Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial.

OBJECTIVE: This 3-year multicentre randomised controlled trial compared, in 6-7-year-old Colombian children, the effectiveness of the ICCMS (International Caries Classification and Management System) with a conventional caries-management system (CCMS) in terms of individual caries-risk, caries lesions, and secondarily, oral-health-related knowledge/attitudes/practices, and number of appointments. MATERIAL AND METHODS: With ethical approval, 240 6-7-year olds from six Colombian clinics were recruited. Trained examiners conducted the following baseline/follow-up assessments: Caries risk (Cariogram-ICCMS); caries severity/activity staging (ICDAS-merged combined radiographic/visual); sealants/fillings/missing teeth, and oral-health-related knowledge, attitudes and practices. Children received their randomly allocated (ICCMS/CCMS) care from dental practitioners. Outcomes: caries-risk control (children); caries-progression control (tooth surfaces); oral-health-related knowledge/attitudes/practices improvement (parents/children), and appointments' number (children). Descriptive and non-parametric/parametric bivariate analyses were performed. RESULTS: Three-year-follow-up: n = 187 (77.9%; ICCMS: n = 92; CCMS: n = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%, p < .001; CCMS: 54.7-5.3%, p < .001) (p > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%, p = .010) and fewer active-caries lesions (49.8% vs. 59.1%, p < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice (p < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8, p = .15). CONCLUSION: Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.

Influence of the Presence of Alveolar Mucosa at Implants: A Histological Study in Humans.

OBJECTIVE: To evaluate the influence of the presence or absence of keratinized mucosa on hard and soft tissues around implants. MATERIAL AND METHODS: Sixteen volunteers with edentulous regions in the distal aspect of the mandible participated in the study. In each patient, 2 solid titanium screw-shaped devices, 3.5 mm in diameter and 5 mm long, were installed. The incision of the mucosa was performed in such a way to allow that, after the suture of the flaps, only the alveolar mucosa surround the test sites and the keratinized mucosa surround the control implants. After 3 months of healing, biopsies were retrieved and ground sections were prepared for histological analysis. RESULTS: Eighteen biopsies from 9 patients were collected for analysis. Both buccal bone resorption and most coronal level of osseointegration were higher at the test sites compared with the control sites, the difference between the 2 sites being 0.2 and 0.5 mm, respectively. The difference in the coronal level of osseointegration between the test and control sites was statistically significant. Mineralized bone-to-implant contact was 70.6% ± 10.9% at the test sites and 71.5% ± 9.2% at the control sites. CONCLUSIONS: The presence of alveolar mucosa at implants resulted in a more apical position of the coronal level of osseointegration in respect of the implant margin compared with the presence of keratinized mucosa.

Knowledge about emergency dental trauma management among school teachers in Colombia: A baseline study to develop an education strategy.

BACKGROUND/AIM: Dental trauma in school populations has a high frequency and school teachers are often close to the place where such injuries occur. However, many studies have confirmed the lack of knowledge as to how to act in these cases. The aim of this study was to determine the knowledge in regard to dental trauma of school teachers in Colombia. MATERIALS AND METHODS: A multicentre, descriptive cross-sectional study was performed in 251 schools using a stratified randomized sampling. A structured hard copy survey was personally delivered to 2390 school teachers in the selected schools. The survey contained questions related to work experience, teaching level and demographic data, as well as questions related to their knowledge of and attitude towards emergency dental trauma management. RESULTS: The response rate was 96%. Most of the school teachers (95%) had never received training related to dental trauma, although 35% had witnessed at least 1 case. Of 2296 school teachers surveyed, only 5.8% would have replanted an avulsed tooth. An association was found between work experience and appropriate management of an avulsed tooth. No significant differences were found in regard to school location (city), school type (private/public), gender and school teachers' education level. CONCLUSIONS: The knowledge of school teachers in Colombia about emergency dental trauma management is inadequate. The findings strongly suggest a need for an education strategy with the involvement of the government, dentistry schools and private organizations.

Psychometric Properties of the Family Adaptability and Cohesion Evaluation Scale III in Latin American University Dental Students.

