Ecological study on needs and cost of treatment for dental caries in schoolchildren aged 6, 12, and 15 years: Data from a national survey in Mexico.

To determine the treatment needs and the care index for dental caries in the primary dentition and permanent dentition of schoolchildren and to quantify the cost of care that would represent the treatment of dental caries in Mexico.A secondary analysis of data from the First National Caries Survey was conducted, which was a cross-sectional study conducted in the 32 states of Mexico. Based on dmft (average number of decayed, extracted, and filled teeth in the primary dentition) and DMFT (average number of decayed, extracted, and filled teeth in permanent dentition) information, a treatment needs index (TNI) and a caries care index (CI) were calculated.At age 6, the TNI for the primary dentition ranged from 81.7% to 99.5% and the CI ranged from 0.5% to 17.6%. In the permanent dentition, the TNI ranged from 58.8% to 100%, and the CI ranged from 0.0% to 41.2%. At age 12, the TNI ranged from 55.4% to 93.4%, and the CI ranged from 6.5% to 43.4%. At age 15, the TNI ranged from 50.4% to 98.4%, and the CI ranged from 1.4% to 48.3%. The total cost of treatment at 6 years of age was estimated to range from a purchasing power parity (PPP) of USD $49.1 to 287.7 million in the primary dentition, and from a PPP of USD $3.7 to 24 million in the permanent dentition. For the treatment of the permanent dentition of 12-year-olds, the PPP ranged from USD $13.3 to 85.4 million. The estimated cost of treatment of the permanent dentition of the 15-year-olds ranged from a PPP of USD $10.9 to 70.3 million. The total estimated cost of caries treatment ranged from a PPP of USD $77.1 to 499.6 million, depending on the type of treatment and provider (public or private).High percentages of TNI for dental caries and low CI values were observed. The estimated costs associated with the treatment for caries have an impact because they represent a considerable percentage of the total health expenditure in Mexico.

p53 and p16 in oral epithelial dysplasia and oral squamous cell carcinoma: A study of 208 cases.

BACKGROUND: The use of p16 and p53 as biomarkers of malignant transformation of oral epithelial dysplasia (OED) and biological behavior of oral squamous cell carcinoma (OSCC) is controversial. AIM: To determine the immunoexpression of p16 and p53 in OED and OSCC and to establish their possible relation to histopathological grading of OED/OSCC. MATERIALS AND METHODS: Ninety-six OEDs (40 mild, 36 moderate, and 20 severe dysplasia); and 112 OSCCs (64 well-differentiated, 38 moderately differentiated, and 10 poorly differentiated) coming from archives of four centers of oral pathology were included. Histological slides from all cases were processed with immunohistochemical technique using anti-p53 and anti-p16 antibodies. The intensity of the immunoreactivity were classified using the ImageLab®MCM systemas follows: <60 mild, >60-<90 moderate, and >90 strong. Forstatistical purposesa χ2 test (P < 0.05) was performed. RESULTS: Severe dysplasia show highest relative frequency of p16-positive (35.5%), whereas p53 is associated with mild dysplasia (P = 0.04). Moderately differentiated OSCC had larger relative frequency of p16-positive and p53-positive cases (47.3% both circumstances) (P > 0.05). Statistical association of p16-positive and p53-positive cells to basal stratum of OED (P = 0.0008; P = 0.0000, respectively) and p16-positive cells and p53-positive cells to perivascular zone of OSCC (P = 0.001; P = 0.0000, respectively) was found. CONCLUSIONS: p16 and p53 could be not specific enough to identify patients suffering OED with high risk to malignancy; however, the evaluation of the presence of p16 and p53 in the tumoral invasive front of OSCC could contribute to establish the tumor progression.

Socioeconomic, sociodemographic, and clinical variables associated with root caries in a group of persons age 60 years and older in Mexico.

AIM: To determine the prevalence of root caries and the root caries index in a population of older Mexicans, and its relationship to socioeconomic, sociodemographic and dental factors. METHODS: We carried out a cross-sectional study in 85 persons 60 years and older living either in long-term care facilities, or independently and attending an elder day-care group. Each subject underwent an oral examination, performed by a trained and standardized dentist, to determine the root caries index and other clinical variables. Questionnaires were administered to collect socioeconomic, sociodemographic and hygiene data. Statistical analyses were performed using non-parametric tests. RESULTS: The prevalence of root caries was 96.5%. The root caries index was 37.7% ± 21.7%. Statistically significant differences (P < 0.05) of root caries index were observed across residential arrangements and marital statuses, and were higher in publicly funded long-term care and among single subjects (P < 0.05). Those who had poor hygiene had more root caries (P < 0.05); persons with a low level of schooling and who brushed their teeth less frequently also showed a difference (P < 0.05). CONCLUSIONS: The prevalence of root caries was very high. The type of long-term care, marital status, schooling and oral hygiene were associated with a higher root caries index. Oral health programs and preventive caries interventions are needed for this age group in general; targeted strategies may be better focused if sociodemographic profiles are used to characterize high need groups.

The impact of orthodontic treatment on normative need. A case-control study in Peru.

OBJECTIVE: To assess the impact of previously provided orthodontic treatment on the normative need in a sample of young adult Peruvians. METHODS: Six hundred and thirty five freshmen, representative of all first year students registering in 2002 at a private university in Lima, were randomly screened to obtain 63 cases and 126 controls. A case was defined as having a definite orthodontic treatment need determined by the DAI and IOTN indices simultaneously. A control was defined as having no need of orthodontic treatment based on both indices. Students were also asked if they had previously undergone any orthodontic treatment. Binary logistic regression was used for the statistical analysis. RESULTS: Sex, age and socioeconomic status of the students were not statistically associated with normative orthodontic treatment need (p = 0.258, 0.556 and > or = 0.272 respectively). The percentage of students with a previous history of orthodontic treatment was similar between the cases and the controls (14.3 per cent and 11 .9 per cent respectively). There were no statistically significant associations between the variables. CONCLUSIONS: The impact of previously provided orthodontic treatment on the current normative need of young adults was limited. Properly designed studies are required to assess the reasons for these findings.