In Vitro Efficacy of Domestic Techniques for Disinfection of Toothbrushes Contaminated With Enterococcus faecalis.

Introduction: Oral hygiene education for patients is fundamental in preventive-promotional dentistry. The disinfection of toothbrushes (TBs) must be integrated into this context due to their proximity to contaminant sources that make them vulnerable to cross infection in homes. The objective of this study was to compare the efficacy of domestic techniques for disinfection of TBs. Materials and Methods: We performed an in vitro study of 76 TBs contaminated with Enterococcus faecalis (Ef) ATCC 29212 subjected to different disinfection protocols: G1. Distilled water (DW; negative control; n = 8), G2. Dimethylsulfoxide (DMSO)10% (negative control; n = 8), G3. Chlorhexidine (CHX) 0.12% (positive control; n = 15), G4. 100% white vinegar (WV; n = 15), G5. Microwave (MW) at 700 W (n = 15), and G6. 200 mg/mL of certified alcoholic extract of purple garlic (GARLIC) from Arequipa (Allium sativum L; n = 15). Bacterial count was assessed by colony-forming units (CFU/mL) categorized as contamination: low (<30), medium (30-300), and high (>300). The Kruskal-Wallis test with post hoc pairs was used at a significance level of p < 0.05. Results: Efficacy against Ef showed highly significant differences between groups (p < 0.001) with lower median CFU/mL in G3 and G4 (Me = 0 [IQR (interquartile range) = 0]: low) and G5 (Me = 6000 [IQR = 45,000]: low/medium) versus negative controls (Me = 378,500 and 5,020,000 [IQR = 4,605,000 and 6,760,000]: medium/high; p ≤ 0.019). The counts of the G5 were not statistically different than G3, G4, and G6 (p > 0.06). The G6 (Me = 1,510,000 [IQR = 590,000]: medium) was inferior to G3 and G4 (p < 0.001), but similar to both negative control groups (p > 0.999). Conclusions: Disinfection of TBs with CHX, WV, and MWs produces a significant effective reduction in the count of Ef.

Morphology of Roots and Canals of Maxillary First Premolars: A CBCT Study in a Peruvian Sample.

Introduction: It is important to take into account variations in structures related to dental pulp for planning the most adequate endodontic treatment management. The objective of this study was to determine the morphology of roots and canals of maxillary first premolars (MFPs) using cone-beam computed tomography (CBCT). Materials and Methods: This retrospective study included a sample of 392 CBCTs of Peruvian adults proportionally selected by sex, age, and quadrant. One MFP per individual was selected for evaluation by a calibrated evaluator based on the number of roots and canal configuration according to the Vertucci classification (VC; Cohen's κ ≥ 0.834). Pearson's χ 2 and Kruskal-Wallis tests were used with a significance level of P < 0.05. Results: Most MFP presented double roots (59.9%) and were VC type IV (52%). Morphology showed a nonsignificant difference by quadrants (P=0.994). A significant positive association was found between the presence of double roots and type IV in men and with older age, while single roots and type I and II were associated with women and younger age (P < 0.05). Double roots were associated with VC type IV (86%) and single roots with types III (34%), II (32%), and I (26%; P < 0.001). Conclusions: MFPs in a Peruvian sample presented a higher frequency of double roots with two separate canals. The morphology of root and canals was associated with age and sex.

Perception of treatments with self-ligating and conventional brackets in peruvian orthodontists.

Introduction: Orthodontists' perception of bracket techniques plays a significant role in planning, allowing critical evaluation of the patient's facial aesthetics. Objective: To compare the perception of Peruvian orthodontists regarding treatments with self-ligating and conventional brackets. Methods: A questionnaire was applied to 168 orthodontic specialists (53% men, average professional experience 9 years) to evaluate preferences for treatment phases, benefits of patient consultation according to the type of bracket, experience with self-ligating brackets, and demographic and clinical characteristics (sex, years of experience, volume of care and length of experience). The Kruskal-Wallis Test and Chi-square test were used with P < 0.05. Results: The total preference for self-ligating brackets (48.9%) was higher than conventional brackets (18.8%). Self-ligating brackets were preferred in most treatment phases (46.4%-63.7%) but not in completion and finishing, in which conventional brackets were preferred. Most orthodontists preferred self-ligating brackets (40.5%-60.7%) over conventional brackets (4.2%-14.3%) due to patient comfort, oral hygiene, and total treatment and appointment time control, but not the cost. The orthodontists reported SLB having mastered their technique in <10 cases (59.5%), the experience of <2 years (45.2%), applying control times of 4-9 weeks (78.6%), and feeling comfortable with their use (89.3%). Preferences were not associated with sex (P > 0.05) but rather with years of professional experience (P < 0.05). Conclusions: Peruvian orthodontists preferred self-ligating brackets over conventional brackets in most treatment phases associated with user comfort and oral hygiene management and treatment/control time, and professional experience. However, some factors, such as cost-effectiveness, counteracted this preference.

