrumentação mecanizada odontopediátrica demonstrou bons resultados em relação ao desvio do canal radicular e quantidade de estrutura remanescente, com menor tempo de instrumentação. A SBF pode ser uma alternativa adequada para a instrumentação endodôntica em molares decíduos.

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PURPOSE: To assess the coverage of information about early childhood caries (ECC) available on YouTube videos in three different languages, regarding technical characteristics of videos and interaction metrics. METHODS: Search strategies were developed in English, Spanish, and Portuguese to make a comprehensive collection of videos from YouTube, encompassing 60 samples for each language, regarding all video types. The videos were assessed by a thematic checklist regarding 17 items on ECC. Videos were dichotomized according to the median of the thematic score and the nature of their authorship (health and non-health authors) to compare groups. The statistical analysis was performed using the Statistical Package for Social Science (version 25.0), applying Spearman's rank correlation coefficient and Mann-Whitney U test. P < 0.05 values were considered significant. RESULTS: Among 120 videos meeting inclusion criteria, ECC aetiology and prevention information proved incomplete, with a median score of 5 (Q1-Q3 = 3-7). No correlation emerged between this score and other video characteristics. However, interaction metrics like views, likes, dislikes, and viewing rates displayed significant correlations. Health authors primarily created these videos, yet non-health author channels had more subscribers. Surprisingly, videos focused on the impact of regular sugary food and beverage consumption on ECC progression received the most attention. CONCLUSIONS: Videos that presented information about the aetiology and prevention of ECC invariably focused on partial aspects of the disease. This highlights the need for better-quality educational videos and the importance of dental professionals in guiding patients toward reliable sources of information.

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PURPOSE: The purpose of this study was to gather existing data on the efficacy of tooth splinting (TS) in patients with traumatized primary teeth, evaluating their overall prognosis and reported complications. METHODS: Electronic searches were performed in seven databases up to Februray/2023. Clinical studies published in the last two decades and presenting the following characteristics were included: (a) reporting on children with traumatized primary teeth; (b) describing the efficacy of splinting those teeth. Studies describing imobilization of dental avulsion were excluded. RESULTS: A total of 163 potentially relevant studies were initially found. After title/abstract screening, and full-text evaluation, three retrospective studies with moderate to high risk of bias were included. The studies described the outcomes of TS in primary teeth with luxation (intrusion, extrusion, lateral displacement), intra-alveolar root fracture, and/or alveolar fracture. High clinical success rate was observed for teeth with root fracture. Benefits of spliting teeth with lateral luxation were not identified, although it may be a reccomended approach. No study was found evaluating TS for alveolar fracture. CONCLUSION: Based on a low level of evidence, the findings highlight a better clinical success rate of the use of TS in the management of deciduous teeth with root fractures.

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BACKGROUND: Primary lower incisors are susceptible to traumatic dental injury (TDI), which may affect both primary and permanent dentitions. AIM: This study aimed to evaluate the prevalence of TDIs in the primary lower incisors and the factors associated with their occurrence and with the incidence of sequelae in the permanent successor teeth. DESIGN: Dental files (n = 2926) from patients who attended a reference center for dental trauma in the primary teeth, from 1998 to 2020, were screened. Multilevel Poisson regression analyses were conducted between exploratory variables related to the traumatized teeth and outcome variables: occurrences of severe TDI and sequelae in the permanent successor. Prevalence ratios (PRs), relative risks (RRs), and respective 95% confidence intervals (95% CIs) were calculated. RESULTS: One hundred and thirteen (3.9%) children and 208 teeth presented with TDIs in the primary lower incisors. The prevalence of severe TDI was lower in 4-year-olds (PR = 0.43; 95% CI = 0.19-0.94) than in 2-year-olds. Moreover, severe TDI was significantly associated with the occurrence of sequelae in the permanent successors (RR = 3.97; 95% CI = 1.72-9.18), when compared to not severe TDI. CONCLUSIONS: The prevalence of TDI in the primary lower incisors is low, with a higher prevalence in children younger than 3 years. Older children also present less frequently with severe TDI, and the risk of sequelae in permanent teeth is higher following severe TDI.

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PURPOSE: Evaluate the impact of the premature loss of primary molars due to caries on oral health-related quality of life (OHRQoL) in schoolchildren. METHODS: A cross-sectional study was conducted with children eight to ten years of age at public schools in the city of Florianópolis selected through cluster sampling. The collection of the clinical data occurred in the school setting by four trained and calibrated examiners (Kappa > 0.7) DMFT/dmft index, PUFA/pufa index, accentuated overjet, and anterior open bite. Sex and age of the child and guardian's schooling (classified as ≤ 8 or > 8 years) were collected through a questionnaire answered by the guardians. OHRQoL was assessed using the Child Perceptions Questionnaire 8-10. The data were submitted to bivariate, multivariate, and hierarchical Poisson analyses. RESULTS: A total of 1456 children participated in the study. The prevalence of premature tooth loss due to caries was 5.8% (n = 85). The prevalence of negative impact on OHRQoL was 47.4% (n = 691). Negative impact on OHRQoL was significantly associated with the premature loss of primary molars (p < 0.001) as well as the sex (girls), guardian's schooling (> 8 years) and the presence of untreated caries (p < 0.001). CONCLUSION: The premature loss of primary molars due to caries was associated a negative impact on the OHRQoL of children eight to ten years of age. Negative impact is also associated with untreated caries, sex, and the level of schooling of guardians.

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Resumen Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo.

Abstract Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines.

