Directiva sanitaria para el manejo de la atención estomatológica a la persona con discapacidad / Health directive for the management of dental care for people with disabilities

La presente publicación describe los criterios técnicos de referencia y contrarreferencia para la atención integral oportuna y de calidad de las personas con discapacidad., así como las actividades y procedimientos del personal que brinda atención estomatológica para disminuir el riesgo de complicaciones y aparición de nuevos casos por enfermedades estomatológicas

Identification of a novel heterozygous PTH1R variant in a Chinese family with incomplete penetrance.

BACKGROUND: Mutations in PTH1R are associated with Jansen-type metaphyseal chondrodysplasia (JMC), Blomstrand osteochondrodysplasia (BOCD), Eiken syndrome, enchondroma, and primary failure of tooth eruption (PFE). Inheritance of the PTH1R gene can be either autosomal dominant or autosomal recessive, indicating the complexity of the gene. Our objective was to identify the phenotypic differences in members of a family with a novel PTH1R mutation. METHODS: The proband was a 13-year, 6-month-old girl presenting with short stature, abnormal tooth eruption, skeletal dysplasia, and midface hypoplasia. The brother and father of the proband presented with short stature and abnormal tooth eruption. High-throughput sequencing was performed on the proband, and the variant was confirmed in the proband and other family members by Sanger sequencing. Amino acid sequence alignment was performed using ClustalX software. Three-dimensional structures were analyzed and displayed using the I-TASSER website and PyMOL software. RESULTS: High-throughput genome sequencing and Sanger sequencing validation showed that the proband, her father, and her brother all carried the PTH1R (NM_000316) c.1393G>A (p.E465K) mutation. The c.1393G>A (p.E465K) mutation was novel, as it has not been reported in the literature database. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the p.E465K variant was considered to have uncertain significance. Biological information analysis demonstrated that this identified variant was highly conserved and highly likely pathogenic. CONCLUSIONS: We identified a novel heterozygous mutation in the PTH1R gene leading to clinical manifestations with incomplete penetrance that expands the spectrum of known PTH1R mutations.

Fluoride varnishes supplemented with nano-sized sodium trimetaphosphate reduce enamel erosive wear in vitro.

OBJECTIVE: To evaluate the effect of fluoride (F) varnishes with sodium trimetaphosphate (TMP) on erosive tooth wear (ETW) in vitro. METHODS: Enamel blocks (n = 100) were divided into 5 experimental groups (n = 20/group): Placebo (Pla - without F/TMP); 5 % NaF (NaF); 5 % NaF + 5 % micrometric TMP (NaF+5 %MICRO); 5 % NaF + 2.5 % nano-sized TMP (NaF+2.5 %NANO), and 5 % NaF + 5 % nano-sized TMP (NaF+5 %NANO). Blocks received a single varnish application (6 h contact), and were submitted to 4 daily erosive challenges (ERO, 0.05 M citric acid, pH 3.2, 90 s, under agitation), for 5 days. After ERO, half of the blocks (n = 10/group) were subjected to brushing abrasion (ERO+ABR). Profilometry, surface hardness (SH), and cross-sectional hardness (ΔKHN) were determined. The data were submitted to 2-way ANOVA and Fisher's LSD test (p < 0.05). RESULTS: Enamel wear was significantly lower for ERO compared with ERO+ABR for all varnishes tested (p < 0.001), following the pattern NaF+5 %NANO < NaF+5 %MICRO < NaF < NaF+2.5 %NANO < Pla (both for ERO and ERO+ABR). The highest SH loss was observed for Pla and the lowest for NaF (ERO) and NaF+2.5 %NANO (ERO+ABR), without significant differences among NaF+2.5 %NANO, NaF, and NaF+5 %MICRO. The highest ΔKHN values were observed for NaF+5 %MICRO and NaF+5 %NANO at 5-30 µm, with less marked differences among the groups at 30-70 µm (ERO and ERO+ABR). CONCLUSIONS: The addition of TMP to F varnishes significantly improves protection against ETW in vitro. The use of 5 % nano-sized TMP further enhances such effects. CLINICAL SIGNIFICANCE: F varnishes containing TMP can reduce enamel loss caused by ERO or ERO+ABR.

The Impact of Prenatal Vitamin D on Enamel Defects and Tooth Erosion: A Systematic Review.

