Empowering Women Researchers in the New Century: IADR's Strategic Direction.

Gender inequality in science, medicine, and dentistry remains a central concern for the biomedical research workforce today. Although progress in areas of inclusivity and gender diversity was reported, growth has been slow. Women still face multiple challenges in reaching higher ranks and leadership positions while maintaining holistic success in these fields. Within dental research and academia, we might observe trends toward a more balanced pipeline. However, women continue to face barriers in seeking leadership roles and achieving economic equity and scholarship recognition. In an effort to evaluate the status of women in dental research and academia, the authors examined the role of the International Association for Dental Research (IADR), a global research organization, which has improved awareness on gender inequality. The goal of this article is to review five crucial issues of gender inequality in oral health research and academics-workforce pipeline, economic inequality, workplace harassment, gender bias in scholarly productivity, and work-life balance-and to discuss proactive steps that the IADR has taken to promote gender equality. Providing networking and training opportunities through effective mentoring and coaching for women researchers, the IADR has developed a robust pipeline of women leaders while promoting gender equality for women in dental academia through a culture shift. As knowledge gaps remained on the levels of conscious and unconscious bias and sexist culture affecting women advancement in academics, as well as the intersectionality of gender with race, gender identity, ability status, sexual orientation, and cultural backgrounds, the IADR has recognized that further research is warranted.

Prevención de osteonecrosis asociada a medicamentos y ensayo clínico multicéntrico, Facultad de Odontología, Universidad de Buenos Aires / Prevention of drug-related osteonecrosis and multicentric clinical trial, School of Dentistry, University of Buenos Aires

La osteonecrosis asociada a medicamentos (ONAM) es un efecto adverso poco frecuente pero potencialmente serio que afecta a pacientes que reciben o recibieron tratamiento con drogas antirresortivas o antiangiogénicas. A partir de una revisión narrativa de la literatura, el presente artículo aporta conceptos básicos e información actualizada acerca de incidencia, factores de riesgo y prevención de ONAM desde la perspectiva de la Práctica Basada en la Evidencia. Además pone en conocimiento a la comunidad profesional de la Facultad de Odontología de la Universidad de Buenos Aires acerca de las actividades de investigación clínica llevadas a cabo en este área en la Cátedra de Cirugía y Traumatología Buco-Máxilo-Facial I de nuestra casa de estudios (AU)

Medicine related osteonecrosis of the jaws (MRONJ) is a rare but potentially serious side effect experienced by patients receiving treatment with antiresorptive or antiangiogenic drugs. Through a narrative review of the literature, this paper provides basic concepts and updated data about incidence, risk factors and prevention of MRONJ from the Evidence Based Practice perspective. It also informs the professional community of the School of Dentistry of the University of Buenos Aires about the clinical research activities carried out in this area in the Oral and Maxillofacial Surgery I Department (AU)

Reevaluation of the Strain Pressure Theory: Toward a Better Understanding the Biology of Tooth Movement / Reevaluación de la Teoría Presión - Tensión: Hacia una Mejor Comprensión de la Biología del Movimiento Dental

The aim of this report was to analyze the majority of publications referred to orthodontic movement Biological basis, principally strain- pressure theory taking account contemporaneous methodological study designs. The literature published in Pubmed from 1967 to 2014 was reviewed, in addition to well-known scientific reports that were not classified under this database like classical manuscripts since 1839. The comment items are: Limitations of animal models, Histological slices, what to watch for, Rats as an experimental model in orthodontics, Strain­pressure, the force used in these studies that fundament this theory, Reevaluation studies about strain-pressure theory in biology movement using contemporaneous models, Up to date concepts, Theory reevaluation the first step to understanding new acceleration concepts and Movement biology research, present and future. After analyzing those items we concluded: A 3D perspective is essential for a complete understanding of events in tooth movement involves two interrelated processes: the bending of alveolar bone and remodeling of the periodontal tissues. It's important to start, and acknowledge that the PDL cannot be divided into two different areas that react independently to an applied force. It´s a continuous periodontal compartment in OTM, rather than a pressure side and a tension side. When an orthodontic force is applied there are two simultaneous effects that correlate. Alveolar bone flexion and remodeling of the periodontal tissues. Alveolar Bone deformation compromising the main structures (PDL, bone and cement), compression and tension can coexist in different directions. The magnitudes of compression and tension are typically different in different directions. As the majority of research and studies indicate that fundamental movement biology are made on animal models, it is important to know that their results and conclusions, under the actual evidenced based practice guidelines do not allow to make clinical decisions even if they are included on systematic reviews.