OBJECTIVE: The Family Adaptability and Cohesion Evaluation Scale III (FACES III) is a self-report instrument that enables the assessment of the dimensions of adaptability and cohesion within a family, establishing whether or not that family is functional and classifying it according to categories within those dimensions. The objective of this research was to determine the psychometric properties of this instrument using a sample of dental students from 5 Latin American countries. MATERIALS AND METHODS: The FACES III was administered to a sample of 2888 university dental students from Colombia (35.3%), Chile (34.6%), the Dominican Republic (19%), Argentina (6%), and El Salvador (5.1%). Confirmatory factor analysis was used to examine the factorial structure of the scale, comparing 3 models proposed in the Latin American literature, establishing a multigroup analysis to examine invariance among countries. RESULTS: The results revealed a structure composed of 2 dimensions: cohesion and adaptability. These dimensions showed adequate structure and internal consistency. The invariance of the measurement model in the participating countries was confirmed. CONCLUSION: In general, this study offers evidence of the adequacy of the psychometric properties of FACES III in Colombian, Chilean, Dominican, Argentine, and Salvadoran dental students.

Impact of a virtual learning environment on the conscious prescription of antibiotics among Colombian dentists.

Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists' awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar's tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.

Influence on Implant Bone Healing of a Collagen Membrane Placed Subjacent the Sinus Mucosa-A Randomized Clinical Trial on Sinus Floor Elevation.

BACKGROUND: Perforation of the sinus mucosa is quite a frequent complication that might occur during sinus floor elevation. The perforation is often protected with a collagen membrane to avoid the extrusion of graft particles within the sinus. However, this procedure might hinder the innate osteogenic potential of the sinus mucosa. Hence, the aim of the study was to evaluate the influence of a placement of a collagen membrane subjacent the Schneiderian membrane during sinus floor elevation on implant bone healing. METHODS: Twenty volunteers took part in the trial. Ten were randomly included in the group that received a collagen membrane subjacent the sinus mucosa (Mb group), and ten did not receive the membrane (non-Mb group). A collagenated corticocancellous porcine bone was used to fill the elevated space. Six 6 months after the sinus floor elevation, a mini implant was placed transcrestally and retrieved after a further 3 months. Histological analyses were then performed on the full body of the mini implant as well as on its coronal and apical portions. RESULTS: The new bone apposition proportion onto the implant surface was similar in the Mb and non-Mb groups, both in the apical and coronal portions of the mini implants. A lesser amount of graft was found in contact with the surface. New bone density around the mini implants were similar both in the apical and coronal portions. However, a statistically higher proportion of graft particles was found in the Mb group compared to the non-membrane group. CONCLUSIONS: The placement of a collagen membrane subjacent the sinus mucosa did not affect bone healing at implants and bone density.

Osseointegration at Implants Installed in Composite Bone: A Randomized Clinical Trial on Sinus Floor Elevation.

Osseointegration of implants installed in conjunction with sinus floor elevation might be affected by the presence of residual graft. The implant surface characteristics and the protection of the access window using a collagen membrane might influence the osseointegration. To evaluate these factors, sinus floor elevation was performed in patients using a natural bovine bone grafting material. The access windows were either covered with a collagen membrane made of porcine corium (Mb group) or left uncovered (No-Mb group) and, after six months, two mini-implants with either a moderate rough or turned surfaces were installed. After 3 months, biopsies containing the mini-implants were retrieved, processed histologically, and analyzed. Twenty patients, ten in each group, were included in the study. The two mini-implants were retrieved from fourteen patients, six belonging to the Mb group, and eight to the No-Mb group. No statistically significant differences were found in osseointegration between groups. However, statistically significant differences were found between the two surfaces. It was concluded that implants with a moderately rough surface installed in a composite bone presented much higher osseointegration compared to those with a turned surface. The present study failed to show an effect of the use of a collagen membrane on the access window.

Prescribing antibiotics by dentists in Colombia: Toward a conscientious prescription.

OBJECTIVES: Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS: In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS: The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION: The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.

Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: a cone-beam computed tomographic study.

