Dental caries prevention in children and adolescents: a systematic quality assessment of clinical practice guidelines.

OBJECTIVES: To evaluate the quality of clinical practice guidelines (CPGs) for dental caries prevention in children and adolescents MATERIALS AND METHODS: We performed a systematic search of CPGs on caries preventive measures between 2005 and 2016. We searched MEDLINE, EMBASE, LILACS, TripDatabase, websites of CPG developers, compilers of CPGs, scientific societies and ministries of health. We included CPGs with recommendations on sealants, fluorides and oral hygiene. Three reviewers independently assessed the included CPGs using the AGREE II instrument. We calculated the standardised scores for the six domains and made a final recommendation about each CPG. Also, we calculated the overall agreement among calibrated reviewers with the intraclass correlation coefficient (ICC). RESULTS: Twenty-two CPGs published were selected from a total of 637 references. Thirteen were in English and nine in Spanish. The overall agreement between reviewers was very good (ICC = 0.90; 95%CI 0.89-0.92). The mean score for each domain was the following: Scope and purpose 89.6 ± 12%; Stakeholder involvement 55.0 ± 15.6%; Rigour of development 64.9 ± 21.2%; Clarity of presentation 84.8 ± 14.1%; Applicability 30.6 ± 31.5% and Editorial independence 59.3 ± 25.5%. Thirteen CPGs (59.1%) were assessed as "recommended", eight (36.4%) "recommended with modifications" and one (4.5%) "not recommended". CONCLUSIONS: The overall quality of CPGs in caries prevention was moderate. The domains with greater deficiencies were Applicability, Stakeholder involvement and Editorial independence. CLINICAL RELEVANCE: Clinicians should use the best available CPGs in dental caries prevention to provide optimal oral health care to patients.

Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial.

INTRODUCTION: Direct pulp capping treatment is intended to preserve pulp vitality, to avoid or retard root canal treatment, and, in cases with an open apex, to allow continued root development. Historically, calcium hydroxide (CH) was the gold standard material, but nowadays calcium silicate materials (CSMs) are displacing CH because of their high bioactivity, biocompatibility, sealing ability, and mechanical properties. However, more randomized clinical trials are needed to confirm the appropriateness of CSMs as replacement materials for CH in direct pulp capping procedures. METHODS: A randomized clinical trial was conducted that included 169 patients (mean age, 11.3 years) from the Maipo district (Chile). The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure, a candidate for a direct pulp capping procedure. The patients were randomly allocated to one of the experimental groups (CH, Biodentine, or mineral trioxide aggregate [MTA]). Clinical follow-up examinations were performed at 1 week, 3 months, 6 months, and 1 year. The Fisher exact test was performed. RESULTS: At the follow-up examination at 1 week, the patients showed 100% clinical success. At 3 months, there was 1 failure in the CH group. At 6 months, there were 4 new failures (1 in the CH group and 3 in the MTA group). At 1 year, there was another failure in the CH group. There were no statistically significant differences among the experimental groups. CONCLUSIONS: CSMs appear to be suitable materials to replace CH. Although no significant differences were found among the materials studied, Biodentine and MTA offered some advantages over CH.

Impact of Faculty Development Workshops in Student-Centered Teaching Methodologies on Faculty Members' Teaching and Their Students' Perceptions.

The aim of this study was to assess, after one year, the impact of faculty development in teaching and learning skills focused on a learner-centered approach on faculty members' perceptions of and approaches to teaching and on their students' learning experiences and approaches. Before training (2014), all 176 faculty members at a dental school in Chile were invited to complete the Approaches to Teaching Inventory (ATI) to assess their teaching approaches (student- vs. teacher-focused). In 2015, all 496 students were invited to complete the Study Process Questionnaire (R-SPQ-2F) to assess their learning approaches (deep or surface) and the Course Experience Questionnaire (CEQ) to measure their teaching quality perceptions. Subsequently, faculty development workshops on student-centered teaching methodologies were delivered, followed by peer observation. In March 2016, all 176 faculty members and 491 students were invited to complete a second ATI (faculty) and R-SPQ-2 and CEQ (students). Before (2014) and after (2016) the training, 114 (65%) and 116 (66%) faculty members completed the ATI, respectively, and 89 (49%) of the then-181 faculty members completed the perceptions of skills development questionnaire in September 2016. In 2015, 373 students (75%) completed the R-SPQ-2F and CEQ; 412 (83%) completed both questionnaires in 2016. In 2014, the faculty results showed that student-focused teaching was significantly higher in preclinical and clinical courses than in the basic sciences. In 2016, teacher-focused teaching fell significantly; basic science teaching improved the most. Students in both the 2015 and 2016 cohorts had lower mean scores for deep learning approaches from year 1 on, while they increased their scores for surface learning. The students' perceptions of faculty members' good teaching, appropriate assessment, clear goals, and e-learning improved significantly, but perception of appropriate workload did not. Teaching and learning skills development produced significant gains in student-centered teaching for these faculty members and in some students' perceptions of teaching quality. However, student workload needs to be considered to support deep learning.

[A retrospective study of 232 cases of lip cancer and pre cancer in Chilean patients. Clinical-histological correlation]. / Estudio retrospectivo de 232 casos de cáncer y precáncer de labio en pacientes chilenos. Correlación clínico-histológica.

BACKGROUND: The most common type of oral cancer is squamous cell carcinoma, which accounts for approximately 90% of all oral malignancies. Therefore the oral cancer problem primarily concerns the diagnosis, biology and management of squamous cell carcinoma (SCC). However, there are red and white lesions, that are considered premalignant, since they may unpredictably transform into cancer. According to WHO, leukoplakia, eritroplakia and actinic cheilitis are considered precancerous lesions which pathologically may correspond to intraepithelial dysplasia, hyperkeratosis, carcinoma in situ or SCC. AIM: To study the clinical and pathological features of lip cancer and premalignant lip lesions. PATIENTS AND METHODS: A retrospective analysis of 232 cases with lip lesions. The frequency, location, gender, age and pathological diagnosis of the lesions were recorded. RESULTS: One hundred fifty four lesions were observed in men and 78 in women, 92% of lesions were located in the lower lip. Seventy two of the 232 lesions were SCC and 72% of these carcinomas were well differentiated. The age of patients with cancer was higher than that of patients with precancerous lesions. CONCLUSIONS: The difference in age between patients with cancer and precancerous lesions, reinforces the existing knowledge that precancerous lesions may transform into cancer if they are not properly diagnosed and treated.