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Introducción: La caries de infancia temprana severa es un problema de salud pública que afecta a los niños que la padecen y a sus familias. Objetivo: Determinar la asociación de variables sociodemográficas, de higiene y alimentación con la caries de infancia temprana severa en niños peruanos. Métodos: Se realizó un estudio observacional, analítico, de casos y controles, de octubre a diciembre del 2019. La muestra estuvo compuesta por 264 niños de 2-5 años de edad y sus acompañantes (100 del grupo sin caries y 164 del grupo con caries de infancia temprana severa) que asistieron al Departamento de Odontopediatría del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizó una entrevista estructurada directa, con preguntas cerradas sobre variables sociodemográficas, de higiene, de alimentación y una evaluación clínica, utilizando el índice cpo-s. Se utilizaron las pruebas estadísticas de chi cuadrado, Kruskal-Wallis y el modelo de regresión logística binaria. Resultados: De las variables sociodemográficas, experiencia dental negativa y seguro de salud, tuvieron un valor p < 0,05. Igual resultado tuvo el uso de una pasta dental fluorada, alimentación por biberón, tiempo de alimentación por biberón y edad de inicio del cepillado dental. En el modelo de regresión logística binaria solo las variables uso de pasta dental fluorada (OR = 0,578; 95 por ciento IC: 0,495-0,674) y edad de inicio del cepillado dental (OR = 0,924; 95 por ciento IC: 0,850-0,938) tuvieron un p < 0,05. Conclusiones: Las variables edad de inicio del cepillado dental y uso de una pasta dental fluorada están asociadas con la aparición de caries de infancia temprana severa en niños peruanos. Las variables sociodemográficas y de alimentación no están asociadas(AU)

Introduction: Severe early childhood caries is a public health problem affecting sufferers and their families. Objective: Determine the association of sociodemographic, hygiene and food intake variables to severe early childhood caries in Peruvian children. Methods: An observational analytical case-control study was conducted from October to December 2019. The study sample was 264 children aged 2-5 years (100 from the group without caries and 164 from the group with severe early childhood caries) and their companions, who attended the Children's Dental Care Department at the National Children's Health Institute in Lima, Peru. Direct structured interviews were held based on closed-ended questions about sociodemographic, hygiene and food intake variables, and a clinical evaluation was performed using the cpo-s index. Use was made of the chi-square statistical test, the Kruskal-Wallis test and the binary logistic regression model. Results: Among the sociodemographic variables considered, a negative dental care experience and health insurance obtained a value of p < 0.05. The same result was obtained by use of fluoride toothpaste, bottle feeding, bottle feeding time and age at tooth brushing start. In the binary logistic regression model only the variables use of fluoride toothpaste (OR = 0.578; 95 por ciento CI: 0.495-0.674) and age at tooth brushing start (OR = 0.924; 95 por ciento CI: 0.850-0.938) obtained a value of p < 0.05. Conclusions: The variables age at tooth brushing start and use of fluoride toothpaste are associated to the appearance of severe early childhood caries in Peruvian children. Sociodemographic and food intake variables are not associated(AU)

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BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has been used as an adjunct treatment of deep caries lesions; however, studies on the effects of aPDT on the longevity of restorations are still limited. AIM: To evaluate the clinical performance of composite restorations in primary molars subjected to selective caries removal (SCR) associated with aPDT. DESIGN: A randomized clinical trial was designed. Primary molars of patients (mean age 6.15 years) with deep caries lesions without signs and symptoms of pulpal involvement were selected. A total of 64 teeth were randomly divided into groups G1 (SCR, 32 teeth) and G2 (SCR + aPDT, 32 teeth) for treatment, restored with composite, and evaluated after a week (T0 ), 6 months (T1 ), and 12 months (T2 ) according to the criteria of FDI. Groups were compared using the Rao-Scott chi-squared test and the logistic regression analysis for complex designs to account for multiple observations per subject (alpha = 0.05). RESULTS: From all FDI criteria evaluated, the marginal adaptation for the SCR + aPDT group was significantly better in comparison with the SCR group at T0 and T2 in the logistic regression analysis (T0: OR = 0.151; 95% CI = 0.03-0.068, P = .015; and T2: OR = 0.201; 95% CI = 0.05-0.79, P = .022). CONCLUSION: The marginal adaptation of primary molar resin restorations was positively affected by aPDT after 12 months of follow-up.

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OBJECTIVES: The purpose of this retrospective cohort study was to investigate the occurrence of sequelae in the permanent teeth after avulsion of their primary antecessors and to evaluate the factors associated with this occurrence. METHODS: We screened 2922 records of patients with photographic and radiographic images who attended a reference centre for dental trauma in the primary teeth from 1998 to 2019. Among them, 240 were eligible records of children who had suffered avulsion of the primary incisors and were followed up until complete eruption of the permanent successors. Multilevel Poisson regression analyses were conducted between the explanatory variables related to children and avulsed teeth; outcome variables were occurrences of any type of sequelae in the permanent teeth, opacities, hypoplasia and malformation. Relative risks (RRs) and respective 95% confidence intervals (95% CIs) were calculated. RESULTS: Among the 240 children's records, 194 fulfilled the inclusion criteria. Finally, we found 266 primary avulsed teeth and 115 (43.2%) permanent teeth presenting with sequelae. Avulsion occurring when children were older than 4 years (RR = 0.48; 95% CI = 0.24-0.95) had lower risks for developing sequelae than children aged 0-2 years of age. Additionally, when avulsion occurred in the lower dental arch (RR = 1.45; 95% CI = 1.06-1.99) and when three or more teeth were affected (RR = 1.57; 95% CI = 1.02-2.41), the occurrence of sequelae in the permanent teeth was more probable than if avulsion occurred in the upper arch and affected only a single tooth. Age older than 3 years was a protective factor for the occurrence of hypoplasia and age older than 4 years protective for the occurrence of opacities. CONCLUSIONS: The risk of sequelae in the permanent teeth after avulsion of their antecessor is higher when the trauma occurs in young children (<2 years) and in patients with avulsions of greater magnitude, such as when it affects the lower jaw, and more teeth are involved.