BACKGROUND: After sinus floor augmentation, a thickening of the sinus mucosa has been described. The aim of the present study was to evaluate the involvement of the maxillary sinus ostium in the edematous processes after a sinus floor augmentation procedure. METHODS: Seventy-two cone-beam computerized tomographies (CBSTs) were taken before sinus floor augmentation and after 1 week and 9 months from surgery and analyses. Sinus mucosa thickness and area, ostium diameter and patency, and extension of the post-surgical transient mucosal thickening in relation to the ostium were evaluated on the CBCTs for all three periods. The term "virtual" when referring to sinus mucosa thickness and area was introduced because of the edema and bleeding that both contributed to a transient thickening and additional elevation of the sinus mucosa. RESULTS: The mean virtual thickness of the sinus mucosa was 2.7 ± 4.0 mm, 7.7 ± 7.1 mm, 1.7 ± 2.0 mm before surgery, and after 1 week and 9 months. The virtual mucosa area was 37.2 ± 52.5 mm2, 184.5 ± 153.8 mm2, and 34.0 ± 50.7 mm2. The ostium diameter at the three periods evaluated was 1.8 ± 0.5 mm, 1.1 ± 0.6 mm, 1.5 ± 0.8 mm, respectively. Three infundibula (4.2%) were found out of patency before surgery while this number increased to 14 (19.4%) after 1 week. Nine months after surgery, only one infundibulum (1.4%) was out of patency, however, without presenting signs of sinus pathologies. The extension of the mucosal edema on the palatal sinus was reduced after 9 months of healing. CONCLUSIONS: One week after sinus floor augmentation, the maxillary sinus mucosa increased in dimensions and in several cases involved the ostium, reducing its diameter and producing a transient loss of patency. After 9 months of healing, the initial conditions were recovered.

Common Mental Disorders and Associated Factors in Dental Students From Cartagena, Colombia. / Trastornos mentales comunes y factores asociados en estudiantes de Odontología en Cartagena, Colombia.

INTRODUCTION: Psychological morbidity assessments are of interest since mental health is part of a person's overall health and early detection promotes emotional well-being. AIM: To determine the association between common mental disorders and related factors in dental students from Cartagena, Colombia. METHODS: We conducted a cross-sectional study in 858 dental students from Cartagena, Colombia; who answered a structured anonymous self-report questionnaire to assess the presence of common mental disorders (CMD) (General Health Questionnaire-12), problematic alcohol consumption (CAGE), sociodemographic and other related variables. Data were analyzed using descriptive statistics and bivariate analysis was conducted later using χ2 tests. The strength of association was obtained with prevalence ratios (PR) and 95% confidence intervals (95%CI). Finally adjusted PRs, and 95%CIs were obtained using a log-binomial regression model. Statistical analysis was performed using Stata v.13.2 for Windows (Stata Corp.; TX, USA). RESULTS: The average age was 20.8±3.01 years of age, and more than half were females. CMD overall prevalence was 30.3% (95%CI, 27.3-33.5). The regression model suggested as associated factors: sex (PR, 1.54; 95%CI, 1.21-1.96), recent economic changes (PR, 1.70; 95%CI, 1.37-2.12), family conflicts [PR, 2.29; 95%CI, 1.89-2.77), abandonment (PR, 1.58; 95%CI, 1.23-2.03), history of abuse (PR, 2.05; 95%CI, 1.27-3.31), and problematic alcohol consumption (PR, 1.35; 95%CI, 1.02-1.78). CONCLUSIONS: CMD prevalence was high. Being female, family conflicts, history of abuse and problematic alcohol consumption are considered as risk factors for CMD development and should be carefully assessed to predict emotional well-being.

Bacterial profile of the supragingival dental biofilm in children with deciduous and early mixed dentition using next generation sequencing (HOMINGS) technique. / Perfil bacteriano del biofilm dental supragingival en niños con dentición temporal y mixta temprana utilizando la técnica de secuenciación de próxima generación (HOMINGS).

OBJECTIVE: Tdescribe the bacterial profile of the supragingival biofilm of children with temporary dentition (CTD) and early mixed dentition (CEMD), with the next-generation sequencing (HOMINGS) technique. METHOD: A comparative descriptive study was carried out with 30 systemically healthy children aged between 5 and 7 years old from public schools in Cartagena-Colombia. All participants were caries-free applying the criteria of the International Caries Detection and Assessment System (ICDAS II) and had no caries experience according to the Decayed, Missing and Filled Teeth (DMFT) index. Supragingival biofilm samples were collected. Bacterial DNA was extracted and used for analysis using HOMINGS (Human Oral Microbe Identification using Next-Generation Sequencing) based on the sequencing of the V3-V4 region of the 16S rRNA gene using the Illumina MiSeq platform (V3-V4 primers). RESULTS: A total of 360 species-specific and 65 genus-specific probes were identified. The bacterial genus most predominant in CTD were Streptococcus, Actinomyces, Veillonella and Fusobacterium (29.2% of all bacterial DNA present), while in CEMD the most predominant were Streptococcus, Leptotrichia, TM7 and Porphyromonas (24.5% of all bacterial DNA present). The bacterial species with the highest relative abundance in the oral biofilm microbiome from CTD were Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, while in CEMD they were S. sanguinis, Leptotrichia spp. HOT-417 and Leptotrichia spp. HOT-498. The Shannon diversity index was 2.77 (SD=0.26) for CTD and 3.01 (SD=0.39) for CEMD (P=0.06). CONCLUSIONS: The analysis of the bacterial profile of the supragingival dental biofilm in children with DMFT, by means of HOMINGS showed low microbiological diversity both in presence and in relative abundance in terms of genus as well as bacterial species.