El objetivo de esta revisión es analizar la mayoría de las publicaciones relacionadas a la fundamentación sobre el movimiento de ortodoncia, principalmente la teoría presión-tensión, teniendo en cuenta los diseños de estudios metodológicos contemporáneos. Se revisó la literatura publicada en la base de datos de MEDLINE, 1967-2013 , además de los informes conocidos que no fueron clasificados en esta base de datos como manuscritos clásicos desde 1839. Los temas principales en los que se divide el artículo son: Limitaciones de los modelos animales, cortes histológicos, las ratas como modelo experimental en ortodoncia, la fuerza utilizada en los estudios que fundamentan esta teoría, reevaluación sobre los estudios de la teoría presión ­tensión en modelos contemporáneos, conceptos actuales en biología del movimiento, reevaluación de la teoría: el primer paso para entender los nuevos métodos en aceleración del movimiento, conceptos e investigaciones en biología del movimiento: presente y futuro. Una perspectiva 3D es esencial para una comprensión completa de los acontecimientos. El movimiento dental implica dos procesos interrelacionados: la curvatura del hueso alveolar y la remodelación de los tejidos periodontales. Es importante empezar, y reconocer que el PDL no puede ser dividido en dos áreas diferentes que reaccionan de forma independiente a una fuerza aplicada. Está en un compartimiento continuo periodontal , en lugar de un lado de presión y un lado de tensión. Al aplicar una fuerza de ortodoncia hay dos efectos simultáneos: la flexión del hueso Alveolar y la remodelación de los tejidos periodontales. La deformación del hueso compromete las estructuras principales (PDL, hueso y cemento) y la compresión y la tensión pueden coexistir en diferentes direcciones.

Programa Nacional de Melhoria do Acesso e da Qualidade dos Centros de Especialidades Odontológicas (Pmaq-CEO): manual instrutivo 2º Ciclo (2015-2017) / National Program for Improving Access and Quality of Dental Specialties Centers (Pmaq-CEO): Instructional manual 2nd cycle (2015-2017)

Uma das principais diretrizes do Ministério da Saúde é executar a gestão pública com base na indução, no monitoramento e na avaliação de processos e resultados mensuráveis, garantindo acesso e qualidade da atenção em saúde a toda a população. Nesse sentido, diversificados esforços têm sido empreendidos no sentido de qualificar a Política Nacional de Saúde Bucal, denominada de Brasil Sorridente, que tem o objetivo de reorganizar o modelo de atenção à saúde bucal e ampliar o acesso às ações e aos serviços de saúde bucal, garantindo a continuidade do cuidado e atenção integral aos indivíduos e às famílias. A Política Nacional de Saúde Bucal (Brasil Sorridente) apresenta como principais linhas de ação a reorganização da Atenção Básica, especialmente por meio das equipes de Saúde Bucal da Estratégia Saúde da Família, da Atenção Especializada, por meio da implantação de Centros de Especialidades Odontológicas (CEO) e Laboratórios Regionais de Próteses Dentárias (LRPD), do fomento à integração ensino-serviço, por meio de programas como o GraduaCEO, da adição de flúor nas estações de tratamento de águas de abastecimento público e da vigilância em saúde bucal.

Progress in Early Childhood Caries and Opportunities in Research, Policy, and Clinical Management.

