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Introduction: Genetic polymorphisms who disturb the mineral homeostasis during tooth development and eruption are candidate to clarify the molecular mechanisms involved in changes in the tooth eruption chronology. In this study, we evaluate whether the FokI (rs2228570) and BglI (rs739837) polymorphisms in the Vitamin D receptor (VDR) gene are associated with changes in the chronology of eruption of permanent teeth. Material & method: This cross-sectional study randomly included 353 biologically unrelated children, both sexes, without systemic impairment or syndromes and history of trauma during the primary dentition. One operator perform the oral clinical examination. The tooth was considered erupted if there was a visible minimum of any tooth surface emerging from the mucosa. Genomic DNA was extracted from buccal epithelial cells from saliva samples. Genotyping was performed by Real-Time Polymerase Chain Reactions using TaqMan® technology. The average of the total number of erupted permanent teeth between the genotypes was compared by the Mann-Whitney test and multivariate Generalized Linear Models (GLM) (α = 5 %). ß values with Confidence Interval (CI) 95 % were calculated. Results: The heterozygous adenine-guanine genotype of the FokI significantly decreases the number of erupted permanent teeth (ß = -1.15; CI 95 % = -2.22 to -0.07; p = 0.036). In the stratified analysis for maxillary and mandibular teeth, this genotype was associated with a decrease in the number of erupted maxillary permanent teeth (ß = -0.65; CI 95 % = -1.22 to -0.09; p = 0.023). BglI was not associated with permanent teeth eruption. Conclusion: The FokI, but not BglI, in the VDR may delay the eruption of permanent teeth.

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A erupção dentária é definida como a movimentação dos dentes em desenvolvimento para emergir através dos tecidos moles da maxila e da mandíbula. O primeiro dente decíduo geralmente irrompe na cavidade bucal em um intervalo entre quatro e dez meses de idade e manifestações locais e sistêmicas associadas à erupção são observadas e relatadas por pais de bebês que passam pelo processo. Deste modo, este trabalho busca revisar e analisar a literatura em relação à percepção dos pais sobre os sinais e sintomas observados durante o processo de erupção dentária em bebês. Foi realizada uma revisão integrativa da literatura, buscando por artigos indexados nas bases eletrônicas de dados PubMed e Portal BVS. Ao final, foram selecionados 16 artigos científicos, sendo em sua maioria estudos com delineamento transversal (n: 11). Apenas dois estudos foram realizados no Brasil, sendo a Índia (n: 4) o país com maior número de artigos incluídos. Os sinais e sintomas mais relatados pelos pais foram febre (n: 16), perda de apetite (n: 13) e aumento da salivação (n: 12). Os estudos analisados apresentaram limitações, como a falta de padronização dos questionários direcionados aos pais. Compreende-se, desta forma, que mais estudos com populações variadas, amostras maiores e questionários padronizados são necessários.

Dental eruption is defined as the movement of developing teeth to emerge through the soft tissues of the maxilla and mandible. The first deciduous tooth usually erupts into the oral cavity between the fourth and tenth month of age. During this time, local and systemic manifestations are observed and reported by parents of babies who undergo the process. Thus, this stud seeks to review and analyze the literature regarding the perception of parents about the signs and symptoms observed during the process of tooth eruption in babies. An integrative literature review was performed, searching for articles indexed in PubMed and Portal BVS electronic databases. Sixteen papers were selected, mostly of which were cross-sectional studies (n: 11). Only two studies were carried out in Brazil, with India (n: 4) being the country with the highest number of articles included. The most reported signs and symptoms were fever (n: 16), loss of appetite (n: 13) and increased salivation (n: 12). The analyzed studies had limitations, such as the lack of standardization of the questionnaires addressed to parents. We conclude more studies with varied populations, larger samples and standardized questionnaires are needed.

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BACKGROUND: There is limited evidence of succinic acid release from amber necklace that justifies its biological plausibility. AIM: This study aimed to evaluate the release of succinic acid from Baltic amber beads in the presence of Staphylococcus epidermidis. DESIGN: The Baltic amber beads from the necklace were stratified according to their weight (average 0.05 g ± 0.067). Subsequently, the beads (n = 8) were submerged in 0.9% buffered saline (Control) or brain-heart infusion culture medium in the presence of a commercial strain of S. epidermidis, a resident skin bacterium incubated at 37°C for 24 h or 7 days. The samples were centrifuged, and the supernatants were analyzed by 1H Nuclear Magnetic Resonance. Multivariate analyses were adopted using the sparse partial least squares discriminant analysis method (p < .05). RESULTS: The group incubated with saline solution showed small release of succinic acid only after 7 days. In the groups with S. epidermidis, the release of succinic acid was observed in the both presence and absence of amber beads, indicating that succinic acid is a product released by bacteria. CONCLUSIONS: It was found that amber beads do not exhibit the ability to release expressive succinic acid, especially in a short period of time, which does not justify their use in infants. The most production of succinic acid is tributed to S. epidermidis.