Tomographic evaluation of the influence of the placement of a collagen membrane subjacent to the sinus mucosa during maxillary sinus floor augmentation: a randomized clinical trial.

AIM: To study the influence of a collagen membrane placed subjacent to the sinus mucosa on the dimensional changes of augmented maxillary sinus floor. METHODS: Twenty patients were recruited in the study and randomly assigned to two groups. After the elevation of the maxillary sinus mucosa, a collagen membrane with standardized dimensions was placed at the test sites subjacent to the sinus mucosa and the elevated space was filled with a xenograft, both at test and control sites. A collagen membrane was then used to cover the antrostomy at both sites, and sutures were applied to close the wounds. Cone beam computed tomographies (CBCTs) were taken for all patients before surgery (T0), after 1 week from sinus floor augmentation (T1), and after 9 months of healing (T2). Dimensional changes over time of soft and hard tissues were evaluated on the CBCTs. RESULTS: After 1 week of healing, the sinus floor was elevated by 10.0 ± 2.8 mm and 10.6 ± 2.5 mm at the no-membrane and membrane groups, respectively. After 9 months of healing, a similar reduction of the height was observed in both groups, providing a total vertical augmentation of 8.6 ± 2.8 mm at the no-membrane sites and 9.1 ± 3.1 mm at the membrane sites. After 9 months of healing, the hard tissues subjacent to the sinus mucosa appeared to be partially corticalized in three patients in the no-membrane group and in six patients in the membrane group. CONCLUSIONS: The use of collagen membranes subjacent to the sinus mucosa did not influence the dimensional variations of the augmented regions and the clinical outcomes after 9 months of healing also in absence of perforations.

Erosion of empathy during medical training by gender. A cross-sectional study. / Erosión empática durante la formación médica según el género. Estudio transversal.

INTRODUCTION: Empathy erosion may be defined as a sudden decline in the levels of empathy that occurs as of the third year of medical school and continues until the fifth year. According to some authors, this process is normal during medical training and may be considered a model of empathic behavior. The objective of this study was to verify whether empathy erosion is a general phenomenon in the schools of medicine included in the study and its relation to gender. DESIGN: Exploratory, cross-sectional study. POPULATION: Students from first through sixth year of the School of Medicine of Universidad del Azuay (Cuenca, Ecuador) and from first through fifth year of the School of Medicine of Corporación Universitaria Rafael Nuñez (Colombia). MATERIALS AND METHODS: The levels of overall empathy and of each component were estimated using the Jefferson Scale of Empathy, which was administered in both schools during July and August of 2016. The significance level was established at α < 0.05. Results. Universidad del Azuay: n= 278 (98% of all students); women= 112; men= 166; Corporación Universitaria Rafael Nuñez: n= 756 (77.86% of all students); women= 434; men= 322. The model of erosion of empathy is not fulfilled at the level of overall empathy or of each studied component according to gender. CONCLUSIONS: Empathy erosion is a specific element of several different models of empathic response (and of its components). Men and women do not have the same empathic response. Such response, in the studied conditions, is variable.