Introducción: La percepción de los ortodoncistas sobre las técnicas de brackets cumple un papel importante en la planificación, al permitir una evaluación crítica de la estética facial del paciente. Objetivo: Comparar la percepción de tratamientos con brackets autoligantes y convencionales en ortodoncistas peruanos. Métodos: Un cuestionario fue aplicado a 168 especialistas en ortodoncia (53% varones, experiencia profesional promedio 9 años) para evaluar las preferencias por fases de tratamiento, beneficios de la consulta del paciente según el tipo de bracket, experiencia con brackets autoligantes, características demográficas y clínicas (sexo, años de experiencia, volumen de atención y tiempo de experiencia). Las pruebas de Kruskal-Wallis y chi-cuadrado se utilizaron con un p < 0,05. Resultados: La preferencia total de los brackets autoligantes (48,9%) fue mayor frente a los brackets convencionales (18,8%). Los brackets autoligantes fueron preferidos en la mayoría de las fases de tratamiento (46,4%-63,7%), pero no en la finalización y acabado, en las que se prefirieron los convencionales. La mayoría de los ortodoncistas prefirieron los brackets autoligantes (40,5%-60,7%) a los convencionales (4,2%-14,3%) debido a la comodidad e higiene oral del paciente, y el tiempo total de tratamiento y citas de control, pero no por el precio. Los ortodoncistas refirieron haber dominado la técnica de los brackets autoligantes en <10 casos (59,5%), experiencia < 2 años (45,2%), aplicando tiempos de control de 4-9 semanas (78,6%), y sentirse cómodo con su uso (89,3%). Las preferencias no se asociaron al sexo (p > 0,05), sino con los años de experiencia profesional (p < 0,05). Conclusiones: Los ortodoncistas peruanos prefirieron los brackets autoligantes sobre los brackets convencionales en la mayoría de las fases de tratamiento, debido a factores asociados con la comodidad e higiene oral del usuario, el manejo y tiempo de tratamiento/control, y la experiencia profesional. Sin embargo, hubo otros factores que contrarrestaron la preferencia, como la rentabilidad en el costo.

Body Height Estimation According to Deciduous Dental Crown Height in a Peruvian Sample of Preschool Children.

Introduction: Odontometry and body height are distinctive biological traits, making their relationship relevant in the identification of individuals. The objective of this study was to estimate body height according to the height of the crown of deciduous teeth in Peruvian preschool children. Materials and Methods: This analytical study was applied to a calculated sample of 204 preschoolers between 3 and 5 years of age (34 per sex/age group) with fully erupted upper anterior deciduous teeth (from #53 to #63). Measurements included body height with a stadiometer (106 ± 6.56 cm; 94-123 cm) and crown height from canine to canine (3.06 mm in #62 to 8.13 mm in #53) in models with digital vernier (intraclass correlation coefficient ≥ 0.781). Linear regression models included calculation of the regression coefficient (ß) to predict height based on crown height for each deciduous tooth at a significance level of P < 0.05. Results: There was no correlation between body height and crown height by tooth type in the total sample (P ≥ 0.05), but there was in a 3-year-old female in #52 (r = 0.4: moderate) and a 5-year-old female in #53 and #63 (r = 0.36-0.38: low) (P < 0.05). Body height prediction equations are shown according to crown height per tooth and sex/age groups. The regressions were significant, explaining 13%-18% of 3-year-old females in #53 and #52 (1.85-1.86 cm error) and 5-year-old females in #53, #51, and #63 (4.61 at 4.63 cm error) (P < 0.05). Conclusions: The odontology method using crown height of the upper anterior deciduous teeth estimated body height in Peruvian girls of 3 and 5 years of age. The teeth are resistant to traumatic forces so these could be used as a body height estimation parameter for forensic human identification.

In Vitro Effect of Mouthrinses on the Microhardness of Three Different Nanohybrid Composite Resins.