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Objetivou-se analisar o panorama das publicações sobre pulpectomia, de forma geral, além de verificar as evidências acerca do potencial de redução de endotoxinas pelo hidróxido de cálcio e investigar a influência da pandemia de COVID-19 em relação à realização de procedimentos endodônticos em Odontopediatria. Para tanto, foram realizados três estudos. O primeiro visou mapear e discutir, por meio de uma revisão bibliométrica, o panorama das publicações científicas acerca da pulpectomia em dentes decíduos utilizando os termos "pulpectomy", "root canal", "child" AND "preschoolar". O segundo estudo delineou-se como uma revisão sistemática, seguida de metanálise objetivando verificar se existem evidências de redução de endotoxinas antes e depois do uso de hidróxido de cálcio como medicação intracanal em canais radiculares infectados. Riscos de avaliação de viés e metanálises foram realizados. A certeza de evidência foi determinada pelo GRADE. O terceiro estudo pretendeu verificar as possíveis influências da pandemia de COVID-19 na realização de procedimentos endodônticos em Odontopediatria, por meio da aplicação de um questionário eletrônico composto por perguntas divididas em 3 domínios: (1) informações profissionais; (2) gerenciamento de biossegurança e (3) protocolo endodôntico de atendimento antes e durante a pandemia. Após a realização dos três estudos, foi identificada uma tendência na pesquisa científica para a utilização de instrumentação mecanizada e pastas obturadoras mais biocompatíveis e eficazes. Foi possível observar ausência de estudos clínicos multicêntricos sobre procedimentos de pulpectomia em dentes decíduos. A maioria dos estudos foi publicada em periódicos de Odontopediatria, apresentaram ampla variedade de protocolos de tratamento e foram realizados principalmente em países em desenvolvimento, denotando claro viés nas opções de tratamento oferecidas para crianças em todo o mundo, uma vez que o acesso aos serviços de anestesia geral em países desenvolvidos favorece a exodontia dos dentes com comprometimento pulpar. Além disso, concluiu-se que o hidróxido de cálcio reduz os níveis de endotoxinas quando usado como medicação intracanal, mas é incapaz de eliminá-las completamente em dentes permanentes, independentemente de sua associação com alguma solução irrigante. Não foram recuperados artigos em dentes decíduos. No terceiro estudo, a amostra final foi composta por 313 participantes de todos os estados brasileiros. A maioria dos participantes era do sexo feminino (90,35%), e mais da metade cursou Odontopediatria em instituição privada (50,25%) há mais de dez anos (53,63%) e trabalha em metrópole (54,75%). No geral, a maioria dos respondentes atualmente prática Odontopediatria exclusivamente em clínicas privadas (61,63%). Durante a pandemia de COVID-19 foi possível ver um aumento na complexidade dos casos planejados previamente e da quantidade de urgências odontológicas. Levando isso em consideração, muitos odontopediatras sentiram a necessidade de se reinventarem, priorizando técnicas minimamente invasivas e com um menor tempo de consulta. Com isso, pôde-se notar uma tendência pela busca do tratamento endodôntico não instrumental (p<0,01), justamente por ser uma técnica mais rápida e barata. Apesar de já existirem muitos trabalhos publicados acerca da endodontia em dentes decíduos, conforme constatado nos dois primeiros estudos, observa-se que ainda são necessárias novas investigações nessa área. (AU)

The objective was to analyze the overview of publications on pulpectomy, in general, in addition to verifying the evidence about the potential for endotoxin reduction by calcium hydroxide and to investigate the influence of the COVID-19 pandemic in relation to the performance of endodontic procedures in Pediatric Dentistry. Therefore, three studies were carried out. The first aimed to map and discuss, through a bibliometric review, the panorama of scientific publications about pulpectomy in primary teeth using the terms "pulpectomy", "root canal", "child" AND "preschooler". The second study was designed as a systematic review, followed by a meta-analysis aiming to verify if there is evidence of endotoxin reduction before and after the use of calcium hydroxide as an intracanal medication in infected root canals. Bias assessment risks and meta-analyses were performed. The certainty of evidence was determined by GRADE. The third study aimed to verify the possible influences of the COVID-19 pandemic on the performance of endodontic procedures in Pediatric Dentistry, through the application of an electronic questionnaire composed of questions divided into 3 domains: (1) professional information; (2) biosafety management and (3) endodontic care protocol before and during the pandemic. After carrying out the three studies, a trend in scientific research towards the use of mechanized instrumentation and more biocompatible and effective filling pastes was identified. It was possible to observe the absence of multicenter clinical studies on pulpectomy procedures in primary teeth. Most studies were published in pediatric dentistry journals, presented a wide variety of treatment protocols, and were carried out mainly in developing countries, denoting a clear bias in the treatment options offered to children around the world, since access to care services general anesthesia in developed countries favors extraction of teeth with pulp involvement. Furthermore, it was concluded that calcium hydroxide reduces the levels of endotoxins when used as an intracanal medication but is unable to completely eliminate them in permanent teeth, regardless of its association with some irrigating solution. No articles in primary teeth were retrieved. In the third study, the final sample consisted of 313 participants from all Brazilian states. Most of the participants were female (90.35%), and more than half had studied Pediatric Dentistry at a private institution (50.25%) for over ten years (53.63%) and worked in a metropolis (54.75% ). Overall, the majority of respondents currently practice Pediatric Dentistry exclusively in private clinics (61.63%). During the COVID-19 pandemic, it was possible to see an increase in the complexity of previously planned cases and the number of dental emergencies. Taking this into account, many pediatric dentists felt the need to reinvent themselves, changing case plans, prioritizing minimally invasive techniques and with less chair time. Thus, a trend towards the search for non-instrumental endodontic treatment (p<0.001) could be noted, precisely because it is a faster and cheaper technique. Although there are many published works about endodontics in deciduous teeth, as seen in the first two studies, it was observed that further investigations are still needed. (AU)