INTRODUCCIÓN: La erosión empática puede ser definida como la disminución brusca de los niveles de empatía que se manifiesta a partir de tercer año y persiste hasta el quinto curso. Según algunos autores, este proceso surge, normalmente, durante la formación médica y podría considerarse como un modelo de comportamiento empático. El objetivo del presente trabajo fue verificar si la erosión empática es un caso general en las facultades de Medicina examinadas y su relación con el género. DISEÑO: Exploratorio y de corte transversal. POBLACIÓN: Estudiantes de los cursos de primero a sexto año de la carrera de Medicina de la Universidad del Azuay (Cuenca, Ecuador) y de primero a quinto en la Corporación Universitaria Rafael Nuñez (Colombia). MATERIAL Y MÉTODOS: Se estimaron los niveles de empatía general y de cada componente mediante la escala de empatía médica de Jefferson en ambas facultades durante los meses de julio y agosto de 2016. El nivel de significación fue de α < 0,05. RESULTADOS: Universidad del Azuay: n= 278 (98% del total); mujeres= 112; hombres= 166; Corporación Universitaria Rafael Nuñez: n= 756 (77,86% del total); mujeres= 434; hombres= 322. El modelo de la erosión empática no se cumple de forma general ni en los propios componentes estudiados por género. CONCLUSIONES: La erosión empática es un caso particular de varios modelos diferentes de la respuesta empática (y la de sus componentes). Los géneros no tienen la misma respuesta empática. Esta respuesta, bajo las condiciones estudiadas, tiene variabilidad.

[Validity and internal consistency of the Maslach Burnout Inventory in Dental Students from Cartagena, Colombia]. / Validez y consistencia interna del Inventario Maslach para burnout en estudiantes de Odontología de Cartagena, Colombia.

OBJECTIVE: To determine the internal consistency and content validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) in dental students from Cartagena, Colombia. MATERIALS AND METHODS: Scale validation study in 886 dental students from Cartagena, Colombia. Factor structure was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was measured using the Cronbach's alpha coefficient. Analyses were performed using the Stata v.13.2 for Windows (Statacorp., USA) and Mplus v.7.31 for Windows (Muthén & Muthén, USA) software. RESULTS: Internal consistency was α=.806. The factor structure showed three that accounted for the 56.6% of the variance. CFA revealed: χ2=926.036; df=85; RMSEA=.106 (90%CI, .100-.112); CFI=.947; TLI=.934. CONCLUSIONS: The MBI showed an adequate internal consistency and a factor structure being consistent with the original proposed structure with a poor fit, which does not reflect adequate content validity in this sample.

Applications of teledentistry in dental practice: a systematic review / Aplicaciones de la teleodontología en la práctica odontológica: revisión sistemática

Abstract Introduction: access to dental services in rural and remote areas is a problem still to be solved; for this purpose, a new alternative known as teledentistry has emerged. Through the application of information and communications technologies (ICTs), teledentistry promotes prevention, diagnosis, and treatment. This study aimed to determine the impact of teledentistry applications on clinical practice in different specialties based on the current evidence in the literature. Methods: two reviewers conducted a literature search in PubMed, EMBASE, EBSCO, ScienceDirect and LILACS databases until August 2019, to identify studies published in English, Spanish and Portuguese. Studies containing interventions applied to teledentistry, published in the last six years and available in full text were included. Bias risk was assessed through validated criteria according to each study type. Results: the search strategy retrieved 1028 articles, 24 of which were selected for evaluation. Twenty-three articles were cross-sectional studies and only one study was quasi-experimental. Seventeen studies (70.8%) considered teledentistry as an alternative to diagnosing and treating oral diseases in rural areas and health centers through mobile devices and clinical photographs. Most studies had moderate to high bias risk. Conclusion: while there is evidence on the use of teledentistry in the various fields of dentistry, it is important to keep in mind that since this is a novel tool that seeks to support access to health services in remote areas, the obtained results are preliminary, and further research with quality publications is necessary to evaluate the effectiveness of this tool.

Resumen Introducción: el acceso a los servicios odontológicos en zonas rurales y remotas es una problemática que aún no está resuelta, por lo que se ha introducido la teleodontología, a través de la aplicación de tecnologías de la información y la comunicación (TICs) por medio de la prevención, diagnóstico y tratamiento. El objetivo del presente estudio consistió en determinar el impacto de las aplicaciones de la teleodontología desde las diferentes especialidades a partir de la evidencia. Métodos: dos revisores realizaron una búsqueda en las bases de datos PubMed, EMBASE, EBSCO, ScienceDirect y LILACS para identificar estudios publicados en inglés, español y portugués. Se incluyeron estudios que contenían intervenciones en teleodontología, publicados en los últimos seis años y en texto completo. La calidad de los artículos se evaluó teniendo en cuenta el diseño del estudio. Resultados: se identificaron 1028 artículos, y se incluyeron 24 artículos para su evaluación. Veintitrés de estos artículos eran estudios transversales y un solo estudio fue de intervención. Diecisiete estudios (70,8%) presentaron la teleodontología como una alternativa para diagnósticos y tratamientos de enfermedades bucales en zonas rurales mediante dispositivos móviles, consultas y fotografías. La mayoría de los estudios presentaban un riesgo de sesgo de moderado a alto. Conclusión: pese a que existe evidencia sobre el uso de la teleodontología en los diferentes campos de la odontología, es importante tener en cuenta que, dado que esta es una herramienta novedosa que busca apoyar el acceso a los servicios de salud en zonas remotas, se hace necesario realizar una nueva búsqueda de evidencia con mejor calidad en la publicación.

