Banca de DEFESA: FERNANDA RAPOSO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : FERNANDA RAPOSO
DATE: 25/10/2023
TIME: 16:00
LOCAL: Plataforma Teams
TITLE:

Effectiveness of the resin infiltration technique in reducing dental hypersensitivity and the occurrence of post-eruptive fractures associated with molar-incisor hypomineralization (MIH)

KEY WORDS:

molar-incisor hypomineralization; hypomineralization; post-eruptive fractures; resinous infiltrant; treatment

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUMMARY:

Introduction: Molar-incisor hypomineralization (MIH) is a qualitative enamel development defect that presents several challenges in terms of clinical management, due to the structural and chemical particularities of affected teeth. The high porosity of hypomineralized enamel associated with chewing efforts causes post-eruptive breakdown (PEBs), which favor the accumulation of biofilm and, consequently, the development of caries lesions. Furthermore, it is also possible that patients report dental hypersensitivity to thermal and/or mechanical stimuli, even when there is no enamel's disintegration yet, impacting their quality of life. Aim: To evaluate the effectiveness of resin infiltration, ionomeric sealant and fluoride varnish in reducing PEBs and hypersensitivity in MIHaffected molars. Methods: A sample was extracted from an epidemiological survey carried out in 6 public schools in Paranoá/DF, Brazil. After the initial screening of children pre-selected for having at least one MIH-affected molar, a detailed clinical examination was done to evaluate dental caries and MIH, using the Nyvad and Molar Incisor Hypomineralization - Severity Scoring System (MIH-) criteria. SSS), respectively. An assessment for dental hypersensitivity (DH) to the air jet and to a tactile stimulus was also carried out, using the shiff cold air sensitivity scale (SCASS) and visual analog scale (VAS). Subsequently, molars with MIH without PEBs were randomized according to the color (white x yellow) and location (free x occlusal surface) of the opacity, and allocated into the following treatment groups: resinous infiltration (test) and fluoride varnish ( control) or ionomeric sealant (control). Six months after implementing the treatments, a new assessment using the Nyvad and MIH-SSS criteria was carried out. To analyze pain intensity using the VAS scale, linear models with mixed effects and random intercepts were used, in which the analysis units (teeth) were nested in clusters (patients). To analyze the volunteers' reaction using the SCASS scale, the models used were generalized mixed linear with cumulative logit of random intercepts. Log odds values were calculated to predict the probability of fracture versus non-fracture by type of treatment, tooth position and surface on which the opacity was located. Results: A total of 46 molars were treated in 26 children with a mean age of 8.15 years (±0.79). 41 teeth were reevaluated, with those that received infiltration having a log chance of not fracturing within a period of 6 months on average 3.13 (±1.13) times greater than sealed teeth and teeth that received fluoride varnish (p=0.012). Molars of children with caries activity have a 21 times greater chance of fracture than those without active caries at baseline (OR=21.26; CI 95 2.20-205.26; p=0.0082). No significant association was observed between color or location of opacity and fracture occurrence. As for DH, the mean pain intensity values for both air stimulation and probing were significantly higher in the control group compared to the test group at baseline (p=0.0091; p=0.0460), in the immediate post-treatment ( p=0.0134; p=0.3356) and at 6 months (p=0.0043; p=0.0570), respectively. At 6 months, the chance of patients in the test group being in a lower category of pain stimulus, was approximately twice the chance of those in the control group, in compariosn with baseline (OR=2.24 ; p =0.0355). Conclusion: The resinous infiltrant was effective in reducing PEBs and tooth hypersensitivity in MIH-affected molars after 6 months. The design of new clinical trials with a larger sample and follow-up is necessary to determine their long-term performance.

COMMITTEE MEMBERS:
Externa à Instituição - CAMILA MARIA BULLIO FRAGELLI - UNESP
Interna - 2867208 - ELIANA MITSUE TAKESHITA NAKAGAWA
Externo à Instituição - FABRICIO KITAZONO DE CARVALHO - USP
Interna - 3493627 - FERNANDA CRISTINA PIMENTEL GARCIA
Presidente - 2220433 - SORAYA COELHO LEAL