Prenatal Vitamin D has been suggested to be critical for dental health in children, affecting outcomes including the prevalence of enamel defects and tooth erosion. This systematic review aimed to evaluate the potential impact of prenatal Vitamin D levels on these dental health outcomes. A total of seven studies, involving 6978 participants, were included after a comprehensive search of PubMed, Web of Science, and Scopus from 2013 to June 2023. The average age of mothers varied across studies, with Vitamin D levels or supplementation practices displaying significant variation among the study populations. The age of children at examination ranged from 3.6 to 6.6 years. The analysis demonstrated a diverse association between Vitamin D levels and dental outcomes, with enamel defects reported in 21.1% to 64% of the children and opacities ranging from 36% to 79.5% across studies. Maternal Vitamin D insufficiency was identified as a significant risk factor for enamel defects in one study (OR: 3.55), whereas high prenatal Vitamin D levels indicated a protective effect against Hypomineralized Second Primary Molars (OR: 0.84) and Molar Incisor Hypomineralization (OR: 0.95) in another. Conversely, low Vitamin D levels increased the risk of enamel hypoplasia (OR: 1.29) and dental decay. The maternal and child demographics varied greatly across the studies, and the assessment and prevalence of Vitamin D deficiency or insufficiency were heterogenous. This review illuminates the potential influence of prenatal Vitamin D on dental health in children, underscoring the importance of adequate Vitamin D levels during pregnancy. However, more robust research is required to establish the optimal Vitamin D intake during pregnancy to ensure healthy dental outcomes in children.

Acquired pellicle engineering with the association of cystatin and vitamin E against enamel erosion.

OBJECTIVE: Evaluate CaneCPI-5 associated with Vitamin E in acquired enamel pellicle (AEP) engineering to prevent dental erosion. METHODS: 180 human enamel specimens were divided into 12 groups and treated with the following solutions: Cane+VitT and Cane+VitS- CaneCPI-5 + Vit E; Vit+CaneT and Vit+CaneS- Vit E + CaneCPI-5; VitT and VitS- Vit E; CaneT and CaneS- CaneCPI-5; ControlT and ControlS - AmF/NaF/SnCl2; WaterT and WaterS- Deionized water. Groups' name followed by "T" were first treated (200 µl; 2 min) and then incubated in human saliva (200 µl; 1 h) to form the AEP. For groups followed by "S", the AEP was formed and then treatment was applied. The erosive challenge consisted of immersion in 1% citric acid (1 min, 1x/day, for 3 days). The percentage of superficial hardness loss (%SHL) and the relative surface reflection intensity (%SRI) were subjected to normality and homogeneity tests, Shapiro-Wilk and Levene tests, respectively. Subsequently, the data were analyzed using two-way ANOVA, Tukey's test and Pearson's correlation (p < 0.005). RESULTS: For%SHL and%SRI, water controls showed significantly lower protective capacity. Cane+VitT, Cane+VitS, and Vit+CaneS presented the lowest%SHL, and VitT and VitS did not differ from Vit+CaneT, but they were different from the other groups (p = 0.002). The greatest%SRI was found for the Cane+VitT, Vit+CaneT, VitT, Cane+VitS, Vit+CaneS, and VitS groups, which did not significantly differ. CaneT and ControlT, showed similar reflections compared to CaneS and ControlS. CONCLUSION: CaneCPI-5 and Vitamin E demonstrated a synergistic protective effect against initial erosion. CLINICAL SIGNIFICANCE: The results open up new possibilities for preventive approaches against erosion through the acquired pellicle engineering, with the combination of CaneCPI-5 and Vitamin E, which demonstrated to be more effective than commercial stannous mouthwash. Further research is warranted to explore the potential of this combination in diverse clinical settings.

NEFL-Related Charcot-Marie Tooth Disease due to P440L Mutation in Two Italian Families: Expanding the Phenotype and Defining Modulating Factors.

INTRODUCTION: Mutations in the neurofilament polypeptide light chain (NEFL) gene account for <1% of all forms of Charcot-Marie-Tooth (CMT) diseases and present with different phenotypes, including demyelinating, axonal and intermediate neuropathies, and with diverse pattern of transmission, with dominant and recessive inheritance being described. METHODS: Here, we present clinical and molecular data in two new unrelated Italian families, affected with CMT. RESULTS: We studied fifteen subjects (11 women, 4 men), age range 23-62 year. Onset of symptoms was mainly in childhood, with running/walking difficulties; some patients were pauci-asymptomatic; almost all shared variably distributed features of absent/reduced deep tendon reflexes, impaired gait, reduced sensation, and distal weakness in the legs. Skeletal deformities were seldom documented and were of mild degree. Additional features included sensorineural hearing loss in 3 patients, underactive bladder in 2 patients, and cardiac conduction abnormalities, requiring pacemaker implantation, in one child. Central nervous system (CNS) impairment was not documented in any subject. Neurophysiological investigation disclosed feature suggestive of demyelinating sensory-motor polyneuropathy in one family and resembling an intermediate form in the other. Multigene panel analysis of all known CMT genes revealed two heterozygous variants in NEFL: p.E488K and p.P440L. While the latter change segregated with the phenotype, the p.E488K variant appeared to act as a modifier factor being associated with axonal nerve damage. CONCLUSIONS: CMT related to P440L mutation in NEFL is associated with a mild, childhood-onset phenotype, showing prevalently sensory distal limbs involving and with motor impairment predominantly involving anterolateral leg muscles, in the absence of CNS involvement. Additional findings, never reported so far in patients with NEFL mutation, are cardiological and urinary dysfunctions. Our study expands the array of clinical features associated with NEFL-related CMT.

A novel mutation in the collagen domain of EDA results in hypohidrotic ectodermal dysplasia by impacting the receptor-binding capability.