Introduction: Daily use of different mouthrinses at home or in the dental office can alter the properties of resin hardness. The present study aimed to compare Vickers microhardness (VHN) in vitro of nanohybrid composite resins (NCRs) immersed in mouthrinses. Materials and Methods: In total, 120 discs (10 ⨯ 2 mm) were prepared from three NCR shade A2 (n = 40/group) with FiltekTM Z350 XT (Z350XT), Tetric EvoCeram (TEC), and Polofil NHT (PNHT). The specimens were incubated in artificial saliva (37°C ⨯ 24 hr). Specimens were distributed into four mouthrinses (n = 10/group) of artificial saliva (control), chlorhexidine (CHX 0.12%, pH 5.6), cetylpyridine chloride (CPC 0.075%, pH 5.84), and CHX 0.12% + CPC 0.05% (pH 6.2) (2 times/day, 2' ⨯ 12 hr). The VHN (300 gf/10") was measured after 24 hr, 14, and 21 days. Data were analyzed by three-way analysis of variance, followed by post hoc Tukey analysis at 0.05 level of significance. Results: The results revealed a global effect of the interaction of the mouthrinses ⨯ time between NRC evaluated (P=0.001). Baseline VHN in PNHT and Z350XT was higher than TEC. Within each group of NCR, VHN of CHX + CPC > other mouthrinses (PNHT/14 days; Z350XT/21 days), and >CPC (Z350XT/14 days). In mouthrinses-intragroups, VHN of PNHT and Z350XT decreased at 14 days (CHX, CPC) and was maintained over time in NCR (CHX + CPC). VHN-TEC was similar among groups. Conclusion: Microhardness showed differences due to the interaction of the type of NCR, the composition of the mouthrinses, and time. VHN decreased after 14 days and was more affected in composite resins with lower filler content and in mouthrinses with a lower pH.

Relationship Between Sagittal Root Position and Alveolar Wall Thickness of Maxillary Teeth in the Esthetic Area for Immediate Implant Treatment Planning in a Peruvian Population.

OBJECTIVE: The purpose of this retrospective study was to assess facial and palatal alveolar wall thickness (AWT) in relation to sagittal root position (SRP) of maxillary anterior teeth using cone-beam computed tomography (CBCT). METHODOLOGY: 102 CBCT images (60 females, 42 males) of anterior maxillary teeth were reviewed. SRP was classified according to Kan's classification, and AWT was evaluated at coronal (4 mm from the cementoenamel junction), mid-root, and apical (2 mm from the apex) levels of the facial and palatal. Secondary variables of sex, age and tooth type were analyzed. RESULTS: The SRP distribution was 76.6% class I, 11.3% class II, 0.8% class III, and 11.3% class IV. AWT, from thickest to thinnest, was found in palatal apical>mid>coronal, followed by facial coronal>mid>apical. CONCLUSIONS: AWT was thickest in SRP class II, followed by class I and III, and least thick in class IV at all measured areas (P<.05). A significantly higher AWT was associated with class I in central incisors, class II in canine teeth and in males, and class IV in central incisors and canines.

Tiempo empleado para estimar edad dental en niños peruanos comparando el método de Demirjian y el cuadro integral del enfoque de Demirjian: un estudio piloto / Time spent to estimate dental age in peruvian children comparing the demirjian method and the comprehensive chart based on demirjian method: a pilot study

El objetivo de este estudio fue comparar el tiempo empleado al estimar la edad dental (ED) entre el método propuesto por Demirjian et al. y el cuadro integral del enfoque de Demirjian (DAEcc) utilizando radiografías panorámicas digitales de individuos peruanos de 5 a 13 años residentes en Lima. Se realizó un estudio no experimental, comparativo, transversal y retrospectivo. Se utilizaron 100 radiografías panorámicas digitales que presentaban siete dientes permanentes mandibulares izquierdos. Una odontóloga forense capacitada y calibrada determinó el tiempo utilizado en evaluar la maduración dental y la estimación de ED con dos métodos (Demirjian y DAEcc). La unidad de medida utilizada fue los minutos (min.). No hubo diferencias en el tiempo de evaluación del estadio de maduración dental entre ambos métodos (p<0,05). El tiempo para estimar ED fue estadísticamente inferior con DAEcc (2,09 min) que con Demirjian (4,19 min). La diferencia del tiempo total de evaluación resultó estadísticamente significativa entre ambos métodos (Δ2,1 min.; 2,05-2,11; p=0,000). La aplicación del DAEcc redujo en 50 % el tiempo empleado en estimar ED en comparación con los cuadros propuestos por Demirjian. Aunque la odontología forense se centra en el estudio de la eficacia de estimación de la edad, es necesario abordar también su uso práctico.