Trastornos mentales comunes y factores asociados en estudiantes de Odontología en Cartagena, Colombia / Common Mental Disorders and Associated Factors in Dental Students From Cartagena, Colombia

RESUMEN Introducción: La valoración de morbilidad psicológica resulta de interés porque la salud mental hace parte de la salud integral de un individuo, y la detección precoz de casos propende al bienestar emocional. Objetivo: Estimar la asociación entre trastornos mentales comunes y factores relacionados en estudiantes de Odontología de Cartagena, Colombia. Métodos: Estudio de corte transversal en 858 estudiantes de Odontología de Cartagena, Colombia, que respondieron a un cuestionario estructurado anónimo autoaplicado para evaluar la presencia de TMC (Cuestionario General de Salud-12), consumo problemático de alcohol (CAGE), variables sociodemográficas y otras relacionadas. Se realizó estadística descriptiva y análisis bivariable con pruebas de la x2. La fuerza de asociación se computó con razones de prevalencia (RP) e intervalos de confianza del 95% (IC95%). Con regresión log-binomial, se obtuvieron RP e IC95% ajustados. El análisis se realizó empleando Stata v.13.2 para Windows (Stata Corp.; College Station, Texas, Estados Unidos). Resultados: El promedio de edad fue 20,8 ± 3,01 arios y más de la mitad eran mujeres. La prevalencia de TMC fue del 30,3% (IC95%, 27,3-33,5). El modelo de regresión indicó como factores asociados: sexo (RP, 1,54; IC95%, 1,21-1,96), cambios económicos recientes (RP, 1,70; IC95%, 1,37-2,12), conflictos familiares (RP, 2,29; IC95%, 1,89-2,77)], abandono (RP, 1,58; IC95%, 1,23-2,03), historia de abuso (RP, 2,05; IC95%, 1,27-3,31) y consumo problemático de alcohol (RP, 1,35; IC95%, 1,02-1,78). Conclusiones: La prevalencia de TMC fue alta. Ser mujer y tener conflictos familiares, historia de abuso y consumo problemático de alcohol son factores de riesgo de TMC y deben ser cuidadosamente evaluados para la predicción del bienestar emocional.

ABSTRACT Introduction: Psychological morbidity assessments are of interest since mental health is part of a person's overall health and early detection promotes emotional well-being. Aim: To determine the association between common mental disorders and related factors in dental students from Cartagena, Colombia. Methods: We conducted a cross-sectional study in 858 dental students from Cartagena, Colombia; who answered a structured anonymous self-report questionnaire to assess the presence of common mental disorders (CMD) (General Health Questionnaire-12), problematic alcohol consumption (CAGE), sociodemographic and other related variables. Data were analyzed using descriptive statistics and bivariate analysis was conducted later using x2 tests. The strength of association was obtained with prevalence ratios (PR) and 95% confidence intervals (95%CI). Finally adjusted PRs, and 95%CIs were obtained using a log-binomial regression model. Statistical analysis was performed using Stata v.13.2 for Windows (Stata Corp.; TX, USA). Results: The average age was 20.8 ± 3.01 years of age, and more than half were females. CMD overall prevalence was 30.3% (95%CI, 27.3-33.5). The regression model suggested as associated factors: sex (PR, 1.54; 95%CI, 1.21-1.96), recent economic changes (PR, 1.70; 95%CI, 1.37-2.12), family conflicts [PR, 2.29; 95%CI, 1.89-2.77), abandonment (PR, 1.58; 95%CI, 1.232.03), history of abuse (PR, 2.05; 95%CI, 1.27-3.31), and problematic alcohol consumption (PR, 1.35; 95%CI, 1.02-1.78). Conclusions: CMD prevalence was high. Being female, family conflicts, history of abuse and problematic alcohol consumption are considered as risk factors for CMD development and should be carefully assessed to predict emotional well-being.