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Objective: This study compared third molar angulation and eruption status in Class I and II malocclusions after orthodontic treatment with and without first premolar extractions. Methods: The sample comprised 93 patients divided into four groups: Group 1, Class I malocclusion treated with first premolar extractions; Group 2, Class I malocclusion treated without extractions; Group 3, Class II malocclusion treated with first premolar extractions; and Group 4, Class II malocclusion treated without extractions. Panoramic radiographs were used to evaluate the third molar mesiodistal angulations at T1 (pretreatment), T2 (posttreatment), and T3 (long-term posttreatment). Third molar eruption status was assessed in dental casts. Intergroup angulations and eruption status comparisons were performed using one-way analysis of variance (ANOVA), followed by Tukey's test and Kruskal-Wallis test, respectively. Results: Significantly greater mesial angulation and percentage of erupted right maxillary third molars were observed in the Class I extraction group. Significantly greater eruption status of the right mandibular third molars was observed in the Class I and Class II malocclusion extraction groups. Conclusion: Class I and II malocclusion extraction treatment exhibited more favorable angulations and a greater number of erupted third molars than non-extraction treatment. The non-extraction groups exhibited a greater percentage of unerupted third molars.

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BACKGROUND: Dental eruption is part of a set of children´s somatic growth phenomena. The worldwide accepted human dental eruption chronology is still based on a small sample of European children. However, evidence points to some population variations with the eruption at least two months later in low-income countries, and local standards may be useful. So, this study aimed to predict deciduous teeth eruption from 12 months of age in a Brazilian infant population. METHODS: We developed a cross-sectional study nested in four prospective cohorts - the Brazilian Ribeirão Preto and São Luís Cohort Study (BRISA) - in a sample of 3,733 children aged 12 to 36 months old, corrected by gestational age. We made a reference curve with the number of teeth erupted by age using the Generalized Additive Models for location, scale, and shape (GAMLSS) technique. The explanatory variable was the corrected children´s age. The dependent variable was the number of erupted teeth, by gender, evaluated according to some different outcome distributional forms. The generalized Akaike information criterion (GAIC) and the model residuals were used as the model selection criterion. RESULTS: The Box-Cox Power Exponential method was the GAMLSS model with better-fit indexes. Our estimation curve was able to predict the number of erupted deciduous teeth by age, similar to the real values, in addition to describing the evolution of children's development, with comparative patterns. There was no difference in the mean number of erupted teeth between the sexes. According to the reference curve, at 12 months old, 25% of children had four erupted teeth or less, while 75% had seven or fewer and 95% had 11 or fewer. At 24 months old, 5% had less than 12, and 75% had 18 or more. At 36 months old, around 50% of the population had deciduous dentition completed (20 teeth). CONCLUSION: The adjusted age was an important predictor of the number of erupted deciduous teeth. This outcome can be a variable incorporated into children's growth and development curves, such as weight and height curves for age to help dentists and physicians in the monitoring the children's health.

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Abstract The consumption and sharing of information on social media contribute to the circulation of false health content. In this sense, popular belief-driven posts recommending the use of amber necklaces to prevent symptoms of teething can be easily found on social media, even when they offer health risks for children. Accordingly, this study aimed to characterize posts in Portuguese by identifying message-based factors associated with higher user interactions of Facebook. A total of 500 Facebook posts published in Portuguese between August 2016 and August 2021 were retrieved by CrowdTangle, and analyzed quantitatively according to time of publication, total user interaction, and post overperforming score, and then qualitatively by two independent investigators, according to motivation, authors' profiles, and sentiment. The data were evaluated by descriptive analysis, Mann-Whitney U test, chi-square test, and multiple logistic regression models regarding interaction metrics. The posts were published predominantly by commercial profiles, with social, psychological, and financial motivations, and expressed positive sentiment. Furthermore, time of publication (OR=2.65), regular user profiles (OR=3.30), and neutral/negative sentiment (OR=2.76) were associated positively with total interactions, whereas only time of publication was associated with post overperforming scores (OR=1.65). In conclusion, Facebook posts promoting efficacy of amber necklaces in managing teething symptoms are primarily created by commercial profiles with vested interests in marketing the product. The key factors that contribute to the success of posts containing false information about amber necklaces on Facebook can be identified by considering the author's profile, sentiment, and time of publication.

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ABSTRACT Objective: To perform a bibliometric analysis on deciduous and permanent eruption publications to discuss the global trends and prospects on the topic. Material and Methods: A systematic search was conducted on the Scopus database. The characteristics of the publications, including co-cited authors, organizations, countries, most cited sources, publications, and keyword co-occurrence, were analyzed using VOSviewer software version 1.6.18. Results: After applying exclusion criteria, 492 studies were included in the analysis. The majority of research centers were located in Europe. "Archives of Oral Biology" emerged as the most frequently cited journal. The United States and Brazil were the most frequently cited countries in the publications. Notable co-authors included Kuchler E. C. and Hägg U. The most frequently cited keywords were associated with oral pathologies, tooth development, odontogenesis, and genetics. The most recent papers were published in journals focused on oral diseases. Conclusion: This bibliometric analysis highlights that the future of research in this field is likely to be focused on the investigation of tooth eruption in both deciduous and permanent teeth, with an emphasis on genetics, tooth development, timing of tooth eruption, and syndromic conditions. While well-accepted in the fields of Pediatrics and Orthodontics, there is a growing interest in this topic within oral biology and pathology journals in the Americas, with the United States and Brazil leading in terms of publications and citations.