SUMMARY: The objective of this study was to compare the time used to estimate dental age (DA) between the method proposed by Demirjian et al., and the comprehensive chart for dental age estimation (DAEcc) using digital panoramic radiographs of Peruvian individuals aged 5 to 13 years residing in Lima. A non- experimental, comparative, cross-sectional and retrospective study was carried out. 100 digital panoramic radiographs showing seven mandibular left permanent teeth were used. A trained and calibrated forensic odontologist determined the time used to assess tooth maturation and DA estimation with two methods (Demirjian and DAEcc). The unit of measurement used was minutes (min.). There were no differences in the evaluation time of the dental maturation stage between both methods (p<0.05). The time spent to estimate DA was statistically less with DAEcc (2.09 min) than with Demirjian (4.19 min). The difference in total evaluation time was statistically significant between both methods (Δ2.1 min; 2.05-2.11; p=0.000).The application of DAEcc reduced by 50 % the time spent estimating DA compared to the method proposed by Demirjian. Although forensic odontology focuses on the study of the effectiveness of age estimation, its practical use needs to be addressed as well.

[Anxiety level and physiological response to invasive dental treatments. a longitudinal study]. / Nivel de ansiedad y respuesta fisiológica ante tratamientos dentales invasivos. un estudio longitudinal.

Objective: To determine the relationship between the level of anxiety and the physiological response to invasive dental treatments. Materials and methods: A convenience sample of 180 patients was formed (73 men and 107 women) ≥18 years (range: 18-58) undergoing treatment with local anesthetics from three private dental offices in the city of Lima. Measurements were made before, during and after treatment on anxiety according to the IDARE questionnaire of 40 questions (20 trait and 20 state) and their physiological response was evaluated according to oxygen saturation (OS), pulse and blood pressure (BP) measured. with digital pulse oximeter and blood pressure monitor. The Friedman and Spearman correlation tests were used, working with a value of P<0.05. Results: Most patients had a medium level of anxiety before dental treatment (state 49.4% and trait 55.6%). OS, pulse and BP increased after application of the anesthetic and decreased at the end of treatment, with significant differences (P<0.05). Anxiety scores were significantly correlated only with pulse (state: r=0.238-0.564; trait: r=0.174-0.323) and BP (state: r=0.429-0.699; trait: r=0.312-0.465) (P<0.05). Conclusion: State-trait anxiety had a positive relationship with the physiological dimensions of blood pressure and pulse before dental treatment with local anesthetics.

Actualización de la Relación Bidireccional de la Diabetes Mellitus y la Enfermedad Periodontal

RESUMEN: La diabetes mellitus y la enfermedad periodontal son patologías con una alta prevalencia en la población, y su frecuencia va en aumento. Ambas presentan mecanismos comunes de progresión y se manifiestan en términos de comorbilidad. El objetivo de esta revisión fue explicar los mecanismos de asociación bidireccional entre la diabetes mellitus y la enfermedad periodontal. Para ello se desarrolló una búsqueda sistematizada de la información en las bases de datos PubMed, ScienceDirect, Scoopus y EBSCO de los últimos tres años y se seleccionaron aquellos en idioma inglés que incluían las vías de asociación entre la diabetes mellitus y la enfermedad periodontal o viceversa de manera unidireccional o bidireccional. La diabetes mellitus corresponde a un desorden metabólico, el cual se caracteriza por una hiperglucemia producto del defecto en la producción o acción de la insulina, o ambas. En los últimos tiempos se ha hecho énfasis en la influencia que tiene la condición periodontal en el control glucémico de los pacientes diabéticos Esta revisión concluyó que existe una asociación bidireccional de la diabetes mellitus y la enfermedad periodontal, así como la existencia de limitaciones de los estudios para explicar esta relación en términos de causalidad.

ABSTRACT: Diabetes mellitus and periodontal disease are pathologies with a high prevalence in the population, and their frequency is increasing. Both present common mechanisms of progression and manifest themselves in terms of comorbidity. The aim of this review was to explain the mechanisms of two-way association between diabetes mellitus and periodontal disease. For this purpose, a systematic search of the information in PubMed databases wasdeveloped, ScienceDirect, Scoopus and EBSCO of the last three years and selected those in English that included the pathways of association between diabetes mellitus and periodontal disease or viceversa in a unidirectional or bidirectional manner. Diabetes mellitus corresponds to a metabolic disorder, which is characterized by a hyperglycemia product of the defect in the production or action of insulin, or both. In recent times, emphasis has been placed on the influence of the periodontal condition on the glycemic control of diabetic patients. This review concluded that there is a bidirectional association of diabetes mellitus and periodontal disease, as well as the existence of limitations of studies to explain this relationship in terms of causality.