Extracurricular factors influence perceived stress in a large cohort of Colombian dental students.

The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context.

Niveles de citocinas (IL1 β, IL 6 y TNF-α) en estudiantes con estrés académico / Levels of cytokines (IL1 β, IL 6 and TNF-α) in students with academic stress

RESUMEN Objetivo: Establecer la posible relación entre el estrés académico, los cambios en los niveles de citocinas (lL-1β, IL-6) y el factor de necrosis tumoral alfa (TNF-α) en estudiantes de odontología. Métodos: Estudio descriptivo de corte transversal, en el que se evaluó el nivel de estrés académico en estudiantes universitarios y se establecieron los niveles de lL-1β, IL-6 y TNF-α en dos grupos. Uno bajo situación de estrés en una prueba académica, y en otro de regreso del periodo vacacional o momento de no estrés. Resultados: Hicieron parte del estudio 65 participantes. Al evaluar los resultados globales de estrés se encontró un promedio de 1,86 ±0,37 en el momento de no estrés y de 2,61 ± 0,38 en el momento de estrés, encontrándose diferencias estadísticas (p < 0,05). Al comparar los valores de las citocinas se encontraron diferencias estadísticas (p < 0,05) en la LL-1Β, en el momento de estrés y no estrés (p < 0,05). Conclusiones: Las pruebas académicas son uno de los factores estresores que pueden influir sobre las citosinas del sistema inmune, ya que sus valores variaron cuando los pacientes se encontraron bajo situaciones de estrés académico.

ABSTRACT Objective: The present study examined the relationship between academic stress, the cytosines (lL-1β, IL-6) and tumor necrosis factor alpha (TNF-α) changes in a group of dental students. Materials and Methods: Descriptive cross-sectional study, in which the academic stress level was evaluated in university students and the levels of l-1β, IL-6 and TNF-α were established in two groups, one under stress (in an academic test), and in another (back from the holiday period or moment of no-stress). Results: A total of 65 participants were included. The overall results of stress 1.86 ± 0.37 was found at the time of no stress and 2.61 ± 0.38 at the time of stress (p <0.05). Compared to summer vacation, during examinations individuals reported significantly more perceived stress (P < 0.0059), there was higher gene expression of IL-1 (P < 0.01) and IL-6 (P < 0.05) during the period of stress vs. non-stress. Conclusion: Academic exams are one of the stressors that can influence the cytosines of the immune system, since their values varied when patients were under situations of academic stress.

Actitud empática en estudiantes de odontología de la Corporación Universitaria Rafael Núñez en la ciudad de Cartagena / Empathetic Attitude in Dentistry Students at Corporación Universitaria Rafael Nuñez in Cartagena / Atitude empática em estudantes de odontologia da Universidade Corporation Rafael Núñez na cidade de Cartagena

Resumen Introducción: la empatía como un aspecto de la personalidad cumple una función importante en las relaciones interpersonales, facilitando la comunicación y la relación odontólogo-paciente. Logrando mejorar la calidad de la atención odontológica. El propósito del estudio fue describir el grado de actitud empática de estudiantes de pregrado de odontología en una institución universitaria de la ciudad de Cartagena, Colombia, según género y niveles de enseñanza. Materiales y métodos: estudio exploratorio de corte transversal. La muestra de 326 estudiantes de 1° a 5° año. Se utilizó la escala de empatía médica de Jefferson versión "S" (EEMJ), psicométricamente validada. Para el análisis se aplicó la prueba de normalidad de Shapiro-Wilk. Se compararon las medias mediante un análisis de varianza bifactorial modelo III con interacción de primer orden (Anova), significancia p < 0,05. Resultados: la confiabilidad fue satisfactoria (0,72). Los puntajes obtenidos en la EEMJ variaron entre un mínimo de 54 y un máximo de 130 puntos para las mujeres y un mínimo de 55 y un máximo de 126 para los hombres; el promedio global de empatía fue bajo: 95,80 ± 12,9; no fueron significativos (p=0,185) para nivel académico y género (p = 0,25). Conclusión: a pesar de que no se encontraron diferencias estadísticamente significativas de orientación empática entre años académicos y género, se destaca que en el último año de la carrera aumentó el puntaje; los hombres reportaron niveles mayores de orientación empática en valores absolutos que las mujeres; el mayor nivel de orientación empática se detectó en tercer año.

