Adrielle Ouchi Lopes

Introduction/Objectives: Dental caries is a significant public health burden in Brazil, with regional disparities deeply affecting children in the North and Northeast. This study assessed the prevalence and severity of dental caries in preschool children from Balsas (MA) and investigated its association with fluoride concentrations in the public water supply. Methods: A cross-sectional study was conducted with 256 children (aged 3–5 years) enrolled in municipal schools. Schools were selected using a stratified sampling strategy based on the water network, with exposure validated via chemical analysis. Calibrated dentists performed examinations using the FOA-UNESP risk scale, assessing biofilm and gingivitis as objective clinical proxies for hygiene. Fluoride levels were analyzed using an ion-selective electrode. Statistical analysis included Fisher’s exact test, Kruskal–Wallis, and Multiple Correspondence Analysis (MCA). Results: Caries prevalence was 60.16%, with 41.8% of children in severe risk categories (F: 27.0%; G: 14.8%). Water analysis revealed universal hypofluoridation (0.02–0.34 µg F/mL). A significant association was found between residual fluoride (0.02 µg F/mL) and greater caries severity (p = 0.04). Poor hygiene markers (biofilm and gingivitis) were significantly associated with a higher number of decayed teeth (p < 0.05). MCA identified a cluster linking residual fluoridation to severe clinical conditions and social vulnerability. Conclusions: High caries prevalence associated with inadequate fluoridation highlights critical regional health inequalities in Balsas. These findings underscore the urgent need for policies ensuring universal water fluoridation and strengthening school-based preventive strategies to mitigate the impact of social determinants on child development.

Hypertension alters tooth formation and Atenolol reduces the blood pressure of spontaneously hypertensive rats (SHR) during pregnancy and lactation, and as demonstrated before, increases the microhardness of the SHR offspring’s teeth. MMP-9 is overexpressed in different tissues of hypertensive animals and treatment of hypertension substances can reverse this alteration. We hypothesize hypertension alters the expression of MMP-9 in dental structures of SHR offspring and that treating female SHR with atenolol prevents this alteration. This study aimed to evaluate the expression of matrix metalloproteinase (MMP-9) in incisor teeth (IT) in male offspring of SHR (30 days old) treated or untreated with Atenolol during pregnancy and lactation. MMP-9 expression was evaluated in ameloblasts (AM), enamel matrix (EM), odontoblasts (OD), and predentin (PD) of IT through immunohistochemical reactions (immunoperoxidase). Data were analyzed by Shapiro-Wilk and Kruskal-Wallis (p < 0.05), with Dunn post-test. Histological differences were not observed between IT tissues of SHR and normotensive Wistar rats. For the first time, our data showed that MMP-9 expression in specific dental structures is not altered in SHR. Atenolol treatment increased MMP-9 immunostaining in EM of Wistar rat, however, Atenolol did not alter MMP-9 in the IT tissues of SHR. Our results demonstrated that MMP-9 expression in dental tissues is not affected by hypertension or atenolol treatment in dental tissues. If confirmed in humans, the results obtained in this study will corroborate the suggestion that MMP-9 is not a viable therapeutic target for the treatment of dental alterations associated with maternal hypertension.

The compound odontoma, classified as an odontogenic tumor, with the highest incidence rates, representing up to 70% of all odontogenic tumors found. It is a benign tumor, composed of odontogenic epithelium with odontogenic ectomesenchyme. Its histology presents with different dental tissues, including enamel, dentin, cementum, and, in some cases, pulp tissue. Therapy consists of surgical excision. This case report aimed to describe the step-by-step surgical procedure for removing a compound odontoma in a pediatric patient, and thereby emphasize the importance of early and conclusive diagnosis, as well as its treatment plan. An 8-year-old male patient with the absence of eruption of teeth 11 and 12 and prolonged retention of tooth 52. The diagnosis and surgical procedure were thorough and precise. During the patient's 7-month follow-up, there was no spontaneous eruption of the teeth. Therefore, diagnosing and investigating clinical, radiographic, and tomographic situations suggestive of odontomas are essential to avoid damage to the permanent dentition and the timeline of tooth eruption.