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Objetivou-se analisar o panorama das publicações sobre pulpectomia, de forma geral, além de verificar as evidências acerca do potencial de redução de endotoxinas pelo hidróxido de cálcio e investigar a influência da pandemia de COVID-19 em relação à realização de procedimentos endodônticos em Odontopediatria. Para tanto, foram realizados três estudos. O primeiro visou mapear e discutir, por meio de uma revisão bibliométrica, o panorama das publicações científicas acerca da pulpectomia em dentes decíduos utilizando os termos "pulpectomy", "root canal", "child" AND "preschoolar". O segundo estudo delineou-se como uma revisão sistemática, seguida de metanálise objetivando verificar se existem evidências de redução de endotoxinas antes e depois do uso de hidróxido de cálcio como medicação intracanal em canais radiculares infectados. Riscos de avaliação de viés e metanálises foram realizados. A certeza de evidência foi determinada pelo GRADE. O terceiro estudo pretendeu verificar as possíveis influências da pandemia de COVID-19 na realização de procedimentos endodônticos em Odontopediatria, por meio da aplicação de um questionário eletrônico composto por perguntas divididas em 3 domínios: (1) informações profissionais; (2) gerenciamento de biossegurança e (3) protocolo endodôntico de atendimento antes e durante a pandemia. Após a realização dos três estudos, foi identificada uma tendência na pesquisa científica para a utilização de instrumentação mecanizada e pastas obturadoras mais biocompatíveis e eficazes. Foi possível observar ausência de estudos clínicos multicêntricos sobre procedimentos de pulpectomia em dentes decíduos. A maioria dos estudos foi publicada em periódicos de Odontopediatria, apresentaram ampla variedade de protocolos de tratamento e foram realizados principalmente em países em desenvolvimento, denotando claro viés nas opções de tratamento oferecidas para crianças em todo o mundo, uma vez que o acesso aos serviços de anestesia geral em países desenvolvidos favorece a exodontia dos dentes com comprometimento pulpar. Além disso, concluiu-se que o hidróxido de cálcio reduz os níveis de endotoxinas quando usado como medicação intracanal, mas é incapaz de eliminá-las completamente em dentes permanentes, independentemente de sua associação com alguma solução irrigante. Não foram recuperados artigos em dentes decíduos. No terceiro estudo, a amostra final foi composta por 313 participantes de todos os estados brasileiros. A maioria dos participantes era do sexo feminino (90,35%), e mais da metade cursou Odontopediatria em instituição privada (50,25%) há mais de dez anos (53,63%) e trabalha em metrópole (54,75%). No geral, a maioria dos respondentes atualmente prática Odontopediatria exclusivamente em clínicas privadas (61,63%). Durante a pandemia de COVID-19 foi possível ver um aumento na complexidade dos casos planejados previamente e da quantidade de urgências odontológicas. Levando isso em consideração, muitos odontopediatras sentiram a necessidade de se reinventarem, priorizando técnicas minimamente invasivas e com um menor tempo de consulta. Com isso, pôde-se notar uma tendência pela busca do tratamento endodôntico não instrumental (p<0,01), justamente por ser uma técnica mais rápida e barata. Apesar de já existirem muitos trabalhos publicados acerca da endodontia em dentes decíduos, conforme constatado nos dois primeiros estudos, observa-se que ainda são necessárias novas investigações nessa área. (AU)