Abstract Introduction: Empathy refers to an aspect of personality that plays an important role in interpersonal relationships, facilitating communication in order to favor the dentist-patient relationship. This interaction will improve the quality of dental care service. The aim of this study was to describe the self-reported empathy levels among dental undergraduate students, according to gender and education levels. Materials and methods: exploratory and cross-sectional questionnaire based study was carried out with a sample size of 326 undergraduate dental students. Data was obtained from the first to the final year, empathy levels of students were assessed by the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire, psychometrically validated to measure empathy. For the analysis of the results, the Shapiro-Wilk normality test was applied. The means were compared using an analysis of variance with bifactorial Model type III (Anova) with first order interaction. With a significance level of p <0.05. Results: reliability was satisfactory (0.72). The scores obtained in the EEMJ ranged from a minimum of 54 to a maximum of 130 points for women and a minimum of 55 and a maximum of 126 for men, the average of global empathy scores was 95,80±12,9, The results were not significant (p = 0.185) for the academic level factor and gender (p = 0.25). Conclusion: although there were no statistically significant differences in empathic orientation between the academic and gender years; it is highlighted that in the last year of the race the score increased; men reported higher levels of empathic orientation in absolute values than women; the highest level of empathic orientation was detected in the third year group.

Resumo Introdução: empatia refere-se a um aspecto da personalidade que desempenha um papel importante em relacionamentos interpessoais, facilitando relação dentista-paciente comunicação e competição, essa interação adequada tenderá a melhorar a qualidade do atendimento odontológico oferecido. O objetivo foi descrever o grau de atitude empática que os alunos têm de Graduação em Odontologia na cidade de Cartagena, Colômbia. Materiais e métodos: estudo exploratório e transversal, a amostra foi composta por 326 estudantes do 1° ao 5° ano. Foi utilizada escala de médico Empathy Jefferson versão «S¼ (EEMJ) (2), psicometricamente validados para medir a empatia. Para a análise dos resultados do teste foi aplicado Shapiro-Wilk normalidade médias foram comparadas usando um análise de variância (Anova) bifatorial Modelo III com a interação de primeira ordem. Com um nível de significância de p <0,05. Resultados: a confiabilidade foi satisfatória (0,72). Os escores obtidos no JSPE variou de um mínimo de 54 e um máximo de 130 pontos para as mulheres e um mínimo de 55 e um máximo de 126 para os homens, as médias de empatia globais foi baixa 85,2 ± DE, os resultados não foram significativos (p = 0,185) para o fator de nível académico e sexo (p = 0,25). Conclussão: embora não houvesse diferenças estatisticamente significativas na orientação empática entre os anos acadêmicos e de gênero; destaca-se que no último ano da corrida a pontuação aumentou; Os homens relataram níveis mais elevados de orientação empática em valores absolutos do que as mulheres; o nível mais alto de orientação empática foi detectado no grupo do terceiro ano.

Bone healing of dental alveoli in smokers with platelet-rich plasma obtained using single or double centrifugation

Introduction: the habit of smoking alters the bone healing process, a problem to consider in oral surgery. objective: to evaluate the bone healing of dental alveoli with PRP obtained using single or double centrifugation in smokers. methodology: extraction of mandibular third molars was performed in a study population divided into smoking group (A), which had PRP applied with the protocol using a single centrifugation step (P1C) in the alveolus of tooth 38 and the protocol of double centrifugation (P2C) in alveolus of tooth 48; a smoking group(B), to whom no PRP was applied; and a non-smokers group (C) to whom PRP was applied obtained using P1C and P2C protocol. radiographic examination was performed at 8, 30 and 60 days post procedure. results: thirty patients met the criteria, 57 percent were female. when evaluating bone healing between the group of smokers and non-smokers, statistically significant differences were observed in the non-smoking group at 30 and 60 days, showing better results with the P2C protocol (p<0.005). statistically significant differences were found at 30 and 60 days (p<0.005), both with the P1C and P2C when comparing bone healing of group A and B. conclusions: bone healing in the alveoli of mandibular third molars that which PRP applied was higher in non-smoking patients, compared with the group of smokers. bone healing was better in patients smokers to whom PRP was applied than those without PRP treatment. regarding the method of obtaining PRP, bone healing was better when a double centrifugation protocol (P2C) was applied.