Ana Daniela Soares

The occurrence of triplication in the deciduous teeth is rare. However, it can cause several problems in primary dentition, alteration of development, and eruption of permanent successors. Case Presentation: A three-year-old boy presented with an exuberant acute periapical abscess in the left front teeth region of the upper jaw. Examination revealed a presence of a triple tooth involving the central and lateral left primary incisors and a supernumerary tooth. Radiographs showed that the fused teeth had separate roots, pulp chambers and root canals. The implemented treatment was extraction under local anesthesia. After 2 years of observation, surgical exposure of the crowns of the permanent maxillary central incisor was performed. After seven years, the permanent dentition was completed without any sequelae. Discussion: Triple tooth, as observed in this case report, results from the union of three tooth germs, potentially influenced by physical, hereditary, or environmental factors, leading to esthetic and functional issues and increased susceptibility to caries. Treatment is challenging, requiring preventive care, complex endodontic procedures, and, in some cases, extraction with space maintenance to avoid future orthodontic complications. Conclusion: Early diagnosis, an adequate treatment plan and clinical monitoring should be performed, aiming at preventing the possible disturbances.

Purpose To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. Methods This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4–8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- Clearfil^TMS³Bond Plus (CSB); GII- Clearfil^TMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). Results The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). Conclusions After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. Trial registration number ISRCTN11458186.

Purpose: The purpose of this in vitro study was to assess and compare the microtensile bond strength of three adhesive systems to primary enamel. Methods: This laboratory study involved the preparation of 16 primary molars, randomly distributed over three groups, using the following adhesive systems: GI-Prime & Bond (R) XP (PBXP); GII-Clearfill (TM) SE Protect Bond (CSEPB); and GIII-Clearfil (TM) S3Bond Plus (CSB). After applying each adhesive system on enamel as recommended, Ceram.XT (TM) Universal composite blocks were built. Samples were then cross-sectioned into quadrangular test specimens and subjected to microtensile tests. Fracture patterns were classified by optical microscopy examination. Statistical analysis was performed using IBM SPSS 24.0 software (five percent significance level). Results: PBXP showed statistically higher levels of microtensile adhesion than CSEPB and CSB, which, in turn, did not significantly differ from each other. Fracture patterns observed were, for the majority, adhesive fractures across all groups. There was no statistically significant association between group and type of failures. Conclusions: Bond strength of the etch-rinse adhesive to primary prepared enamel was statistically higher than for the two self-etch systems tested, which, in turn, did not significantly differ from each other.

Purpose To assess the prevalence of early childhood caries (ECC) and associated factors among a 5-year-old cohort. Methods An observational longitudinal study was conducted with a sample of 142 preschoolers. A calibrated dentist performed intraoral examinations following International Caries Detection and Assessment System (ICDAS-II) criteria at baseline and after 6 months. A questionnaire on sociodemographic variables and oral health-related behaviours was answered by caregivers. Statistical analysis included descriptive statistics and computation of confidence intervals (95% confidence level). Results Baseline prevalence of ECC and severe ECC (S-ECC) were 40.1% and 11.3%, respectively. After 6 months ECC and S-ECC prevalence rates were 46.5%, and 13.2%, respectively. At both evaluations most caries lesions were untreated. Parental education and occupation were significantly associated with ECC. Behaviour variables found to be significantly associated with the disease comprised: establishing toothbrushing habits before the first year, toothbrushing twice daily and with parental assistance, frequency of dental visits, age at first dental visits, daily ingestion of sweets and number of daily meals. Conclusion The prevalence of ECC was very high, with most of the lesions left untreated. ECC experience was associated with participants’ socioeconomic background and several of the surveyed oral health-related behaviour variables.

Objectives: Saliva metabolome is a promising diagnostic tool concerning oral and systemic diseases. We aimed at establishing a suitable protocol for saliva collection and gauging the relative impacts of gender, dentition stage, and caries on the saliva metabolome of a small children cohort.Subjects and methods: A nuclear magnetic resonance‐based metabolomics cross‐sectional study of children saliva (n = 38) compared the effects of: (a) stimulation and unstimulation conditions, and (b) collection through passive drool and using an absorbing device. Multivariate and univariate statistical analyses were applied to evaluate such effects and those related to gender, dentition stage and caries.Results: No significant differences were found between unstimulated and stimulated saliva, and the former was used for subsequent studies. Swab collection induced significant changes in sample composition, indicating passive drool as preferential. The impacts of gender and dentition stage were not significant compared to that of caries, which induced variations in the levels of 21 metabolites. These comprised amino acids and monosaccharides observed for the first time to our knowledge regarding children caries, suggesting protein hydrolysis and deglycosylation.Conclusions: Unstimulated passive drool saliva metabolome may carry a caries signature.

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