The objective was to analyze the overview of publications on pulpectomy, in general, in addition to verifying the evidence about the potential for endotoxin reduction by calcium hydroxide and to investigate the influence of the COVID-19 pandemic in relation to the performance of endodontic procedures in Pediatric Dentistry. Therefore, three studies were carried out. The first aimed to map and discuss, through a bibliometric review, the panorama of scientific publications about pulpectomy in primary teeth using the terms "pulpectomy", "root canal", "child" AND "preschooler". The second study was designed as a systematic review, followed by a meta-analysis aiming to verify if there is evidence of endotoxin reduction before and after the use of calcium hydroxide as an intracanal medication in infected root canals. Bias assessment risks and meta-analyses were performed. The certainty of evidence was determined by GRADE. The third study aimed to verify the possible influences of the COVID-19 pandemic on the performance of endodontic procedures in Pediatric Dentistry, through the application of an electronic questionnaire composed of questions divided into 3 domains: (1) professional information; (2) biosafety management and (3) endodontic care protocol before and during the pandemic. After carrying out the three studies, a trend in scientific research towards the use of mechanized instrumentation and more biocompatible and effective filling pastes was identified. It was possible to observe the absence of multicenter clinical studies on pulpectomy procedures in primary teeth. Most studies were published in pediatric dentistry journals, presented a wide variety of treatment protocols, and were carried out mainly in developing countries, denoting a clear bias in the treatment options offered to children around the world, since access to care services general anesthesia in developed countries favors extraction of teeth with pulp involvement. Furthermore, it was concluded that calcium hydroxide reduces the levels of endotoxins when used as an intracanal medication but is unable to completely eliminate them in permanent teeth, regardless of its association with some irrigating solution. No articles in primary teeth were retrieved. In the third study, the final sample consisted of 313 participants from all Brazilian states. Most of the participants were female (90.35%), and more than half had studied Pediatric Dentistry at a private institution (50.25%) for over ten years (53.63%) and worked in a metropolis (54.75% ). Overall, the majority of respondents currently practice Pediatric Dentistry exclusively in private clinics (61.63%). During the COVID-19 pandemic, it was possible to see an increase in the complexity of previously planned cases and the number of dental emergencies. Taking this into account, many pediatric dentists felt the need to reinvent themselves, changing case plans, prioritizing minimally invasive techniques and with less chair time. Thus, a trend towards the search for non-instrumental endodontic treatment (p<0.001) could be noted, precisely because it is a faster and cheaper technique. Although there are many published works about endodontics in deciduous teeth, as seen in the first two studies, it was observed that further investigations are still needed. (AU)

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The aim of this study is to report a clinical case of lesion sterilization and tissue repair in primary molar, with follow-up until the eruption of the permanent successor. A 6-year-old male patient came to the Pediatric Dentistry Clinic at Faculdade Sao Leopoldo Mandic in Campinas-SP, with his mother, complaining of "caries in several teeth". On clinical examination, it was found that tooth 85 had a severe carious lesion with pulp involvement and fistula. Radiographically, radiolucency was observed in the furcation region. It was then decided to perform lesion sterilization and tissue repair of the tooth with CTZ paste. After 6 months of the procedure, the tooth was clinically and radiographically normal and after 3 years it was observed that tooth 85 was in complete root resorption. After extraction, the permanent successor erupted naturally without clinical or radiographic alterations. It can be concluded that the present clinical case demonstrated success in the use of CTZ paste in the lesion sterilization and tissue repair of primary molars, until the complete eruption of the permanent successor. (AU)

O objetivo desse estudo é relatar o caso clínico de esterilização da lesão e reparação de tecidos em molar decíduo com pasta CTZ, com acompanhamento até a erupção do pré-molar sucessor. Paciente do sexo masculino, 6 anos de idade, apresentou-se à Clínica de Odontopediatria da Faculdade São Leopoldo Mandic em Campinas-SP, acompanhado de sua mãe, queixando-se de "cárie em vários dentes". Ao exame clínico, verificou-se que o dente 85 apresentava lesão de cárie severa com envolvimento pulpar e fístula. Radiograficamente, observou-se radiolucidez na região de furca. Optou-se, então, por realizar a esterilização da lesão e reparação de tecidos do dente com pasta CTZ. Após 6 meses da realização do procedimento, o dente apresentava-se clinica e radiograficamente normal e após 3 anos observou-se que o elemento 85 estava em rizólise completa. Feita a extração, o permanente sucessor erupcionou naturalmente sem alterações clínicas ou radiográficas. Pode-se concluir que o presente caso clínico demonstrou sucesso do emprego da pasta CTZ na esterilização da lesão e reparação de tecidos de molar decíduo, até completa erupção do permanente sucessor. (AU)

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Introducción: En la atención odontológica a niños es crucial seleccionar materiales restaurativos con buen rendimiento clínico y corto tiempo de aplicación, especialmente en pacientes con capacidad de atención limitada. Las resinas compuestas, con el mejoramiento de sus propiedades físicas y mecánicas, constituyen hoy uno de los materiales de mayor elección por el odontopediatra. Las resinas de relleno masivo son una alternativa atractiva para las restauraciones en el sector posterior. Objetivo: Comparar el grado de microfiltración marginal de resinas de relleno masivo y nanohíbrida en molares deciduos. Métodos: Estudio experimental, in vitro, en cuarenta molares deciduos; exodonciados por motivos terapéuticos, divididos en dos grupos. Grupo I: resina nanohíbrida con técnica incremental (Tetric® N Ceram - Ivoclar Vivadent) y Grupo II: resina de relleno masivo con técnica monoincremental (Tetric® N Ceram bulk fill - Ivoclar Vivadent). Se realizó un proceso de termociclado manual de 500 ciclos, entre 5 ºC ± 2 ºC y 55 ºC ± 2 ºC. Las muestras fueron sumergidas en azul de metileno al 0,5 por ciento durante 24 horas a 37 ºC. Se analizaron con el microscopio estereoscópico de luz a 40X. Resultados: Todas las muestras presentaron microfiltración. Con el uso de resina nanohíbrida, el 25 presentó microfiltración leve; el 30 por ciento, moderada; y el 45 por ciento, severa. En el grupo de la resina de relleno masivo, el 30 por ciento presentó microfiltración leve; el 35 por ciento, moderada; y el 35 por ciento, severa. No se encontró diferencia significativa entre ambos grupos (p = 0,55). Conclusiones: Ambas resinas, de relleno masivo y nanohíbrida, presentaron similar microfiltración marginal in vitro, en molares deciduos; por lo que la técnica de relleno masivo, por su fácil y rápida aplicación en un solo tiempo, es una buena alternativa en la rehabilitación dental odontopediátrica(AU)

