Relationships between Clinical and Non-Clinical Variables concerning Traumatic Dental Injuries in Deciduous Teeth Attended in a Children's Hospital.

This study aimed to describe Traumatic Dental Injuries (TDI) in a child population, with a discussion focused on the impact of non-clinical variables on TDI. A cross-sectional, descriptive, and relational study about TDI in deciduous dentition in a children's hospital was performed. A total of 166 patients were included, of which 51.8% were male and 48.2% were female. Subluxation was the most observed injury (37.5%), and high-severity lesions predominated (60.2%). Regarding non-clinical variables, 89.2% of the patients attended urgent care centers within 24 h, and 43.4% within the first 3 h. Pointed objects were the leading cause of TDI (47%). Most TDIs were concentrated between the ages of 2 and 4 (53.5%). Concerning the place of TDI occurrence, the school (41.6%) was associated with faster urgent dental care attendance, and the home (37.3%) was associated with TDI occurrence in children under 2 years of age. Previous TDI experience (24.1% of patients) did not generate differences in the time interval between the TDI and arrival at the hospital, compared with children without a TDI history. While the behavior of clinical variables agrees with the literature reviewed, several non-clinical variables show wide differences. There is a need to identify the non-clinical variables that can significantly interact with phenomena specific to the study population (social, demographic, and cultural). The study of these variables can be useful in applying health policies. In the group studied, the non-clinical data reveals the need to educate parents or guardians on the importance of timely care in TDI, the long-term consequences of traumatism affecting deciduous dentition, and the implication of the maturation of the child's motor skills in TDI.

Declarative knowledge in oral health: The case of the term 'centric occlusion'.

INTRODUCTION: The lack of academic agreement in the practical or clinical use of declarative knowledge can generate unnecessary confusion and miscommunication. The concept Centric Occlusion (CO) is part of the body of declarative knowledge in dentistry, but its definition remains unclear. OBJECTIVE: To ascertain the CO concept in articles published in dental journals as a study case for the dentistry "corpus" of declarative knowledge. METHODOLOGY: The alternative definitions of CO used by the GPT (Glossary of Prosthodontic Terms) from 1956-1977, 'CO as a synonym for maximum intercuspal contact (MIC)', or by the GPT from 1987-2017, 'CO may or may not coincide with MIC', were searched in the articles. The association between the CO definition used and variables such as article aims, journal scope and authors specialty was assessed. RESULTS: Eight hundred and twelve articles were analysed. The widespread use of CO as synonym of MIC was the main finding and was significantly associated to the Orthodontics field. The CO definition according to the GPT 1987-2017 was less frequently observed but appeared in all dentistry fields, showing a significant association with the Oral Rehabilitation field. The difficulty of incorporating the current definition of CO (by GPT) into the main clinical discussions was evidenced all the long of the review process. CONCLUSION: The lack of consensus in the concept use was confirmed by the present study case, showing the influence of specific fields in Oral Health declarative knowledge. This methodology can provide a tool to the academy to assess controversial terms or concepts in Oral Health education, thus facilitating the critical and reflexive learning by students.

Moderate and Severe Dental Fluorosis in the Rural Population of Anantapur, India: Change in Their Biological Susceptibility?

Dental fluorosis affects the quality of life. A cross-sectional, observational study was conducted in a community affected by endemic fluorosis for several generations with a conserved biological and social environment. The study included patients from the rural population of Anantapur, India. The Dean index (DI) and the Thylstrup and Fejerskov Index (TFI) were used for fluorosis classification. Additionally, water samples were collected for fluoride analysis, taken from the patients' living areas. The statistical association between the variables was analyzed. In total, 785 patients between 10 and 60 years old were included in the study (58.7% women and 41.3% men). Fluorosis signs were found in 94.6% of patients examined using the DI and 94.4% using the TFI. Moderate-severe dental fluorosis was observed in 62.8% by DI and 73.1% by TFI consuming untreated water with up to 2.9 ppm of fluoride. Furthermore, moderate-severe dental fluorosis was observed in 33.2% by DI and 39.9% by TFI consuming water with ≤1.5 ppm of fluoride. The high prevalence of moderate-severe dental fluorosis in patients consuming water with a low fluoride concentration suggests that other factors are involved. Biological susceptibility change could play an essential role in the severity of dental fluorosis in populations exposed for several generations, affecting its actual and future quality of life.

Genetic Polymorphisms Associated with Early Implant Failure: A Systematic Review.

PURPOSE: Early implant failures have been observed in dental implant treatments even when the procedures are performed under appropriate conditions and in patients without local or systemic contraindications, suggesting that an intrinsic component of the patient could modify the osseointegration process. The objective of this systematic review was to analyze the association between early implant failure and genetic polymorphisms. MATERIALS AND METHODS: A systematic search was performed in the PubMed, ScienceDirect, and Scopus databases using the PRISMA statement as the main guidelines and "Dental implant" AND "Polymorphism" as search terms. The search cutoff date was August 2019. In addition, the risk of bias, methodologic quality, and heterogeneity of the included studies were analyzed. RESULTS: The search strategy yielded 225 articles, and the titles and abstracts were reviewed to evaluate if they were relevant to the subject. Twenty-four articles were selected for a complete reading, of which 10 articles met the inclusion criteria. Finally, five studies citing the association of the following polymorphisms with early implant failure were chosen: G-1607GG of the MMP 1 gene, C-799T of the MMP 8 gene, and -77 A>G of the gene MMP 13. CONCLUSION: The polymorphisms analyzed are from the promoter region, generating altered cellular transcriptional activity for MMP 1, MMP 8, and MMP 13, the effects of which are observed in inflammation and extracellular matrix degradation. Establishing a relationship between genetic polymorphisms and phenomena such as early implant loss is necessary for the development of precision medicine in the field of dentistry.

Sinus Floor Augmentation by Intraoral Endoscopic Approach for Biomaterial Study in a Rabbit Model.

AIM: To develop a new surgical model for sinus floor augmentation (SFA) in rabbit for experimental purposes. MATERIALS AND METHODS: Eight adult rabbits were used, two for a surgical design using the anatomical dissection study, and the other six for an endoscopically assisted intraoral approach of SFA unilaterally, creating a subantral space where an allograft biomaterial was deposited. SFA was verified through cone-beam computerized tomography. Healing, weight, food, feces, and behavior were evaluated for 4 weeks post-operatively. RESULTS: All animals survived. There was no bleeding or infection; inflammation was mild. No changes were observed in terms of feeding, weight, feces, or behavior. Tissue healing was normal. CONCLUSION: This model is a refinement of the experimental technique and is a real option for SFA, without compromising animal morbidity because of its conservative design. The minimally invasive approach with endoscopic assistance reduces bias and improves surgical predictability.