Oral Health Literacy-Measurement Instruments and their Psychometric Properties: A Systematic Review.

OBJECTIVE: This article aims to provide an evaluation of the psychometric properties of the instruments of oral health literacy in adults. METHODS: An electronic search for instrument studies was performed in the PubMed, PubMed Central, ScienceDirect, Scopus, EMBASE, and PsycINFO databases to find articles published up to June 2021. The risk of bias of the included studies was assessed using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) Risk of Bias checklist for systematic review. RESULTS: From an initial sample of 2617 articles, 14 instrument studies were included in the present review. Their sample sizes ranged from 177 to 1405 adults, and the number of items per measurement instrument ranged from 14 to 99. For structural validity, statistical techniques were performed using the classical test theory (exploratory and confirmatory factor analysis) and the item response theory (dichotomous and polytomous models). The Rapid Estimate of Adult Literacy in Dentistry 30, elaborated in the USA, was the measurement instrument that had the greatest number of cultural adaptations, having been validated in such countries as Saudi Arabia, Brazil, Turkey, and Romania. The evaluation of the risk of bias, undertaken using the COSMIN Risk of Bias checklist, showed that 6 of the 10 parameters had been evaluated. CONCLUSION: The psychometric properties that were evaluated in the present systematic review were structural validity, internal consistency, reliability (test-retest), and hypothesis testing for construct validity. To date, there is no gold standard measuring instrument to evaluate the criterion validity parameter.

Paladar o Tuberosidad, ¿Cuál es la Mejor Zona Donadora para un Injerto de Tejido Blando?: Una Revisión Sistemática / Palate or Tuberosity, Which is the Best Donor Site for a Soft tissue graft? A Systematic Review

RESUMEN: Comparar mediante una revisión sistemática los resultados clínicos de los procedimientos de cirugía plástica periodontal/periimplantar (CP) con injerto de tejido blando autógeno (ITB) obtenido del área lateral del paladar (ALP) versus del área de la tuberosidad (AT). Se realizó una búsqueda electrónica de ensayos clínicos en la base de datos Medline/Pubmed, Cochrane y las revistas de Periodoncia e Implantes de mayor impacto según la Web of Science, para hallar artículos publicados hasta abril del 2020. Se valoró el riesgo de sesgo de los artículos añadidos según el manual Cochrane Versión 5.1.0 para ensayos clínicos aleatorizados y la escala Newcastle-Ottawa para ensayos clínicos controlados. De una muestra inicial de 930 artículos, cuatro ensayos clínicos (tres aleatorizados) fueron incluidos en el presente estudio, donde se realizaron un total de 87 CP alrededor de piezas e implantes dentales, de las cuales 42 cirugías fueron realizadas con ITB del ALP y 45 cirugías con ITB del AT, se evaluó los resultados desde las 8 semanas hasta los 12 meses. No se hallaron diferencias estadísticamente significativas en los resultados clínicos entre ambos grupos, se mejoró el fenotipo gingival en la zona receptora para el grupo que obtuvo el ITB del AT y el nivel del dolor del sitio donador del AT fue menor en las dos primeras semanas que el sitio donante del ALP. Los estudios incluidos manifestaron un bajo riesgo de sesgo en promedio. Ambas áreas donantes de injerto de tejido blando proporcionan resultados clínicos similares, el injerto del área de la tuberosidad mejora el fenotipo gingival de la zona receptora y reduce el dolor post operatorio en las primeras semanas del sitio donador.