BACKGROUND: Hypohidrotic ectodermal dysplasia (HED) mainly results from gene mutations in the EDA/EDAR/NF-κB pathway. Function analysis of the mutations in the collagen domain of ectodysplasin A (EDA)result in HED has been rarely studied. This study aimed at determining the mechanism by which the novel collagen domain mutation of EDA results in HED. METHODS: We analyzed the DNAs from a Chinese family with HED and performed bioinformatics analysis. A new three-dimensional structure model of the EDA trimer was built and used to predict the effect of the mutations on EDA. We performed a western blot to detect EDA1 proteins in cell lysates and supernatants. We then performed coimmunoprecipitation to determine whether the mutation would affect the interaction of EDA1 with the EDA receptor (EDAR). Dual luciferase reporter assay and immunofluorescence were performed to detect the effect of the mutant EDA1 protein on nuclear factor kappa B (NF-κB) activation. RESULTS: A novel missense mutation (c.593G > A, p. Gly198Glu) in the collagen domain of EDA was detected. The mutation was predicted to be disease-causing. A three-dimensional structure model of the EDA trimer was first built in this study, in which the mutation site is located around the receptor binding domain. Functional studies showed that there was no difference in the secretion activity between the mutant EDA1 and the wild-type EDA1. However, the receptor-binding activity and the transcription activation of NF-κB were impaired by the mutation. CONCLUSION: We identified a novel mutation (c.593G > A, p. Gly198Glu) in the collagen domain of EDA. Bioinformatics analysis and functional studies showed this mutation was damaging, indicating that mutations in the collagen domain of EDA could result in HED by affecting the receptor-binding activity of EDA and the transcriptional activity of NF-κB.

Dental developmental complications in pediatric hematopoietic stem cell transplantation patients: A study using CMC clinical data warehouse.

OBJECTIVE: This study aimed to investigate the prevalence and extent of dental developmental complications in patients who have undergone pediatric hematopoietic stem cell transplantation (SCT) and identify the risk factors. MATERIALS AND METHODS: We retrospectively investigated the clinical data warehouse of the Catholic Medical Center information system for identifying patients who: 1) visited the Department of Pediatrics between 2009 and 2019, 2) underwent SCT under the age of 10, and 3) had panoramic radiographs. Thus 153 patients were included in this study. The prevalence and extent of tooth agenesis, microdontia, and root malformation were assessed using panoramic radiographs obtained after SCT, and the risk factors were analyzed using regression analysis. RESULTS: All 153 patients had at least one dental anomaly. When grouped according to the age at initial chemotherapy (≤ 2.5; 2.6-5.0; 5.1-7.5; > 7.5 years), the prevalence of agenesis showed statistically significant differences among the different age groups (P < 0.001). The prevalence of agenesis was highest in the youngest age group. As the initial age at chemotherapy increased, the number of affected teeth per patient decreased for all three anomalies. The location of the affected tooth was also influenced by the age at initial chemotherapy. Regression analysis demonstrated that young age at initial chemotherapy was a risk-increasing factor for tooth agenesis and microdontia. CONCLUSIONS: The age at initial chemotherapy may be a critical factor in determining the type, extent, and location of dental complications after SCT. These results suggest that careful dental follow-up and timely treatment are recommended for pediatric patients undergoing SCT.

Barotrauma y barodontalgia en la aviación / Barotrauma and barodontalgia in Aviation / Barotrauma e barodontalgia na aviação

Introducción: se ha estudiado ampliamente la importancia de los cambios de presión y sus consecuencias en el cuerpo humano. De esto se desprenden dos conceptos importantes: el barotrauma que se define como el daño producido por cambios en la presión atmosférica; y la barodontalgia que se define como el dolor dentario producido por variaciones de presión barométrica, por ejemplo cuando existen gases atrapados en restauraciones o en la cámara pulpar y/o conducto radicular. Estos conceptos se fundamentan en las leyes de los gases: la Ley de Difusión Gaseosa, la Ley de Dalton, la Ley de Boyle, la Ley de Charles y la Ley de Henry. Discusión: el estudio y prevención de la barodontalgia es de suma importancia, ya que aunque no tiene alta prevalencia entre los aviadores, su aparición es súbita y de alta intensidad, lo que puede provocar en el piloto una incapacidad física y mental, que aumenta el riesgo de accidentes. Conclusiones: en esta revisión, se reúnen las estrategias recomendadas para prevenir su aparición.

Introduction: the importance of pressure changes and their consequences on the human body has been widely studied. Two important concepts arise from this: barotrauma, which is defined as the damage produced by changes in atmospheric pressure; and barodontalgia, which is defined as dental pain produced by variations in barometric pressure, for example when gases are trapped in restorations or in the pulp chamber and/or root canal. These concepts are based on the gas laws: the Law of Gaseous Diffusion, Dalton's Law, Boyle's Law, Charles' Law and Henry's Law. Discusion: the study and prevention of barodontalgia is of utmost importance, since although it is not highly prevalent among aviators, its onset is sudden and of high intensity, which can cause physical and mental incapacity in the pilot, increasing the risk of accidents. Conclusions: this review brings together the recommended strategies to prevent its occurrence.