The 2014 Early Childhood Caries Conference encompassed evidence-based reviews on the state of the science regarding early childhood carries (ECC) epidemiology, etiology, prevention, and disease management. The purpose of this paper was to discuss the work presented at the conference and identify opportunities in research, policy, and clinical management that may improve early childhood caries outcomes and lower costs of care. While great progress has been made since the 1997 ECC Conference, there remains a paucity of high-quality evidence from randomized controlled trials on what are the most effective means to prevent and manage ECC. Analyses of studies indicate that some approaches, such as chlorhexidine, iodine, and remineralizing agents, have not shown consistent findings in preventing ECC. However, evidence exists to yield recommendations in some areas. There are useful risk assessment indicators to identify preschool children at risk for caries. Fluoridated toothpaste and fluoride varnish currently are the most effective chemotherapeutic strategies to prevent ECC. Motivational interviewing, a form of patient-centered counseling, is effective for motivating oral health behaviors and shows promise for reducing caries. Additionally, evidence is emerging that shows the value of chronic disease management approaches and integrating ECC oral health care within medical care settings. Recommendations for future directions in ECC research and policy were also key outcomes of the conference.

Creating a new generation of pediatric dentists: a paradigm shift in training.

The University of California, Los Angeles (UCLA) School of Dentistry has implemented a Health Resources and Services Administration-funded program to prepare dentists for the complex and comprehensive needs of pediatric patients within rapidly changing demographics and a paradigm shift in dentistry. Traditional dental education has focused on how to respond to oral disease, whereas UCLA's program shifts the paradigm to emphasize early assessment, risk-based prevention, and disease management. A holistic approach to dental care that considers social and environmental determinants is used with minimally invasive techniques for restorative care. To support this change, pediatric dental residents receive traditional training combined with new didactics, advocacy opportunities, and applied learning experiences at community-based organizations. These new elements teach residents to recognize the causal factors of disease and to identify interventions that promote oral health at the individual, family, community, and policy level. Consequently, they are better prepared to treat a diverse group of patients who historically have faced the greatest burden of disease as well as an increased number of barriers to accessing oral health care; these consist of low-income, minority, and/or pediatric populations including children with special health needs. The program's ultimate goal is for residents to deploy these skills in treating vulnerable populations and to demonstrate greater interest in collaborating with non-dental health providers and community organizations to increase access to dental services in private or public health practice settings.

Interprofessional education between dentistry and nursing: the NYU experience.

In 2005, New York University Colleges of Dentistry and Nursing formed an organizational partnership to create a unique model of interprofessional education, research, service and practice. This paper describes the first eight years of experience, from the early reaction of the public to the partnership, to examples of success and past and current challenges.

A decade of experience evolving visiting dental services in partnership with rural remote Aboriginal communities.

BACKGROUND: Embedding research capabilities and workforce development activities with clinical service entities promotes the development of sustainable, innovative, quality-focused oral health care services. Clinical and strategic governance is an important area of consideration for rural and remote dental services, posing particular challenges for smaller service structures. Sustaining remote area dental services has some significant complexities beyond those involved in urban service models. METHODS: This study describes the sustaining structure of a remote area dental service with a decade of history. RESULTS: In the current climate, chief among these challenges may be those associated with dental workforce shortages as these impact most heavily in the public sector, and most particularly, in remote areas. As sustained workforce solutions come from developing a future workforce, an essential element of the workforce governance framework for remote dental service provision should be the inclusion of a student participation programme. Collaborative partnership approaches with Aboriginal health services promote the development and maintenance of effective, culturally sensitive dental services within rural and remote Aboriginal communities. Having sustained care for 10 years, this collaborative model of integrated research, education and service has demonstrated its effectiveness as a service model for Aboriginal communities in Western Australia. CONCLUSIONS: This descriptive study finds the core values for this success have been communication, clinical leadership, mentorship within effective governance systems all linked to an integrated education and research agenda.

Acceleration of tooth movement during orthodontic treatment--a frontier in orthodontics.