ABSTRACT: The objective of the study was to compare, through a systematic review, the clinical results of periodontal / peri-implant plastic surgery (CP) procedures with autogenous soft tissue graft (ITB) obtained from the lateral palate area (ALP) versus the tuberosity area (AT). We conducted an electronic search of clinical trials in the Medline/Pubmed, Cochrane database and the journals of Periodontics and Implants with the greatest impact according to the Web of Science, to find articles published until April 2020. The risk of bias of the articles added was assessed according to the Cochrane Manual Version 5.1.0 for randomized clinical trials and the Newcastle-Ottawa scale for controlled clinical trials. From the initial sample of 930 articles, four clinical trials were included (three randomized) in the present study, where a total of 87 PC were performed around dental pieces and implants, of which 42 surgeries were performed with ITB of the ALP and 45 surgeries with ITB of the AT, the results were evaluated from the 8 weeks to 12 months. No statistically significant differences were found in the clinical results between the two groups, the gingival phenotype in the receiving area was improved for the group that obtained the ITB of the AT and the level of pain at the donor site was lower in the first two weeks than the ALP donor site. The studies showed a lowrisk of bias on average. Both soft tissue graft donor areas provide similar clinical results, grafting the tuberosity area improves the gingival phenotype of the recipient area and reduces post-operative pain of the donor site in the first few weeks.

Preservación de reborde en el sector posterior: Una revisión sistemática / Ridge preservation in posterior sites: A systematic review

Objetivo: Evaluar mediante una revisión sistemática los cambios dimensionales producidos después de una extracción dental en el sector posterior empleando técnicas de preservación de reborde alveolar y cicatrización convencional. Material y métodos: Dos revisores independientes y calibrados realizaron una búsqueda electrónica de ensayos clínicos aleatorizados publicados hasta diciembre del 2018 en Pubmed y Cochrane la cual fue complementada con una búsqueda manual en las revistas de mayor impacto en Periodoncia e Implantología según el ISI Web of Science. La evaluación del riesgo de sesgo en los estudios incluidos fue realizada siguiendo el manual de Cochrane para intervenciones de revisiones sistemáticas Versión 5.1.0. Resultados: Un total de 435 piezas posteriores, entre premolares y molares, fueron evaluadas en los estudios incluidos a partir de los 3 meses post extracción. Se obtuvo valores estadísticamente significativos para el grupo que realizó la preservación de reborde (pérdida ósea vertical desde -0,25 hasta -1,53 mm y a nivel horizontal desde -0,91 hasta -2,87 mm) en comparación al grupo control (pérdida ósea vertical desde -0,71 hasta -3,1 mm y a nivel horizontal desde -2,26 hasta -3,96 mm). El biomaterial más utilizado fue el xenoinjerto más membrana de colágeno. Los estudios incluidos manifestaron un bajo riesgo de sesgo. Conclusiones: La preservación de reborde en sitios posteriores es recomendada porque conduce a mantener los tejidos duros y blandos, reduce la neumatización sinusal y minimiza la reabsorción del hueso crestal simplificando así los procedimientos para una buena posición tridimensional del implante.

Objective: To evaluate the dimensional changes produced after a dental extraction in the posterior sites using techniques of preservation of ridge and conventional healing. Materials and methods: Two independent and calibrated reviewers conducted an electronic search of randomized clinical trials published until December 2018 in Pubmed and Cochrane, which was complemented by a manual search in the journals with the greatest impact in Periodontics and Implantology according to the ISI Web of Science. The evaluation of the risk of bias in the included studies was carried out following the Cochrane manual for interventions of systematic reviews Version 5.1.0. Results: A total of 435 posterior pieces, between premolars and molars, were evaluated in the included studies after 3 months post extraction. Statistically significant values were obtained for the group that performed ridge preservation (vertical bone loss from -0.25 to -1.53 mm and horizontally from -0.91 to -2.87 mm) compared to the control group (vertical bone loss from -0.71 to -3.1 mm and at horizontal level from -2.26 to -3.96 mm). The most used biomaterial was the xenograft plus collagen membrane. The included studies showed a low risk of bias. Conclusions: The ridge preservation in posterior sites leads to: maintaining hard and soft tissues, reduces sinus pneumatization and minimizes the resorption of the crestal bone, generating a great volume of bone tissue, thus simplifying the procedures for a good three-dimensional position of the implant.