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BACKGROUND: Lower third molars (L3M) are the last teeth to erupt in the oral cavity. Uneruption of these teeth still raises questions about its causes, in the literature (1) genetic factors, (2) dental lamina activity and, mainly, (3) insufficient growth and development of the bone bases are included. While the lack of space theory influenced by mandibular morphology and size of L3M was argued to be the main reason for L3M impaction, there is a limitation in the literature in examining such association using more accurate tomographic analysis obtained from CBCT. This work aimed to evaluate the relationship between mandibular morphology and the eruption of L3M. METHODS: In this regard, 85 Cone Beam Computed Tomographies (CBCT), with 147 L3M, were selected from the archives of the Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, obtained using an Accuitomo® Morita device and using the Dolphin Imaging 11.9 software. L3M eruption was related to linear measurements of jaw length (Co-Gn), retromolar space dimension (D2R), mesiodistal width of the L3M crowns, mandibular first molars (L1M) and mandibular canines (LC) and the angle mandibular (Ar-Go-Me). Independent samples t-test, chi-square tests and logistic regression were performed adopting a significance level of 5%. RESULTS: The average mandible length of 116.446 mm + 6.415 mm, retromolar space of 11.634 mm + 2.385 mm, mesiodistal size of the L3M of 10.054 mm + 0.941 mm, sum of the mesiodistal widths of the L1M and LC of 15.564 mm + 1.218 mm and mandibular angle of 127.23° + 6.109. There was no statistically significant association between these factors and the eruption. CONCLUSION: With the results obtained in this study, we conclude that the length and angle of the mandible, teeth size and dimension of the retromolar space are not associated with the L3M eruption.

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INTRODUCTION: The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly. PATIENT CONCERNS: A 10-year-old boy was presented with no complaints for a routine orthodontic evaluation during mixed dentition. PRIMARY DIAGNOSES: The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine. INTERVENTIONS: Phase 1 started with rapid maxillary expansion to correct maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months. RESULTS: An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up. CONCLUSION: In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition.

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BACKGROUND: Ectopic eruption of the maxillary first permanent molar is a local disturbance that affects the development of the occlusion. AIM: To evaluate the occurrence of self-correction of maxillary first permanent molar's ectopic eruption and its predictive factors. DESIGN: Five electronic databases and part of the gray literature were investigated. The risk of bias was assessed using the Newcastle-Ottawa scale and the certainty of evidence using the GRADE tool. RESULTS: Four studies were selected: Three had a low risk of bias, and one, moderate. Evidence with a moderate level of certainty was generated, indicating a possibility of 47%-78% of spontaneous correction up to 7 years of age. Supporting the prognosis, whether reversible or irreversible, there was a positive correlation between the severity of the atypical distal resorption of the second primary molar, a higher magnitude of impaction, a larger eruption angle, and a bilateral occurrence with the irreversibility of the cases. CONCLUSION: Spontaneous correction of the ectopic eruption of the maxillary first permanent molar is feasible and dependent on the severity of predictive factors. Early intervention is mandatory in irreversible cases.

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Introducción: Las tendencias seglares influyen en el crecimiento y desarrollo general del individuo. El brote dentario no escapa a esta realidad. Existen variables que pueden retardarlo o acelerarlo, dentro de las que se encuentran el sexo y el color de la piel. Objetivos: Determinar la cronología y el orden de brote de los dientes permanentes en niños y adolescentes. Métodos: Se realizó un estudio transversal descriptivo desde mayo de 2017 a noviembre de 2020. El universo constituido por 21383 niños y adolescentes entre 5 y 13 años de edad, de la provincia Holguín, Cuba, que no presentaban pérdida prematura de dientes temporales o extracciones de dientes permanentes, ni enfermedades sistémicas que influyen en el crecimiento y desarrollo. En el procesamiento estadístico se utilizaron las medidas de resúmenes para las variables cuantitativas y el test de comparación de las medias. Resultados: La edad de brote de todos los dientes permanentes resultó adelantada en comparación con las tablas para su valoración clínica. El primer diente en brotar fue el primer molar superior, entre los 5,66 años, y el último el segundo molar maxilar, entre los 10,38 años. Al comparar las medias de brote de los dientes permanentes según el sexo, hubo diferencias altamente significativas en la arcada superior: primer premolar (p = 0,000), arcada inferior: canino (p = 0,009), primer premolar (p = 0,000) y segundo molar (p = 0,012). Se encontraron diferencias altamente significativas entre las medias de brote para el color de la piel en el maxilar: incisivo central (p = 0,004), incisivo lateral (p = 0,000), canino (p = 0,002), mandíbula: incisivo central (p = 0,000), incisivo lateral (p = 0,000) y segundo premolar (p = 0,000). Conclusiones: La cronología de brote de todos los dientes permanentes resultó adelantada. Los dientes permanentes siguieron la secuencia de brote, tal como describe Mayoral. Se encontraron diferencias al comparar las medias de brote según el sexo y color de la piel(AU)