Nowadays, there is an increased tendency for researches to focus on accelerating methods for tooth movement due to the huge demand for adults for a shorter orthodontic treatment time. Unfortunately, long orthodontic treatment time poses several disadvantages like higher predisposition to caries, gingival recession, and root resorption. This increases the demand to find the best method to increase tooth movement with the least possible disadvantages. The purpose of this study is to view the successful approaches in tooth movement and to highlight the newest technique in tooth movement. A total of 74 articles were reviewed in tooth movement and related discipline from 1959 to 2013. There is a high amount of researches done on the biological method for tooth movement; unfortunately, the majority of them were done on animals. Cytokine, PTH, vitamin D, and RANKL/RANK/OPG show promising results; on the other hand, relaxin does not accelerate tooth movement, but increases the tooth mobility. Low-level laser therapy has shown positive outcome, but further investigation should be done for the best energy and duration to achieve the highest success rate. Surgical approach has the most predictable outcomes but with limited application due to its aggressiveness. Piezocision technique is considered one of the best surgical approaches because it poses good periodontal tissue response and excellent aesthetic outcome. Due to the advantages and disadvantages of each approach, further investigations should be done to determine the best method to accelerate tooth movement.

Estudo bibliométrico de pesquisas realizadas com fitoterápicos na odontologia / Bibliometric study of dental research on herbal medicines

OBJETIVO: Investigar a produção científica da pesquisa odontológica brasileira envolvendo fitoterápicos, através de um estudo bibliométrico. MÉTODOS: Realizou-se um estudo transversal, por meio da observação indireta dos resumos publicados na Reunião Anual da Sociedade Brasileira de Pesquisa Odontológica - SBPqO no período de 2006 a 2010. Os trabalhos foram caracterizados de acordo com o ano, estado de origem, espécie vegetal estudada, atividade farmacológica, área de conhecimento, desenho do estudo, recebimento de fomento e agência financiadora. A coleta foi realizada por dois examinadores, sendo o instrumento de registro dos dados um formulário específico. As informações foram analisadas com o Epi Info e apresentadas por meio da estatística descritiva. RESULTADOS: Foram identificados 292 trabalhos (1,8%), sendo que a maioria foi desenvolvida na região sudeste (59,6%), principalmente no estado de São Paulo (51,3%). A atividade farmacológica mais frequentemente avaliada foi a antimicrobiana (62,7%), seguida da atividade de reparação tecidual (14,4%). Pesquisas in vitro representaram 63,4% e nos estudos in vivo com animais, o modelo com ratos o mais utilizado (96,2%). CONCLUSÃO: Os estudos com plantas medicinais em Odontologia são reduzidos existindo necessidade de pesquisas com maior força de evidência científica como os ensaios clínicos randomizados para ratificar as propriedades farmacológicas das diferentes espécies, confirmar ou refutar possíveis efeitos adversos, oferecendo mais segurança no uso destes fármacos

OBJECTIVE: To investigate the scientific production of Brazilian dental research involving herbal medicines through a bibliometric study. METHODS: A cross-sectional study was conducted by means of indirect observation of abstracts published at the Annual Meeting of the Brazilian Society for Dental Research in the period between 2006 and 2010. Studies were characterized according to year, region of origin, plant species studied, pharmacological activity, of knowledge, study design, funding received and funding agency. Data collection was carried out by two examiners who used a specific form to record the data. Information was analyzed by Epi Info and underwent descriptive statistics. RESULTS: The sample consisted of 292 works (1.8%), most of which were performed in Southeastern Brazil (59.6%), mainly in São Paulo (51.3%). The most frequently pharmacological activity assessed was the antimicrobial effect (62.7%), followed by tissue repair activity (14.4%). In vitro studies accounted for 63.4% and in vivo study model with rats was the most used (96.2%). CONCLUSION: A few studies approaching medicinal plants in dentistry may be found. Therefore, there is a need for further research with greater scientific evidence level such as randomized clinical trials, in order to confirm the pharmacological properties of different plant species and to confirm or refute possible adverse effects, thus providing more security for the use of these drugs

A critical review of Dr. Charles S. Greene's article titled "Managing the Care of Patients with Temporomandibular Disorders: a new Guideline for Care" and a revision of the American Association for Dental Research's 1996 policy statement on temporomandibular disorders, approved by the AADR Council in March 2010, published in the Journal of the American Dental Association September 2010.

Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.