Introduction: In children's dental care it is crucial to select restorative materials of proven clinical quality and a short application period, particularly with patients of limited attention capacity. Due to their improved physical and mechanical properties, composite resins are currently one of the materials of choice for children's dental care. Bulk fill resins are an attractive alternative for posterior restorations. Objective: Compare the degree of marginal microleakage of bulk fill and nanohybrid resins in deciduous teeth. Methods: An experimental in vitro study was conducted of 40 deciduous teeth extracted for therapeutic reasons, which were divided into two groups. Group I: nanohybrid resin by incremental technique (Tetric® N Ceram - Ivoclar Vivadent) and Group II: bulk fill resin by monoincremental technique (Tetric® N Ceram bulk fill - Ivoclar Vivadent). A manual 500-cycle thermocycling procedure was performed at 5ºC ± 2ºC to 55ºC ± 2ºC. The samples were soaked in 0.5 percent methylene blue at 37ºC for 24 hours and analyzed under a light stereo microscope at 40X. Results: Microleakage was present in all the samples. In the nanohybrid resin group, microleakage was mild in 25 percent, moderate in 30 percent and severe in 45 percent. In the bulk fill resin group, microleakage was mild in 30 percent, moderate in 35 percent and severe in 35 percent. No significant difference was found between the groups (p = 0.55). Conclusions: Both resins, bulk fill and nanohybrid, presented similar in vitro marginal microleakage in deciduous molars. The bulk fill technique is therefore a good alternative for children's dental rehabilitation, due to its easy and fast application in a single session(AU)

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Root fractures vary in severity, extent, and location, according to the physical and mechanical aspects of the accident. Root fractures are rare in primary teeth and they affect dentin, cementum, periodontal ligament and the pulp. This paper reports a case of a two-and-a-half-year-old baby who had a root fracture of the upper right primary central incisor (tooth 51) as a consequence of trauma that was managed with minimally invasive intervention. After clinical and radiographic examinations, the presence of tooth mobility, pain, bleeding and a horizontal apical root fracture was diagnosed on tooth 51. The treatment of choice was splinting for 120 days, which can deliver excellent results regardless of the patient's age. The tooth was preserved without needing endodontic intervention until its physiologic exfoliation and normal eruption of its permanent successor. As sequelae to the fractured tooth 51, there was some coronal color alteration and dystrophic calcification of the root canal. This tooth did not develop ankylosis or mobility during the follow-up period. After 57 months of follow-up, repositioning and splinting were appropriate ways to manage this horizontal root fracture in the apical third of this primary tooth. It allowed the tooth to be preserved in the arch with normal function.

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OBJECTIVE: This cross-sectional study evaluated the prevalence of tooth enamel defects and risk factors associated in primary dentition. METHODS: A sample of 656 schoolchildren (population based), aged 4 years old, from Araraquara-SP (Brazil) was evaluated by two trained examiners according to the following indexes: Dental fluorosis (DF), deciduous molar hypomineralization (DMH), non-fluoride related developmental defects of enamel (DDE), tooth erosion and tooth attrition. Structured questionnaires identified socioeconomic condition, medical/dental history, behavior and dietary habits. Data were analyzed using Chi-square tests (p < 0.05). RESULTS: Of the enamel congenital defects, DF was the most prevalent (6.1%, n = 40), followed by DMH (5.6%, n = 37). Of the acquired defects, attrition was the most prevalent (36.9%, n = 242), followed by erosion (2.4%, n = 16). The caries experience was similar between the affected children (29,5%; n = 94) and total sample (30.6%; n = 201). The etiological factors related to congenital defects were: not exclusively fed breast milk (p = 0.003) and jaundice at birth (p < 0.001); the association with acquired defects was found with vomiting frequent episodes (p = 0.037). CONCLUSION: The general prevalence of enamel defects in primary dentition in Araraquara was 48.6%. Enamel defects may be associated with health-related factors and current lifestyle.