Introduction: Secular tendencies influence the overall growth and development of the individual. Tooth eruption does not escape this reality. There are variables that can delay or accelerate it, among which are sex and skin color. Objectives: To determine the chronology and order of eruption of permanent teeth in children and adolescents. Methods: A descriptive cross-sectional study was conducted from May 2017 to November 2020. The universe constituted by 21383 children and adolescents between 5 and 13 years of age, from Holguín province, Cuba, who did not present premature loss of primary teeth or extractions of permanent teeth, nor systemic diseases that influence growth and development. Statistical processing used summary measures for quantitative variables and the comparison test of the average values. Results: The age of teething of all permanent teeth was advanced in comparison with the tables for clinical assessment. The first tooth was the upper first molar at 5.66 years of age and the last tooth was the maxillary second molar at 10.38 years of age. When comparing the teething averages of the permanent teeth according to gender, there were highly significant differences in the upper arch: first premolar (p = 0.000), lower arch: canine (p = 0.009), first premolar (p = 0.000) and second molar (p = 0.012). Highly significant differences were found between bud means for skin color in maxilla: central incisor (p = 0.004), lateral incisor (p = 0.000), canine (p = 0.002), mandible: central incisor (p = 0.000), lateral incisor (p = 0.000) and second premolar (p = 0.000). Conclusions: The teething chronology of all permanent teeth resulted advanced. The permanent teeth followed the teething sequence as described by Mayoral. Differences were found when comparing the teething averages according to gender and skin color(AU)

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OBJECTIVE: The aim of this study was to assess the frequency of mandibular second premolar (MnP2) distoangulation among orthodontic patients and the angular changes after a longitudinal follow-up. METHODS: The sample was collected from the orthodontic records of 865 patients. The distoangulation group was composed of 42 patients (mean age 9.29 ±â€…1.24 years, 16 male, 26 female) with distoangulation of MnP2. The control group was composed of 32 patients (mean age 9.38 ±â€…1.10 years, 15 male, and 17 female) without distoangulation of MnP2. Panoramic radiographs taken in the mixed (T1) and the early permanent dentition (T2) were analyzed in both groups. Longitudinal angular changes (distal angle θ and premolar-molar angle γ), degree of root formation, second premolar depth, and prevalence of associated dental anomalies were analyzed. Intergroup comparison was performed with Mann-Whitney, t-tests, and chi-square tests (P < 0.05). RESULTS: The prevalence of MnP2 distoangulation in the mixed dentition was 4.85%. The distoangulation group showed a smaller initial distal angle (59.34o ±â€…8.41) when compared to control group (79.88o ±â€…7.60). The spontaneous eruption of the MnP2 with distoangulation was observed in 76.57% of the sample. MnP2 distoangulation was significantly associated with agenesis of its antimere, small maxillary lateral incisors, and deciduous molar infraocclusion. LIMITATIONS: Severe cases of MnP2 distoangulation were absent in this study. CONCLUSIONS: The frequency of MnP2 distoangulation among orthodontic patients was 4.85%. Mild to moderate distoangulated Mnp2 spontaneously uprighted from the mixed to the permanent dentition. Small lateral incisors, second premolar agenesis, and infraocclusion of deciduous molar were frequently found in cases with MnP2 distoangulation.

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BACKGROUND: This study aimed to evaluate the prevalence of retained primary teeth (RPT) associated with delayed permanent tooth eruption and the factors associated with this condition in German children. METHODS: This is a cross-sectional retrospective study that evaluated panoramic radiographs from orthodontic patients. The diagnosis of RPT was established according to Nolla developmental stage. The primary tooth was considered retained when its successor permanent tooth was in Nolla stage 8, 9, or 10. Statistical analysis was performed with an α of 5% (p < 0.05). RESULTS: A total of 102 children (48 girls and 54 boys), and 574 primary teeth and their respective permanent successor teeth were evaluated. We classified 192 teeth as RPT. Sixty-one (59.8%) children presented one or more RPT. Gender was not significantly different between RPT and control teeth (p = 0.838; odds ratio 0.95, confidence interval 95% 0.44-2.16). In the majority of the RPT cases (68.7%), no clear cause to explain the prolonged retention was identified. The pathological problems most commonly observed with RPT were dental fillings (19.3%), followed by dental caries (4.6%), and ectopic tooth eruption (2.1%). CONCLUSIONS: The incidence of RPT associated with delayed permanent tooth eruption in German children was high and the most common pathological condition associated with RPT was dental caries.

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OBJECTIVES: To assess the influence of estrogen deficiency on tooth eruption rate (TER) and gene expression of estrogen receptor alpha and beta (ERα and ERß) in the odontogenic region of teeth with continuous formation in a rat model. MATERIALS AND METHODS: Ovariectomies (OVX; n = 25) and sham surgeries (SHAM; n = 25) were performed in female Wistar rats when animals were 25 days old. The TER of the lower incisors, both in impeded (hyperfunction condition) and unimpeded (trimmed incisal edge-hypofunction condition) conditions, was evaluated using standardized digital photographs acquired every 48-72 h for 3 weeks (35th-53rd day of life), using a camera coupled to a stereomicroscope. Quantitative real-time PCR was performed to evaluate the relative gene expression of ERα and ERß in the odontogenic region. RESULTS: The OVX group showed a significant reduction in TER when compared to the SHAM group, only in the impeded condition (p = 0.03). There was no statistically significant difference between the groups in ERα gene expression (p = 0.33). ERß showed a significantly higher gene expression in the OVX group (p ≤ 0.05). CONCLUSIONS: Estrogen deficiency decreases TER in teeth under impeded condition. Estrogen deficiency also increases ERß gene expression in the odontogenic region of teeth with continuous formation. CLINICAL RELEVANCE: Hormonal disturbances affecting estrogen levels can cause alterations in dental formation and teeth eruption.