Introducão: a importância das mudanças de pressão e suas conseqüências sobre o corpo humano têm sido amplamente estudadas. Dois conceitos importantes podem ser derivados disto: barotrauma, que é definido como o dano produzido por mudanças na pressão atmosférica; e barodontalgia, que é definida como a dor dental produzida por variações na pressão barométrica, por exemplo, quando os gases estão presos em restaurações ou na câmara de polpa e/ou canal radicular. Estes conceitos são baseados nas leis do gás: a Lei de Difusão Gasosa, a Lei de Dalton, a Lei de Boyle, a Lei de Charles e a Lei de Henry. Discusion: o estudo e prevenção da barodontia é de suma importância, pois embora não seja muito prevalente entre os aviadores, seu início é repentino e de alta intensidade, o que pode causar incapacidade física e mental no piloto, aumentando o risco de acidentes. Conclusões: esta revisão reúne as estratégias recomendadas para evitar sua ocorrência.

Developmental Abnormalities of Teeth in Children With Nephrotic Syndrome.

INTRODUCTION: Treatment with glucocorticoids in children with nephrotic syndrome can be the cause of developmental disorders of the masticatory organ and bone or teeth abnormalities. The aim was to assess the frequency and type of dental abnormalities and the correlation of their occurrence with a dosage of glucocorticoids and treatment time in children with idiopathic nephrotic syndrome. METHODS: The study group consisted of 31 patients aged 5 to 17 diagnosed with idiopathic steroid-sensitive nephrotic syndrome and 33 overall healthy children. The studies included clinical evaluation of dentition, radiologic diagnostics, and statistical analysis. RESULTS: In the study group, 77.4% of patients were diagnosed with abnormalities in dental development. Tooth number disorders, presence of persistent deciduous teeth and impacted teeth, abnormal crown or root shape, developmental defects of enamel, pulp stones, and bone structure disorders were identified. Statistical analysis showed significant differences in the average treatment time of glucocorticoids in patients without and with tooth developmental abnormalities. CONCLUSIONS: Long-term use of glucocorticoids in children with nephrotic syndrome promotes the occurrence of developmental abnormalities of the teeth, calcification of the pulp, and disorders of bone tissue metabolism. For this reason, patients with steroid-sensitive nephrotic syndrome should be under the constant care of a dentist.

Medical Conditions, Oral Health Practices, and Barriers to Treatment among Patients Visiting a Teaching Dental Hospital in Eastern Saudi Arabia.

OBJECTIVE: To assess the prevalence of medical conditions, oral hygiene practices, and dental visits among patients who attended a teaching dental hospital in Dammam, Saudi Arabia. Materials & Methods. This retrospective cross-sectional study used patient records from 2009 to 2015 from the dental hospital of the College of Dentistry Imam Abdulrahman Bin Faisal University, Dammam. Patients' demographics, medical history, oral hygiene practices, reasons for attending the facility, attendance patterns, and smoking habits were studied. RESULTS: The study included 1502 records of patients with 65.1% of males and 34.9% of females. The prevalence of medical conditions was 25.7% in the study. The most common medical conditions included diabetes mellitus (7.2%), hypertension (6.5%), and anemia (4.7%). Only 21.8% reported visiting the dental hospital in the past one year. The prevalence of smoking was 16.7%, and this did not differ significantly between healthy and medically compromised patients (P=0.165). Fillings were the most common (21.6%) reason for visiting a dental hospital, followed by treatment for periodontal problems (12.9%) and oral lesions (12.6%), whereas treatment for braces (orthodontics) was the least common (5%) reason for visiting the hospital. The reasons for visiting the hospital did not differ significantly between healthy and medically compromised patients (P > 0.05). The three most common barriers to dental visits included long waiting time (18.1%), fear of dental treatment (14.4%), and difficulty in getting an appointment (11.3%). CONCLUSION: The study showed that dental patients had a high prevalence of medical conditions. Diabetes mellitus was the most prevalent problem. Most patients visited the dental hospital to receive restorative treatment, and a long waiting time was the most common barrier to dental visits. Public health measures should be taken to improve the general health and oral care of patients.

Odontogenic sinusitis - case series and review of literature.

BACKGROUND: Odontogenic sinusitis is a common cause of rhinosinusitis that is often undiagnosed and overlooked. No single sign or symptom is specific for odontogenic sinusitis, and failure to focus on the specific radiological features can delay diagnosis. OBJECTIVE: This paper presents four cases of chronic sinusitis that had an odontogenic origin. Each case was referred for a second opinion. Three patients had previously undergone unsuccessful surgical management. METHODS: The literature, and the associated contributory clinical, radiological and microbiological features required for correct diagnosis and management, are reviewed. RESULTS: Each case resulted in a positive patient outcome following the involvement of both otolaryngology and maxillofacial surgery departments. CONCLUSION: A high index of suspicion is advocated for odontogenic sinusitis in cases not responding to standard management plans. Collaboration with a maxillofacial specialist is important for diagnosis and management. This should be considered where standard management fails, or clinical features and radiological signs of odontogenic sinusitis are present. This paper also highlights the need for otolaryngologists to incorporate, at the very least, a basic dental history and examination as part of their assessment in recalcitrant cases.