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A presente dissertação foi dividida em três estudos: o primeiro avaliou o Tratamento Restaurador Atraumático (TRA) associado ou não ao Brix3000™ quanto ao tempo de tratamento, experiência de dor e aceitabilidade de crianças (n=20) de 3-9 anos em um ensaio clínico controlado e randomizado. O tempo foi cronometrado do início ao fim do tratamento. A experiência de dor foi avaliada pela versão revisada da escala "Face, Legs, Activity, Cry, Consolability" (FLACC-r) e a aceitabilidade por uma escala facial hedônica. O grupo TRA + Brix3000™ gastou 4 minutos a mais (13,14±4,0 min) que o grupo TRA (9,8±2,7 min) (p=0,03). Não houve diferença quanto à aceitabilidade e à dor (p>0,05). O segundo estudo caracterizou a literatura científica mundial sobre produtos de remoção químico-mecânica de tecido cariado (RQMTC), por meio de mineração de dados bibliométricos, metodológicos e dos resultados de 397 artigos. Houve maior número de publicações entre 2011-2020, no Journal of Dental Research, desenvolvidos no Brasil e Índia. Estudos in vitro foram mais prevalentes, seguidos dos estudos clínicos. Nestes últimos, Carisolv™e Papacarie™ foram os produtos mais utilizados, prescritos para uso isolado e comparados ao uso de brocas. Os produtos para RQMTC foram mais estudados em crianças, cujos dentes foram restaurados com o cimento de ionômero de vidro, nos quais o tempo gasto e dor foram os principais desfechos. Observou-se que a RQMTC demanda maior tempo, entretanto, promove redução de ansiedade, dor e necessidade de anestesia local. O estudo 3 avaliou o conhecimento de dentistas brasileiros sobre odontologia de mínima intervenção (OMI) pelo desenvolvimento, validação e aplicação de uma escala de conhecimento (Minimal Interventional Dentistry for Dental Caries Knewlodge Scale - MIDDeC-KS), de 12 itens (0-12 pontos). Quanto maior a pontuação, maior o conhecimento do dentista. Dados sociodemográficos e de formação acadêmica foram coletados. A escala (α=0,72; ICC=0,85) foi aplicada por meio da plataforma Survey Monkey™ a 637 dentistas que demostraram ter conhecimento médio de 7,4±2,5 sobre OMI. As maiores pontuações foram alcançadas por mulheres (7,8±2,4; p=0,00); profissionais com mais de 10 anos de formados (7,6±2,6; p=0,02); emfaculdades públicas (7,8±2,4; p=0,00), atuando no setor público (7,9±2,3; p=0,00) ou acadêmico (8,8±2,3; p=0,04). Pontuações maiores foram alcançadas por especialistas em Odontopediatria (9,2±1,6) e menores por Cirurgiões buco-maxilo-faciais (3,1±2,1). Houve maior conhecimento sobre controle de dieta, biofilme e aplicação tópica de flúor. Técnica de Hall, infiltrante resinoso e RQMTC foram as técnicas menos conhecidas. Com a presente dissertação, concluiu-se que o TRA associado ao Brix3000™ demandou mais tempo de tratamento, sem diferença quanto à aceitabilidade e à dor. Os estudos com produtos para RQMTC aumentaram ao longo dos anos, principalmente em países em desenvolvimento. Os estudos clínicos com crianças tendem a avaliar o tempo gasto e a dor em comparação ao uso de brocas e, a RQMTC reduz ansiedade, dor e necessidade de anestesia, embora aumente o tempo de tratamento. Foi constatada suficiente evidência psicométrica da escala MIDDeC-KS. As maiores pontuações foram alcançadas por profissionais do gênero feminino e especialistas em Odontopediatria, com maior conhecimento sobre controle de dieta, biofilme e aplicação tópica de flúor. (AU)

This dissertation was divided into three studies: the first evaluated the Atraumatic Restorative Treatment (ART) associated or not with Brix3000 ™ in terms of treatment time, pain experience and acceptability of children (n=20) aged 3-9 years through a randomized controlled clinical trial. The time was calculated from the beginning to the end of the treatment. Pain experience was assessed by the revised version of the "Face, Legs, Activity, Chy, Consolability" (FLACC-r) scale and acceptability by a hedonic facial scale. The ART + Brix3000 ™ group spent 4 minutes longer (13.14±4.0 min) than the ART group (9.8±2.7 min) (p=0.03). There was no difference regarding acceptability and pain (p>0.05). The second study characterized the world scientific literature on chemical-mechanical carious tissue removal (CMCTR) products, through bibliometric, methodological and results data mining of the 397 articles. There was a greater number of publications between 2011-2020, in the Journal of Dental Research, which were developed in Brazil and India. In vitro studies were more prevalent, followed by clinical studies. In the latter, Carisolv ™ and Papacarie ™ were the most used products prescribed for isolated use and compared to the use of drills. CMCTR products have been most studied in children whose teeth were restored with glass ionomer cement, in which time spent and pain were the main outcomes. Clinical application of CMCTR takes more treatment time but can also reduce patient anxiety, pain and need for anesthesia Study 3 assessed the knowledge of Brazilian dentists about minimal intervention dentistry (MID) through the development, validation, and application of a 12-item (0-12 points) knowledge scale (Minimal Interventional Dentistry for Dental Caries Knewlodge Scale - MIDDeC-KS). The higher the score, the greater the knowledge of the dentist. Gender, educational level, specialty, academic training institutions and workplace were collected. The final scale (α=0.72; ICC=0.85) was applied through the Survey Monkey™ platform to 637 dentists who demonstrated an average knowledge of 7.4±2.5 about MID. The highest scores were achieved by women (7.8±2.4; p=0.00); professionals with more than 10 years of graduation (7.6±2.6; p=0.02); in public colleges (7.8±2.4; p=0.00), working in the public sector (7.9±2.3; p=0.00) or academic (8.8±2.3; p =0.04). Higher scores were achieved by specialists in Pediatric Dentistry (9.2±1.6) and lowest by maxillofacial surgeons (3.1±2.1). There was greater knowledge about diet and biofilm control, as well as topical application of fluoride. Hall technique, resin infiltration and CMCTR were the least known MID techniques. With the present master thesis, it was concluded that ART associated with Brix3000™ required more treatment time, with no difference in terms of acceptability and pain. Studies with products for CMCTR have increased over the years, mainly in developing countries. The clinical studies with children tend to assess the time spent and pain compared to the use of drills. CMCR clinical application reduces anxiety, pain and need for anesthesia, despite increase treatments' time Sufficient psychometric evidence of the MIDDeC-KS scale was observed. The highest scores were achieved by women, specialists in Pediatric Dentistry, with more knowledge about diet control, biofilm, and topical fluoride application. (AU)