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The aim was to characterise the endocannabinoid system (ECS) in the dental pulp of teeth at different stages of eruption. Pulp of: erupted premolars (EPM), third molars in pre-eruptive (PThM), intraosseous (IThM) and eruptive stages (EThM) (n = 12 each group) were used. Messenger RNA expression of components of the ECS as cannabinoid receptors (CBr1 and CBr2), and anandamide synthetizing (NAPE-PLD) and degradation (FAAH) enzymes were measured by RT-PCR. Data were analysed using Student's t-test for comparisons between two groups and one-way analysis of variance and Tukey's post-test for multiple comparisons (statistical significance: p < 0.05). mRNA expression of CBr2, NAPE-PLD and FAAH was similar in the studied stages, was lower in IThM than in PThM and EThM, and the lowest in EThM (p < 0.01); of note, CBr2 mRNA expression was not detected in EThM. CBr1 mRNA did not differ significantly between IThM and PThM but was lower in EThM (p < 0.01). The absence of CBr2 and presence of CBr1 in EThM suggest the involvement of the ECS via CBr1 as a mediator of tooth and bone tissue homeostasis during tooth eruption.

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PURPOSE: Estimate the incidence of teething symptoms and investigate risk factors at three centers in different regions of Brazil. METHODS: A prospective cohort study enrolled children at birth in the cities of Manaus (northern region), Porto Alegre (southern region) and Salvador (northeast region). Sociodemographic and anthropometric variables were collected at baseline and 6 months. At 12 months, data were collected on the child's health through structured interviews and dental examinations, including the primary outcome: occurrence of signs and symptoms of tooth eruption reported by parents. Statistical analysis involved Poisson regression with robust variance, with calculation of relative risks (RR). RESULTS: The incidence of teething symptoms was 82.4% (238/289). The multivariate analysis revealed a higher occurrence of the outcome in the city of Salvador (RR = 1.39; 95% CI 1.23-1.58), when mother's education was more than 11 years (RR = 1.31; 95% CI 1.04-1.65), when a larger number of individuals resided in the home (RR = 1.15; 95% CI 1.02-1.29), when a smoker resided in the home (RR = 1.16; 95% CI 1.03-1.31) and when the child presented flu or cold in the first year of life (RR = 1.23; 95% CI 1.09-1.38). The most reported symptoms were fever (50.5%), irritability (42.6%), itching (40.8%) and diarrhea (35.3%). Most parents (82%) took some action to alleviate symptoms, including unprescribed systemic medication, such as analgesic, anti-inflammatory and anti-diarrheic agents. CONCLUSION: Reports of teething symptoms were associated with the city investigated, socioeconomic factors of the families and characteristics of the child's health. A high rate of administering unprescribed medication was also found.

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Resumo Este artigo possui como objetivo relatar 3 casos clínicos de pacientes com Síndrome de Down (SD) com anomalias dentárias associadas, incluindo agenesia dentária, irrupção ectópica e dentes inclusos. O padrão de anomalias dentárias (PAD) é um assunto amplamente descrito na população sem síndromes. No entanto, o PAD associado à Síndrome de Down ainda é pouco abordado na literatura. O tratamento ortodôntico em pacientes com Síndrome de Down deve ser cuidadosamente monitorado durante o desenvolvimento dentário, considerando a herança genética e o aumento do risco de distúrbios de irrupção dentária e outras anomalias dentárias. Intervenções interceptivas podem contribuir para simplificar o tratamento ortodôntico e reduzir os efeitos adversos (AU)

Abstract Individuals with Down Syndrome (DS) have a higher prevalence of dental anomalies than non-syndromic patients. This series of cases aim to report 3 patients seeking orthodontic treatment with several associated dental anomalies, including tooth agenesis, ectopic eruption and impacted teeth. The dental anomaly pattern (DAP) is well described subject in non-syndromic population. However, DAP in association with DS is still uncovered in the literature. The orthodontic treatment in patients with Down Syndrome should be carefully monitored during dental development, considering the genetic background and the increased risk for dental eruption disturbances and other dental anomalies. Interceptive interventions might contribute to simplify orthodontic treatment and reduce adverse effects (AU)