La concentración de fluoruro en agua potable y la fluorosis dental en niños / Fluoride concentration in drinking water in relation to dental fluorosis in children

Dental treatment is a highly sought-after but costly procedure in the world, so it is important to consider measures to prevent dental disease. Among the ways of prevention, drinking water fluoridation, which involves adding relevant amounts of fluoride to the water supply reaching communities, stands out. However, it is not clear whether there are enough researchers who have addressed the issue, or that their methodology has been adequate to provide alternatives to solve some conditions, such as dental fluorosis, which, in contrast, is manifested by excessive fluoride intake. The main objective was to explore and analyse the academic production on the concentration of fluoride present in drinking water in order to find a relationship with dental fluorosis in children. To this end, the PRISMA model was used as a starting point in order to carry out a systematic review of academic articles chosen according to selection criteria. These will be extracted from five databases, using a documentary-type methodology, whose data collection will be carried out in virtual environments. From this, it was concluded that the academic production includes the concentration of fluoride in drinking water as a means of prevention for dental pathologies; however, the levels of fluoride allowed in children should be known, as the excess of fluoride in the teeth causes dental fluorosis, which turns out to be the cause of psychological complexes in children due to an aesthetic issue.

El tratamiento dental es un procedimiento muy solicitado en el mundo, pero costoso de realizar; por lo que, es importante considerar medidas para prevenir enfermedades dentarias. Entre las formas de prevención, destaca la fluoración del agua potable, que implica añadir cantidades pertinentes de flúor al suministro de agua que llega a las comunidades. Sin embargo, no se precisa si existen suficientes investigadores que hayan abordado el tema, o que su metodología empleada haya sido la adecuada como para brindar alternativas para solucionar algunas afecciones, tales como la fluorosis dental que; en contraste, se manifiesta por la excesiva ingesta de flúor. El objetivo principal, realizar una exploración y análisis de la producción académica sobre la concentración de flúor presente en el agua potable con el fin de encontrar una relación con la fluorosis dental en niños. Para ello, se partió del modelo PRISMA con el fin de proceder una revisión sistemática de artículos académicos escogidos mediante criterios de selección. Estos serán extraídos de cinco bases de datos, valiéndose entonces, de una metodología de tipo documental, cuya recolección de datos se efectuará en entornos virtuales. A partir de ello, se concluyó que la producción académica incluye a la concentración del flúor en agua potable como un modo de prevención para patologías dentales; no obstante, se debe conocer los niveles de flúor permitido en los niños, pues el exceso de flúor en los dientes origina fluorosis dental, la cual resulta ser causante de complejos psicológicos en los niños debido a un tema estético.

Avaliação clínica de restaurações Classe V em cavidades tratadas com o laser de Er: YAG associado ao uso de sistemas adesivos autocondicionantes / Clinical evaluation of Class V restorations in cavities treated with Er: YAG laser associated with the use of self-etching adhesive systems

O objetivo deste estudo clínico, controlado, randomizado, cego e prospectivo foi de avaliar a efetividade clínica de restaurações em lesões não cariosas (cavidades Classe V) realizadas em superfícies dentais pré-tratadas ou não com laser de Er:YAG e utilizando dois sistemas adesivos autocondicionantes. Este estudo foi realizado com um total de 91 lesões e divididas em 4 grupos (n = 23) :G1(FL): Sem pré-tratamento e utilizando o adesiso FL-Bond II/Shofu; G2 (CF): sem pré-tratamento e utilizando o adesivo Clearfil SE Bond 2/Kuraray Noritake; G3 (Laser + FL): pré-tratamento associado ao uso do FL-Bond II/Shofu e G4 (Laser + CF): pré-tratamento associado ao uso do Clearfil SE Bond 2/Kuraray Noritake Os dentes avaliados foram os pré-molares de ambas as arcadas. A avaliação foi feita imediatamente após o tratamento e ao longo do tempo, em 3, 6 e 12 meses após a finalização da restauração. Para a avaliação da sensibilidade foi considerado a EVA (Escala Visual Analógica) e para a qualidade da restauração o método do USPHS modificado, considerando a avaliação de perda de retenção, integridade marginal, pigmentação marginal, presença de lesão de cárie em margem de restauração, vitalidade pulpar e sensibilidade pós-operatória. Os dados foram registrados em tabelas de frequência, e os escores transformados em postos para a aplicação do teste ANOVA. A significância estatística foi considerada para valores de p<0,05. Para os resultados da avaliação de sensibilidade houve uma diferença estatística significante da sensibilidade ao longo do tempo (p<0,001), sendo que essa diferença se deu a partir da avaliação T1 (48 horas) em todos os grupos. Em relação aos critérios avaliados no USPHS, foram encontrados variações estatísticas em alguns tópicos: Pigmentação marginal - G1 (FL) (p=0,041) e G2 ( Laser + FL) (p=0,009) e Integridade marginal G1(FL)( p=0,036). Os demais grupos e critérios não apresentaram variações estatísticas significantes.Pré-tratamentos com laser Er:YAG podem ser uma alternativa viável em restaurações adesivas do tipo classe V; no entanto, nenhum efeito sinérgico de ambos os tratamentos combinados foi observado.