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O objetivo dessa dissertação foi apresentar o protocolo de pulpectomia desenvolvido pelo Grupo de Pesquisa de Endodontia em Odontopediatria da FO-UFRJ (GEDOPED-UFRJ), transformando-o em um guia prático baseado em evidências científicas, com o intuito de ampliar o seu alcance para odontopediatras e clínicos gerais; e, através de uma revisão bibliométrica, investigar na literatura as condutas acerca do atendimento odontopediátrico no contexto da pandemia por COVID-19. O primeiro artigo foi elaborado por meio de uma revisão de literatura baseada em evidências científicas, criando um produto objetivo e prático. Para a revisão bibliométrica realizou-se uma busca eletrônica nas bases de dados MEDLINE (via PubMed), Scopus (Elsevier), Web of Science Core collection (Clarivate Analytics) e LILACS/VHL (Biblioteca virtual em saúde) utilizando termos do vocabulário controlado Medical Subject Headings (MeSH), sinônimos e termos de entrada. Foram incluídos artigos científicos completos e originais, de revisão, relatos de caso e comunicações curtas publicadas acerca da COVID-19 no campo da Odontopediatria. A seleção dos estudos foi feita por meio da leitura dos títulos e resumos e aplicação dos critérios de elegibilidade. Cada estudo foi classificado uma vez dentro de cada categoria, de acordo com o desenho, amostra e assunto principal. Para as análises bibliométricas, as variáveis consideradas foram: título, palavras-chave, autores, ano de publicação, periódico, fator de impacto e país de afiliação do autor correspondente. A taxa de recuperação dos dados foi superior a 90% e a avaliação bibliométrica dos dados extraídos foi feita através dos programas Vantage Point® e Microsoft Excel®. O primeiro artigo apresenta o protocolo de pulpectomia realizado na Disciplina de Odontopediatria da FO-UFRJ, através de um guia clínico com o passo a passo, bem como os materiais e instrumentais necessários para a execução do procedimento. No segundo artigo, inicialmente 162 publicações foram identificadas e destas, 49 foram incluídas. Os desenhos de estudo mais utilizados foram a revisão de literatura (n=25;51%) e o estudo observacional (n=23;47,0%). Os principais temas discutidos foram emergências odontológicas (n=9; 18,3%), biossegurança (n=8; 16,3%), teleodontologia (n= 6; 12,2%), mínima intervenção (n= 2; 4,0%) e educação em saúde (n= 1; 2,0%). As urgências dentárias mais relatadas foram trauma dentário (n=12; 63,1%), edema (n=9; 47,3%) e dor (n=9; 47,3%). O procedimento clínico mais citado foi a exodontia (n=10; 53,0%). Após as revisões de literatura, elaborou-se um artigo contendo o protocolo de pulpectomia preconizado pelo GEDOPED-UFRJ a fim de divulgar amplamente a técnica. Posteriormente, com a revisão bibliométrica observou-se que as urgências de origem pulpar foram relatadas como um dos principais procedimentos odontológicos no período da pandemia por COVID-19, porém sem descrever as etapas do procedimento realizado. São necessários protocolos com alternativas de manejo tanto do comportamento quanto dos procedimentos para uma abordagem segura e eficiente na Odontopediatria, sobretudo em decorrência das mudanças nos atendimentos em consequência da pandemia por COVID-19, principalmente nos atendimentos infantis. (AU)

The objective of this dissertation was to present the pulpectomy protocol developed by the Research Group of Endodontics in Pediatric Dentistry at FO-UFRJ (GEDOPED-UFRJ), transforming it into a practical guide based on scientific evidence, in order to expand its reach to pediatric dentists and general practitioners; and, through a bibliometric review, to investigate the conducts in the literature regarding pediatric dental care in the context of the COVID-19 pandemic. The first article was prepared through a literature review based on scientific evidence, creating an objective and practical product. For the bibliometric review, an electronic search was carried out in the MEDLINE (via PubMed), Scopus (Elsevier), Web of Science Core collection (Clarivate Analytics) and LILACS/VHL (Virtual Health Library) databases using terms from the controlled vocabulary Medical Subject Headings (MeSH), synonyms and input terms. Complete and original scientific articles, reviews, case reports and short communications published about COVID-19 in the field of Pediatric Dentistry were included. The selection of studies was made by reading the titles and abstracts and applying the eligibility criteria. Each study was classified once within each category, according to design, sample and main subject. For bibliometric analyses, the variables considered were: title, keywords, authors, year of publication, journal, impact factor and country of affiliation of the corresponding author. The data recovery rate was greater than 90% and the bibliometric evaluation of the extracted data was performed using Vantage Point® and Microsoft Excel® software. The first article presents the pulpectomy protocol performed at the Pediatric Dentistry Department at FO-UFRJ, through a step-by-step clinical guide, as well as the materials and instruments needed to perform the procedure. In the second article, initially 162 publications were identified and of these, 49 were included. The most used study designs were the literature review (n=25;51%) and the observational study (n=23;47.0%). The main topics discussed were dental emergencies (n=9; 18.3%), biosecurity (n=8; 16.3%), teleodontology (n=6; 12.2%), minimal intervention (n=2; 4 .0%) and health education (n= 1; 2.0%). The most common dental emergencies were dental trauma (n=12; 63.1%), edema (n=9; 47.3%) and pain (n=9; 47.3%). The most cited clinical procedure was extraction (n=10; 53.0%). After the literature reviews, an article was prepared containing the pulpectomy protocol recommended by GEDOPED-UFRJ in order to widely disseminate the technique. Later, with the bibliometric review, it was observed that emergencies of pulp origin were reported as one of the main dental procedures in the period of the COVID-19 pandemic, but without describing the steps of the procedure performed. Protocols with alternatives for managing both behavior and procedures are needed for a safe and efficient approach in pediatric dentistry, especially as a result of changes in care as a result of the COVID-19 pandemic, especially in child care. (AU)

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