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Esta tese é composta por 5 artigos científicos e 1 produto técnico. O primeiro artigo científico, é uma revisão sistemática sobre a eficácia de tratamentos para alívio dos sinais e sintomas da erupção de dentes decíduos. Foram incluídos estudos clínicos que avaliaram o efeito de qualquer intervenção para aliviar os sinais e sintomas associados à dentição em bebês e crianças. O risco de viés foi avaliado usando as ferramentas ROB-2 e ROBINS-I. Foram selecionados 5 artigos, classificados como alto ou grave risco de viés respectivamente. Três estudos usando homeopatia relataram melhora nos distúrbios do apetite, desconforto nas gengivas e excesso de salivação. Um estudo mostrou que um novo gel com ácido hialurônico foi mais eficaz do que um gel anestésico na melhora de sinais e sintomas como dor, vermelhidão gengival e má qualidade do sono. Outro estudo selecionado aplicou tratamentos não farmacológicos, que se mostraram mais eficazes, principalmente contra o excesso de salivação. O segundo artigo avaliou as práticas clínicas adotadas por odontopediatras (OPs) frente aos sinais e sintomas da erupção dos dentes decíduos e a influência do tempo de formado e de especialista no autorrelato (AR) de segurança na adoção de tais medidas. Aplicou-se um questionário online aos OPs. Coletaram-se dados sobre tipo de prática, relato de eficácia, fonte de conhecimento sobre o tema, segurança na prática adotada, tempo de formado e tempo de especialista. Realizaram-se análises descritivas e inferenciais (teste X2, α=0,05). Foram 451 respondentes. Mordedores gelados (96,8%); alimentos congelados (69,1%) e massagem digital (58,3%) foram os mais prescritos e considerados eficazes (78,2%, 30,3% e 28,8%, respectivamente). Livros de odontopediatria (58,9%), curso/congresso (56,3%) e experiência profissional (40,7%) foram as fontes de conhecimento mais citadas. O tempo médio de formado dos OPs foi 18,4±11,3 anos, sendo 13,1±11,0 anos de especialista. A maioria sente-se seguro (79,6%) no tratamento dos sinais e sintomas da erupção dentária, mas 93,1% sentem falta de estudos científicos sobre o tema. O tempo de formado (p=0,12) e o de especialista (p=0,90) não influenciaram no AR de segurança na prática adotada. O terceiro artigo analisou a composição molecular de uma amostra de âmbar báltico, verificou-se a presença ou ausência de compostos benéficos à saúde humana e discutiu o potencial terapêutico dessa resina fóssil. Para isso, foi realizada uma análise qualitativa por cromatografia gasosa acoplada à espectrometria de massas (sistema GC-MS), que é capaz de realizar uma separação automatizada em componentes individuais do âmbar. As amostras eram compostas por terpenos e terpenóides: monoterpenóides; sesquiterpenóides; diterpenóides; hidronaftaleno; ácido succínico e ácido isopimárico. Estes componentes têm potencial terapêutico para várias doenças; inibem várias fases do processo inflamatório e tem efeitos analgésicos. No quarto artigo analisouse e avaliou-se a qualidade, confiabilidade e visualizações dos vídeos disponibilizados no Youtube® como fonte de informação, relacionados ao uso terapêutico do colar de âmbar para bebês durante o período de erupção dentária. Uma busca no YouTube®, foi realizada no dia 23 de agosto de 2022. O termo escolhido para a busca foi "colar de âmbar para bebê" no site Google Trends®. Como critério de inclusão, os vídeos deveriam conter informações sobre o uso do colar de âmbar como terapia para diminuir os sintomas da erupção dentária em bebês. Os vídeos foram analisados quanto à confiabilidade das informações, com base em uma escala de 5 pontos, adaptada da ferramenta DISCERN, e quanto à qualidade com a ferramenta Global Quality Score (GQS), que varia de 1- má qualidade a 5- excelente qualidade. Foram encontrados 22 vídeos com o termo de busca, dos quais 15 foram selecionados. A frequência de qualidade GQS "1" foi a mais alta e observou-se que houve diferença de qualidade entre as origens dos vídeos (p<0,05). As fontes provenientes de jornais e profissionais de saúde foram iguais e melhores (p=0,002) na escala de confiabilidade, quando comparadas aos outros grupos como Opiniões e Fontes de marketing. No quinto artigo objetivou-se identificar os possíveis benefícios da resina de âmbar na sintomatologia da fase de erupção dentária dos bebês, através de um estudo clínico preliminar observacional. Foram incluídos bebês de ambos os gêneros, com idade entre 8 e 36 meses que já tivessem pelo menos um dente da dentição primária em erupção. A amostra foi composta por 3 grupos: 1. Grupo que não usou nenhum tratamento (controle); 2. Grupo que usou a pulseira placebo e 3. Grupo que usou a pulseira de âmbar. Os sintomas da dentição mais frequentes na linha de base (t1) foram coceira, inchaço e irritação; após o tratamento foram os mesmos, acrescido de vermelhidão. Houve diferenças de frequência, com diminuição dos sintomas, entre os grupos, para as manifestações clínicas irritação e coceira. A segunda etapa consistiu na criação de um vídeo, na plataforma de criação de vídeos PowToon®, informativo para os responsáveis, sobre a fase de erupção dentária. No vídeo procurou-se abordar sobre a sequência comum de erupção dentária, os principais sinais e sintomas e possíveis tratamentos não farmacológicos para alívio dessa fase que gera muitas dúvidas nos responsáveis. Pode-se concluir com os estudos que algumas terapias não farmacológicas podem ter um efeito favorável sobre os sinais e sintomas relacionados à dentição. No entanto, conclusões definitivas sobre sua eficácia não podem ser tiradas, devido à certeza muito baixa das evidências. Pesquisas primárias, intervencionais sobre o assunto são escassas, heterogêneas e tem falhas metodológicas; a prescrição de tratamentos não farmacológicos para a dentição decídua é uma prática comum entre os odontopediatras, e seu auto relato de segurança no uso de tais medidas não está associada ao tempo decorrido após a graduação e especialização; o âmbar da amostra testada no terceiro estudo, é formado por terpenos e terpenóides, substâncias com propriedades anti-inflamatórias e analgésicas. Entretanto, é necessário um estudo aprofundado sobre a liberação e absorção de substâncias na pele humana, ou seja, atentar a sua real eficácia; Vídeos assistidos através da plataforma do YouTube®, ainda que postados por profissionais e veículos de comunicação, não possuem embasamento científico suficiente sobre o assunto quando se fala sobre o âmbar e seu uso para saúde, o que implica baixa confiabilidade e segurança da informação. Nesse sentido, estudos clínicos controlados, com maior número de participantes, sobre os reais benefícios do uso da resina de âmbar para bebês no período de erupção dentária, são fundamentais e devem ser realizados, a fim de consolidar as evidências sobre o assunto e reais benefícios para a saúde. Da mesma forma que o vídeo criado serve como informação aos pais sobre a fase de erupção dentária, e que foi baseado no que foi encontrado em evidências científicas. Após a realização da presente tese, observou-se que não existem muitos estudos que abordem sobre os tratamentos mais eficazes para essa fase na vida do bebê. (AU)