The objective of this clinical, controlled, randomized, blinded and prospective study was to evaluate the clinical effectiveness of restorations in non-carious lesions (Class V cavities) performed on dental surfaces pre-treated or not with Er:YAG laser and using two adhesive systems self-conditioning. This study was carried out with a total of 91 lesions and divided into 4 groups (n = 23) :G1(FL): No pre-treatment and using the FL-Bond II/Shofu adhesive; G2 (CF): without pre-treatment and using Clearfil SE Bond 2/Kuraray Noritake adhesive; G3 (Laser + FL): pre-treatment associated with the use of FL-Bond II/Shofu and G4 (Laser + CF): pre-treatment associated with the use of Clearfil SE Bond 2/Kuraray Noritake The teeth evaluated were the premolars of both arcades. Assessment was performed immediately after treatment and over time, at 3, 6, and 12 months after completion of the restoration. The VAS (Visual Analogue Scale) was used for the sensitivity assessment and the modified USPHS method for the quality of the restoration, considering the assessment of loss of retention, marginal integrity, marginal pigmentation, presence of caries in the restoration margin. , pulp vitality and postoperative sensitivity. Data were recorded in frequency tables, and the scores were transformed into ranks for the application of the ANOVA test. Statistical significance was considered for values of p<0.05. For the results of the sensitivity evaluation, there was a statistically significant difference in sensitivity over time (p<0.001), and this difference occurred from the T1 evaluation (48 hours) in all groups. Regarding the criteria evaluated at the USPHS, statistical variations were found in some topics: Marginal pigmentation - G1 (FL) (p=0.041) and G2 (Laser + FL) (p=0.009) and Marginal integrity - G1(FL)( p =0.036). The other groups and criteria did not present significant statistical variations. Pretreatments with Er:YAG laser can be a viable alternative in class V adhesive restorations; however, no synergistic effect of both treatments combined was observed.

Valoración del grado de pigmentación en dientes acrílicos sometidos a humo del cigarrillo / Assessment of the degree of pigmentation in acrylic teeth subjected to cigarette smoke

INTRODUCCIÓN. Los cambios de color en los dientes acrílicos dependen de varios factores, con el humo de cigarrillo como uno de los principales agentes de igmentación de las prótesis. OBJETIVO. Valorar el grado de pigmentación en dientes acrílicos sometidos al humo del cigarrillo, mediante espectrofotometría digital. MATERIALES Y MÉTODOS. Estudio observacional, analítico, de caso y control. Muestra de 60 dientes acrílicos divididos en dos grupos: A (resina acrílica de 3 capas) y B (resina acrílica de 4 capas). Se subdividió en: grupo 1: dientes sometidos a humo de cigarrillo estándar con filtro de carbón; grupo 2: dientes sometidos a humo de cigarrillo estándar sin filtro; y, grupo 3: grupo control. Cada uno de éstos se expuso a 150 cigarrillos, 5 diarios durante 30 días y el grupo control fue mantenido a 37ºC en saliva artificial durante 30 días sin aplicación de humo de cigarrillo. Para la toma de color se empleó espectrofotómetro Vita Easyshade®. Los análisis se realizaron en el programa estadístico International Business Machines Statistical Package for the Social Sciences mediante la prueba de Kruskal-Wallis y comparaciones de Dunn. RESULTADOS. Se determinó que la pigmentación del grupo B fue mayor a la del grupo A, con una diferencia significativa entre ellos (p< 0,05). No se encontró datos estadísticamente significativos entre cigarrillos (con filtro - sin filtro). CONCLUSIÓN. La exposición al humo de cigarrillo pigmentó los dientes acrílicos de ambas propiedades siendo mayor en los dientes de resina acrílica de 4 capas.

INTRODUCTION. Color changes in acrylic teeth depend on several factors, with cigarette smoke as one of the main agents of denture pigmentation. OBJECTIVE. To assess the degree of pigmentation in acrylic teeth subjected to cigarette smoke, using digital spectrophotometry. MATERIALS AND METHODS. Observational, analytical, case-control study. Sample of 60 acrylic teeth divided into two groups: A (3-layer acrylic resin) and B (4-layer acrylic resin). It was subdivided into: group 1: teeth subjected to standard cigarette smoke with charcoal filter; group 2: teeth subjected to standard cigarette smoke without filter; and, group 3: control group. Each of these was exposed to 150 cigarettes, 5 daily for 30 days and the control group was maintained at 37ºC in artificial saliva for 30 days without application of cigarette smoke. Vita Easyshade® spectrophotometer was used for color determination. The analyses were performed in the statistical program International Business Machines Statistical Package for the Social Sciences using the Kruskal-Wallis test and Dunn's comparisons. RESULTS. It was determined that the pigmentation of group B was greater than that of group A, with a significant difference between them (p< 0,05). No statistically significant data was found between cigarettes (filtered - unfiltered). CONCLUSION. Cigarette smoke exposure pigmented acrylic teeth of both properties being higher in 4-layer acrylic resin teeth.

