[Design and evaluation of a booklet for the Oral Health Program in children from birth].

BACKGROUND: There is no preventive control of oral health from birth in Spain. This situation entails a number of risks, such as increased caries lesions in children. The objective of this study was to design a pediatric dentistry booklet for the clinical assessment and follow-up of oral health in children, as well as its evaluation by health professionals and parents. METHOD: Design of the booklet, in 2018, by pediatric dentists of the Murcia University Dental Clinic, based on a biblio-graphic review, to instruct in preventive (dietary and oral hygiene) and curative (planning of pediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists, pediatricians and parents was carried out to evaluate the preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects of the booklet and suggestions. RESULTS: The evaluation of the preliminary version of the booklet by health professionals and parents was positive. It was modified in line with their suggestions and the final version was made: a 16-page booklet, with data on the child's affilia-tion and parents, with a preventive and curative approach, making pediatric and pediatric dental check-ups coincide in time. CONCLUSIONS: The pediatric dentistry booklet was created and has been positively valued by professionals and parents, its use is recommended for early dental care, and can be extended to other health systems at the regional level in Spain.

Application of International Caries Detection and Assessment System (ICDAS) and Caries Management by Risk Assessment (CAMBRA) systems in child cancer patients: a clinical case report.

BACKGROUND: Leukaemia represents 30-40% of all paediatric malignant tumours and is the main cause of death in patients aged <15 years. One of the main complications in these patients is infection, which may often occur in the oral cavity. Chemotherapy-related oral health problems may be reduced by oral healthcare strategies based on the International Caries Detection and Assessment System (ICDAS) and Caries Management by Risk Assessment (CABRA). CASE REPORT: A case is reported of a 14-year-old girl treated for leukaemia who presented with established dental caries lesions which were classified and treated according to ICDAS and CABRA protocols. After three, no new caries was observed. FOLLOW-UP AND CONCLUSION: ICDAS and CAMBRA provide useful and effective guidance for the avoidance of dental and systemic problems. Their introduction into standard practice could reduce the legal difficulties derived from dental treatment in these patients.

Histomorphometric and mineral degradation study of Ossceram: a novel biphasic B-tricalcium phosphate, in critical size defects in rabbits.

OBJECTIVE: To carry out a histomorphometric analysis of a new highly porous (95%) biphasic calcium phosphate (hydroxyapatite 60%/B-tricalcium phosphate 40%), used to fill critical size defects in rabbit tibiae, supplementing histomorphometric findings with radiographic thermal imaging, EDX analysis and Ca/P ratio mapping at different time stages. MATERIALS AND METHODS: Two critical size defects of 6 mm diameter were created in both tibiae of 21 New Zealand rabbits, test group (Ossceram) and control group. Histomorphometric, radiographic thermal imaging, EDX and element mapping analysis were performed at 15, 30 and 60 days after graft insertion. RESULTS: Histomorphometric analysis at 30 days showed more new bone formation in defects filled with Ossceram 4.41 ± 0.23 mm than the test group 1.94 ± 0. 28 mm (P<0.05). Element analysis revealed higher percentages of Ca (42.33 ± 2.8%) and P (1.3 ± 0.8%) in the test group than in the control group (P<0.05). Element mapping showed that Ca and P were concentrated in medullar and cortical zones in the test group but were concentrated only in cortical zones in the control group. Test group histomorphometry at 60 days showed complete closure of the cortical defect 5.37 ± 0.32 mm more than the control group 2.3 ± 0.54 mm. There was no cortical defect closure or medullar bone formation in the control group (P<0.05). Element analysis revealed higher percentages of Ca (32.26 ± 21.7%) and P (1.5 ± 0.3%) in the test group than in the control group (P<0.05). CONCLUSION: Defects of a critical size in a rabbit tibia model can be sealed using a highly porous biphasic calcium phosphate; this supports new bone formation, creates a bridge between borders and facilitates bone ingrowth. Furthermore, this study observed partial dissolution of the mineral phase of the graft material and its incorporation into the surrounding bone. Radiographic thermal imaging may be used to supplement histological and chemical analyses.

A new use for self-etching resin adhesives: cementing bone fragments.

OBJECTIVES: To evaluate the bond capacities of four self-etching resin cements and the self-etching adhesives of the same manufacturer when used to cement bone fragments and compare them with a well-known N-butyl-2-cyanoacrylate bone adhesive. METHODS: 125 cylindrical bone specimens from pig mandibular ramus bone were prepared using terphane burs and cemented to the corticals of 125 other specimens obtained from pig mandibular body bone using the following bond systems: Group A: Adper PLP/Relyx; group B: Optibond/Maxcem; group C: Hystoacryl; group D: AdheSE/Multilink; group E: G-Bond/G-Cem. Shear bond strength was measured 15 min after cement application using a universal testing machine. RESULTS: Shear bond strength results: group A 2.54+/-0.23 MPa; group B 4.83+/-0.4 MPa; group C 2.90+/-0.24 MPa; group D 2.10+/-0.17 MPa; group E 4.22+/-0.24 MPa. Values for shear bond strength were significantly greater for group B and E compared to groups A, C and D (p<0.005, test Mann-Whitney). SEM images showed the presence of a hybrid layer similar to that formed by these bond systems when used on dentine. CONCLUSION: Within the limitations of an in vitro investigation, results show that self-etching resin cements together with self-etching adhesives may be used for cementing bone fragments.

Histological and histomorphometric evaluation of immediate implant placement on a dog model with a new implant surface treatment.

PURPOSE: The aim of this study was to evaluate crestal bone resorption and bone apposition resulting from immediate post-extraction implants in the canine mandible, comparing a conditioned sandblasted acid-etched implant surface with a non-conditioned standard sandblasted implant surface. MATERIAL AND METHODS: In this experimental study, third and fourth premolars and distal roots of first molars were extracted bilaterally from six Beagle dog mandibles. Each side of the mandible received three assigned dental implants, with the conditioned surface (CS) on the right side and the non-conditioned surface (NCS) on the left. The dogs were sacrificed at 2 (n=2), 4 (n=2) and 12 weeks (n=2) after implant placement. RESULTS: The microscopic healing patterns at 2, 4 and 12 weeks for both implant types (CS and NCS) yielded similar qualitative bone findings. The mean crestal bone resorption was found to be greater for all implants with NCS (2.28+/-1.9 mm) than CS (1.21+/-1.05 mm) at 12 weeks. The mean percentage of newly formed bone in contact with implants was greater in implants CS (44.67+/-0.19%) than with the NCS (36,6+/-0.11%). There was less bone resorption with the CS than the NCS. CONCLUSION: The data show significantly more bone apposition (8% more) and less crestal bone resorption (1.07 mm) with the CS than with the NCS after 12 weeks of healing. This CS can reduce the healing period and increase bone apposition in immediate implant placements.