This thesis is composed of 5 scientific articles and 1 technical product. The first scientific article is a systematic review on the effectiveness of treatments to relieve the signs and symptoms of eruption of deciduous teeth. Clinical trials evaluating the effect of any intervention to alleviate signs and symptoms associated with teething in infants and children were included. The risk of bias was assessed using the ROB-2 and ROBINS-I tools. Five articles were selected, classified as high or severe risk of bias. Three studies using homeopathy reported improvement in appetite disorders, gum discomfort and excess salivation. One study showed that a new gel with hyaluronic acid was more effective than an anesthetic gel in improving signs and symptoms such as pain, gum redness and poor sleep quality. Another selected study applied nonpharmacological treatments, which proved to be more effective, especially against excess salivation. The second article evaluated the clinical practices adopted by pediatric dentists (POs) in view of the signs and symptoms of eruption of deciduous teeth and the influence of time since graduation and specialist in the self-report (AR) of safety in the adoption of such measures. An online questionnaire was applied to the OPs. Data were collected on the type of practice, effectiveness report, source of knowledge on the subject, safety in the adopted practice, time since graduation and time as a specialist. Descriptive and inferential analyzes were performed (X2 test, α=0.05). There were 451 respondents. iced teethers (96.8%); frozen foods (69.1%) and digital massage (58.3%) were the most prescribed and considered effective (78.2%, 30.3% and 28.8%, respectively). Pediatric dentistry books (58.9%), course/conference (56.3%) and professional experience (40.7%) were the most cited sources of knowledge. The average time since graduation of OPs was 18.4±11.3 years, with 13.1±11.0 years as a specialist. Most feel confident (79.6%) in treating the signs and symptoms of tooth eruption, but 93.1% feel that there is a lack of scientific studies on the subject. Time since graduation (p=0.12) and specialist time (p=0.90) did not influence the AR of safety in the adopted practice. The third article analyzed the molecular composition of a sample of Baltic amber, verified the presence or absence of compounds beneficial to human health and discussed the therapeutic potential of this fossil resin. For this, a qualitative analysis was carried out by gas chromatography coupled to mass spectrometry (GC-MS system), which can perform an automated separation into individual amber components. The samples were composed of terpenes and terpenoids: monoterpenoids; sesquiterpenoids; diterpenoids; hydronaphthalene; succinic acid and isopimaric acid. These components have therapeutic potential for various diseases; inhibit various phases of the inflammatory process and have analgesic effects. The fourth article analyzed and evaluated the quality, reliability and views of the videos available on YouTube® as a source of information, related to the therapeutic use of the amber necklace for babies during the period of tooth eruption. A search on YouTube® was performed on August 23, 2022. The term chosen for the search was "baby amber necklace" on the Google Trends® website. As an inclusion criterion, the videos should contain information about the use of the amber necklace as a therapy to reduce the symptoms of tooth eruption in babies. The videos were analyzed for the reliability of the information, based on a 5-point scale, adapted from the DISCERN tool, and for quality with the Global Quality Score (GQS) tool, which ranges from 1-poor quality to 5-excellent quality. 22 videos were found with the search term, of which 15 were selected. The GQS quality frequency "1" was the highest and it was observed that there was a difference in quality between the origins of the videos (p<0.05). Sources from newspapers and health professionals were equal and better (p=0.002) on the reliability scale, when compared to other groups such as Opinions and Marketing sources. The fifth article aimed to identify the possible benefits of amber resin in the symptomatology of the tooth eruption phase of babies, through a preliminary observational study. Infants of both genders, aged between 8 and 36 months, who already had at least one erupting primary dentition tooth, were included. The sample consisted of 3 groups: 1. Group that did not use any treatment (control); 2. Group that used the placebo bracelet and 3. Group that used the amber bracelet. The most frequent dentition symptoms at baseline (t1) were itching, swelling and irritation; after treatment they were the same, plus redness. There were differences in frequency, with a decrease in symptoms, between the groups, for the clinical manifestations of irritation and itching. The second stage consisted of creating a video, on the PowToon® video creation platform, informative for those responsible, about the tooth eruption phase. In the video, an attempt was made to address the common sequence of tooth eruption, the main signs and symptoms and possible nonpharmacological treatments to alleviate this phase, which raises many doubts in those responsible. It can be concluded from the studies that some non-pharmacological therapies can have a favorable effect on signs and symptoms related to dentition. However, definitive conclusions about its effectiveness cannot be drawn, due to the very low certainty of the evidence. Primary, interventional research on the subject is scarce, heterogeneous and has methodological flaws; the prescription of nonpharmacological treatments for the primary dentition is a common practice among pediatric dentists, and their self-reported safety in the use of such measures is not associated with the time elapsed after graduation and specialization; the amber of the sample tested in the third study is formed by terpenes and terpenoids, substances with anti-inflammatory and analgesic properties. However, an in-depth study on the release and absorption of substances in human skin is necessary, that is, paying attention to their real effectiveness; Videos watched through the Youtube® platform, even if posted by professionals and communication vehicles, do not have sufficient scientific basis on the subject when talking about amber and its use for health, which implies low reliability and information security. In this sense, controlled clinical studies, with a larger number of participants, on the real benefits of using amber resin for babies in the period of tooth eruption, are fundamental and must be carried out, in order to consolidate the evidence on the subject and real benefits for health. In the same way that the video created serves as information to parents about the stage of tooth eruption, and which was based on what was found in scientific evidence. After carrying out this thesis, it was observed that there are not many studies that address the most effective treatments for this phase in the baby's life. (AU)