Morphological evaluation of dental diseases in Parion chamber tomb (OM 5) Roman people / Evaluación morfológica de enfermedades dentales en la tumba de la cámara de Parion (OM 5) del pueblo romano

SUMMARY: Most of the dental diseases occur due to tooth or jaw morphology or nutritional habits. Anatomical differences in the teeth and jaws of men and women can cause different dental diseases between the sexes. In this study, 33 skeletons obtained from the excavation of the ancient city of Parion, which are dated to the late Roman period, were examined. Dental diseases and possible causes were investigated on a total of 33 skeletons. In the evaluations, it was evaluated that some diseases were caused by the difference between the sexes, while some were classified as nutritional diseases. The rates of tooth decay are different between men and women with Parion. It has been determined that the most important reason for this is the different morphological structure of the jaws and teeth, but the nutritional differences also cause this. Other dental and jaw diseases were also evaluated in the Parion population.

RESUMEN: La mayoría de las enfermedades dentales se deben a la morfología de los dientes o la mandíbula o a los hábitos nutricionales. Las diferencias anatómicas en los dientes y las mandíbulas de hombres y mujeres pueden causar diferentes enfermedades dentales entre los sexos. En este estudio, se examinaron 33 esqueletos obtenidos de la excavación de la antigua ciudad de Parion, que datan del período romano tardío. Se investigaron las enfermedades dentales y las posibles causas en un total de 33 esqueletos. En las evaluaciones, se determinó que algunas enfermedades fueron causadas por la diferencia entre los sexos, mientras que otras fueron clasificadas como enfermedades nutricionales. Además se encontraron diferentes estimaciones de caries entre hombres y mujeres. Se analizó que la razón más importante de esto es la diferencia de la estructura morfológica de los maxilares y los dientes, sin embargo las diferencias nutricionales también es un factor que se debe considerar. Se evaluaron además, otras enfermedades dentales y de la mandíbula en la población de Parion.

Evaluación de lesiones orales en pacientes intubados y su asociación con el motivo de hospitalización / Evaluation of oral lesions in intubated patients and its association with the reason of hospitalization

asistencia ventilatoria cuando la vía aérea y la consciencia están comprometidas. Los elementos utilizados en este procedimiento se encuentran en contacto directo con estructuras dentofaciales, causando diversos tipos de lesiones, principalmente bucales. Aunque existen cuidados clínicos durante procesos de intubación, hay poca información, particularmente de la zona norte del país donde se hayan evaluado las posibles asociaciones entre los motivos de consulta más frecuentes y las diversas características, tanto clínicas como no clínicas de pacientes que han sido intubados. Objetivo: Identificar las alteraciones bucodentales más frecuentes en pacientes intubados, así como explorar las posibles asociaciones de acuerdo con los motivos de intubación más frecuentes. Material y métodos: Se realizó un estudio observacional, transversal y comparativo en el cual se evaluaron alteraciones bucodentales y sistémicas de pacientes intubados. Los grupos de estudio se desarrollaron de acuerdo con el motivo de intubación y la determinación de las asociaciones fue con cada una de las alteraciones bucodentales y sistémicas. Resultados: El motivo de intubación más frecuente fue el evento cerebral vascular (EVC) y las alteraciones dentofaciales más prevalentes fueron caries, lengua saburral y cálculo dental, entre otras. Además, se encontraron diferencias significativas entre pacientes con EVC, mostrando una mayor frecuencia en tabaquismo, hipertensión arterial y diabetes mellitus, así como en la presencia de gingivitis y úlceras. Pacientes con traumatismo craneoencefálico (TCE) tuvieron mayor frecuencia en la presencia de periodontitis. Conclusión: El motivo de hospitalización y las condiciones sistémicas preexistentes pueden ser un factor de riesgo para desarrollar lesiones bucales específicas antes y durante el periodo de intubación (AU)