Assuntos

RESUMO

Resumo Introdução: O traumatismo dental na dentição decídua pode influenciar o desenvolvimento dos sucessores permanentes e causar um deslocamento da coroa em relação à raiz dental, gerando uma curvatura definida como dilaceração, que em grande parte dos casos impede a irrupção normal do dente permanente. Diversas são as possibilidades de tratamento, desde exodontia ao tratamento ortocirúrgico. Objetivo: O presente trabalho tem o objetivo de relatar um caso clínico de incisivo central superior esquerdo (21) com dilaceração radicular cujo tratamento envolveu procedimento cirúrgico e tracionamento ortodôntico ancorado no disjuntor maxilar. Resultado: O desfecho do tratamento foi satisfatório, visto que o dente incluso foi reposicionado e a má oclusão da paciente foi corrigida. Conclusão: O tracionamento ortocirúrgico de incisivo superior permanente com dilaceração radicular é desafiador e com prognóstico incerto. Contudo, seu reposicionamento é possível quando se realiza um diagnóstico, planejamento periodontal e biomecânico adequado (AU)

Abstract Introduction: Dental trauma in the primary dentition can influence the development of permanent successors and cause a displacement of the crown in relation to the dental root, generating a curvature defined as laceration, which in most cases prevents the normal eruption of the permanent tooth. There are several treatment possibilities, from extraction to orthosurgical treatment. Objective: The present study aims to report a clinical case of a left upper central incisor (21) with root laceration whose treatment involved a surgical procedure and orthodontic traction anchored in the maxillary breaker. Result: The treatment outcome was satisfactory, since the included tooth was repositioned and the patients' malocclusion was corrected. Conclusion: Orthosurgical traction of the permanent upper incisor with root dilaceration is challenging and has an uncertain prognosis. However, its repositioning is possible when a diagnosis, periodontal and biomechanical planning is performed.(AU)

Assuntos

RESUMO

ABSTRACT Permanent canines are essential for the preservation of the stomatognathic system, as they are part of the occlusal and aesthetic function and balance. During the normal development of occlusion, canines follow a long and complex trajectory until their eruption, that is, they are more likely to suffer disturbances during this process. Removal of the permanent canine should only be considered in extreme cases, where the canine itself is not susceptible to orthodontic traction. Orthodontic traction is the most indicated treatment due to the high morphofunctional and aesthetic value of the permanent canine. The aim of this study is to report a clinical case of traction surgery of the superior permanent canine included in the maxilla. A 13-year-old female patient attended the dental clinic at the Nilton Lins University accompanied by her guardian, referred by an orthodontistfor canine traction surgery. during the examIn the clinical analysis, tooth 13 was absent from the dental arch. The patient had a computed tomography scan, where it was possible to verify the actual position of the toothimpacted with the partially erupted crown on the alveolar ridge. After planning, surgery was performed to install an orthodontic button and adapt the ligature with a 0.30 mm wire. After the 10-month follow-up period, the presence of the tooth in arch, completely erupted, was observed, showing effectiveness in the proposed treatment. Therefore, the procedure for bonding the orthodontic device was performed satisfactorily without complications or intercurrences, making it possible to continue the orthodontic treatment. The patient remains under follow-up.

RESUMO Os caninos permanentes são essenciais para a preservação do sistema estomatognático, visto que, fazem parte da função e equilíbrio oclusal e estético. Durante o desenvolvimento normal da oclusão, os caninos seguem uma longa e complexa trajetória até seu irrompimento, ou seja, estão mais propensos a sofrerem distúrbios no decorrer desse processo. A extração do canino permanente só deve ser considerada em casos extremos, onde o próprio não se encontra suscetível à tração ortodôntica. O tracionamento ortodôntico é o tratamento mais indicado devido ao alto valor morfofuncional e estético do canino permanente. Sendo assim, o objetivo deste estudo é relatar um caso clínico de cirurgia de tracionamento de canino permanente superior incluso em maxila. Paciente de 13 anos, gênero feminino, compareceu a clínica odontológica da Universidade Nilton Lins acompanhado de seu responsável, encaminhada por um ortodontista para cirurgia de tracionamento de canino. Durante o exame clínico observou-se ausência do dente 13 na arcada dentária. A paciente apresentou a tomografia computadorizada, onde foi possível verificar o real posicionamento do dente impactado com a coroa parcialmente irrompida no rebordo alveolar. Após o planejamento, realizou-se a cirurgia destinada a instalação de botão ortodôntico e adaptação da amarrilha com fio 0,30 mm. Posteriormente ao período de acompanhamento de 10 meses, observou-se a presença do dente em arco, totalmente erupcionado, mostrando efetividade no tratamento proposto. Portando, o procedimento de colagem de dispositivo ortodôntico ocorreu de forma satisfatória sem complicações ou intercorrências, tornando possível a continuidade do tratamento ortodôntico. A paciente permanece em acompanhamento.