Introduction: Intubation is a procedure that allows ventilatory assistance when the airway and consciousness are compromised. The elements used in this procedure are in direct contact with dentofacial structures causing various types of injuries, mainly oral. Although there is clinical care during intubation processes, there is little information, particularly from the northern part of the country where the possible associations between the most frequent reasons for consultation and the various clinical and non-clinical characteristics of patients who have been intubated have been evaluated. Objective: The objectives of the present study were to identify the most frequent oral alterations in intubated patients, as well as to explore possible associations according to the most frequent reasons for intubation. Material and methods: An observational, cross-sectional and comparative study was carried out in which oral and systemic alterations of intubated patients were evaluated. The study groups were formed according to the reason for intubation and the association was determined with each of the oral and systemic disorders. Results: The most frequent reason for intubation was the vascular cerebral event (CVA) and the most prevalent dentofacial alterations were caries, coated tongue, and dental calculus, among others. In addition, significant differences were found between patients with CVA, showing a higher frequency in smoking, hypertension, and diabetes mellitus, as well as in the presence of gingivitis and ulcers. Patients with traumatic brain injury (TBI) had a higher frequency in the presence of periodontitis. Conclusion: The reason for hospitalization and pre-existing systemic conditions can be a risk factor for developing specific oral lesions before and during the intubation period (AU)

Associação entre idade na primeira consulta odontológica e tipo de tratamento dentário realizado em pacientes infantis: estudo transversal / Association between age of the first dental visit and type of dental treatment performed in infant patients: a cross-sectional study

Objetivo: Avaliar a associação entre idade na primeira consulta odontológica e o tipo de tratamento dentário realizado em pacientes infantis por meio de um estudo transversal que avaliou registros em prontuários odontológicos. Métodos: A coleta de dados foi realizada por meio de prontuários de pacientes de 0-5 anos atendidos em uma Clínica Escola de Odontologia, de março de 2014 a julho de 2018, com registro de informações referentes às características dos participantes e procedimentos odontológicos realizados. Para a análise dos dados, foram calculadas medidas descritivas e posteriormente os dados foram ajustados em um modelo de regressão logística; o desfecho foi o tipo de procedimento realizado, dicotomizado em tratamentos não-invasivos (fluorterapia e/ou restauração) e invasivos (endodontia e/ou exodontia). Resultados: Foram avaliados prontuários de 210 crianças, com média de idade na primeira consulta de 38 meses (DP=14,5). Fluorterpia e/ou restauração foram realizados em 74,8% das crianças, enquanto tratamentos invasivos foram realizados em 25,2% da amostra. A análise ajustada indicou um incremento (OR = 1,03, p = 0,027) na chance de realização de tratamentos invasivos com o aumento da idade das crianças na primeira consulta odontológica. Conclusão: Quanto maior a idade das crianças na primeira consulta, maior a chance de terem recebido um tratamento invasivo. Ressalta-se a importância da consulta odontológica nos primeiros meses de vida, com a finalidade de prevenção e manutenção da saúde bucal.(AU)

Objective: To evaluate the association between the age of the first dental visit and the type of dental treatment performed in infant patients through a cross-sectional study that examined dental records from the years 2014 to 2018. Methods: Data collection was conducted using medical records of patients aged 0 to 5 years treated at a Dental School Clinic, including information about participants' characteristics and the types of dental procedures performed. For data analysis, descriptive measures were calculated, and the data were subsequently fitted into a logistic regression model. The outcome was categorized into non-invasive treatments (fluoridation therapy and/or restoration) and invasive treatments (endodontics and/or extraction). Results: Medical records of 210 children were evaluated, with a mean age of the first dental visit being 38 months (SD = 14.5). Non-invasive treatments, including fluoride therapy and/or dental restoration, were performed in 74.8% of children, while invasive treatments were performed in 25.2% of the sample. Adjusted analysis indicated an increase (OR = 1.03, p = 0.027) in the odds of undergoing invasive treatments as the children's age at the first dental visit increased. Conclusion: Older age at the first appointment was associated with increased odds of receiving invasive treatment. The significance of early dental consultations within the first months of life is underscored, aiming to prevent and maintain oral health.(AU)

Dental enamel defects and oral cavity manifestations in Asian patients with celiac disease.

BACKGROUND: While the small intestine is the main site of disease, many other organs are affected by celiac disease (CeD). Dental enamel defects (DED) are common in patients with CeD, and these are one of the indicators of CeD, even when no other symptom of CeD is present. Data on dental and oral cavity manifestations in Asian patients with CeD are scanty. The purpose of the current study was to evaluate dental and oral manifestations in Asian patients with CeD. METHODS: We recruited 118 patients with biopsy-confirmed CeD (36 treatment naïve and 82 on follow-up for at least 1 year on gluten-free diet [GFD]) and 40 controls. Diagnosis was made as per the standard criteria. Oral and dental manifestations were evaluated by a dental surgeon. The DED were evaluated according to Aine's criteria. RESULTS: Overall higher number of patients with CeD (66.9%), both treatment naïve (69.4%) and those on GFD (65.8%) had DED in comparison to controls (20%) (odds ratio, 8.1, 95% confidence interval [CI] 3.4-19.2; p<0.001). Specific/bilaterally symmetrical DED were significantly higher in patients with CeD than controls. Recurrent aphthous ulcers were also significantly higher in patients with CeD. Approximately 80.6% and 63.4% treatment-naïve patients and those on GFD, respectively reported dry mouth sensation, which was significantly higher than the controls. CONCLUSION: Almost two-third of patients with CeD had DED. Physicians and dietitians caring for patients with CeD should be trained in identification of DED and other oral manifestations of CeD.