Research and clinical findings--a wholistic view.

Valuable information is available to clinicians both from research articles, and reports from clinicians. Both sources have limitations. Research, with the exception of longitudinal studies, tends to isolate a variable or two from the whole, limiting its usefulness. Clinical techniques reported are sometimes biased, and perform well for certain therapists in certain settings, and not so well for others. Interrelationships are important among variables such as dentition, anatomy, physiology, oral muscle functions, oral rest postures, eating, and speech. Each affects the others. Equally important are interrelationships among all the specialists who treat patients with orofacial myofunctional disorders. A wholistic approach to the evaluation and treatment of orofacial disorders is advocated.

Emprego do óleo de Melaleuca alternifolia Cheel (Myrtaceae) na odontologia: perspectivas quanto à utilização como antimicrobiano alternativo às doenças infecciosas de origem bucal / Use of Melaleuca alternifolia Cheel (Myrtaceae) oil in dentistry: perspectives on its use as alternative antimicrobial to infectious diseases of oral origin

O interesse por medicamentos alternativos, principalmente daqueles provenientes de extratos naturais, tem aumentado nas últimas décadas. A Melaleuca alternifolia é um arbusto pertencente ao gênero Melaleuca, popularmente conhecida como "árvore de chá", cujo principal produto é o óleo essencial (TTO - tea tree oil), de grande importância medicinal por possuir comprovada ação bactericida e antifúngica contra diversos patógenos humanos. Em virtude da atividade terapêutica em diversas especialidades médicas, o TTO passou a ser empregado na área odontológica. Esta revisão de literatura foi realizada com o objetivo de discutir os ensaios já realizados com o TTO contra microrganismos relacionados à doença cárie, doença periodontal e problemas pulpares. O óleo de Melaleuca tem demonstrado boa ação antibacteriana in vitro contra microrganismos bucais, porém, pesquisas envolvendo o estudo do mecanismo de ação sobre as células microbianas ou estudos in vivo ainda são escassos e precisam ser realizados, já que esse produto pode ser útil na odontologia, seja na manutenção química da higiene ou prevenção de doenças bucais.

The interest in alternative medicines, especially those from natural extracts, has increased in recent decades. Melaleuca alternifolia is a shrub belonging to the genus Melaleuca, popularly known as "tea tree", the main product of which is its essential oil (TTO - tea tree oil), of great medicinal importance for its proven bactericidal and antifungal activity against several human pathogens. By virtue of its therapeutic activity in various medical specialties, TTO is now used in dentistry. This literature review was conducted in order to discuss the tests already carried out with TTO against microorganisms related to dental caries, periodontal disease and pulpal problems. Melaleuca oil has shown good in vitro antibacterial activity against oral microorganisms; however, research involving the study of its mechanism of action on the microbial cells or in vivo studies are still scarce and need to be done since this product may be useful in dentistry, either in the chemical maintenance of hygiene or in the prevention of oral diseases.

Alternative careers in pediatric dentistry: a survey of pediatric dental residents.

Pediatric dentistry has enjoyed growing popularity in recent years, yet there remains a need for leadership in academe, research, and public health. In November 2008, the first Maternal and Child Health Bureau-sponsored regional Leadership in Pediatric Dentistry convocation was held at the Columbia University College of Dental Medicine. Seventy-two pediatric dentistry trainees from thirteen programs in the New York City area participated in interactive presentations and exercises. Of the sixty- seven participants who completed a pre-event survey, 93 percent stated they would likely or very likely pursue careers that involved, at least in part, private practice, 55 percent in care of children in Medicaid, 51 percent academics, 36 percent dental public health, and 12 percent research. Barriers related to finances, competence, or work environment/location were perceived by 83 percent for careers involving research, 73 percent for dental public health, 66 percent for providing care to children in Medicaid, 46 percent for academics, and 9 percent for private practice. Results of a pair of pre-event and post-event surveys completed by sixty-three attendees showed no change in reported likelihood to pursue a career alternative except for an increase in the likelihood of working in a practice that accepts Medicaid. The challenge before dental educators is to provide consistent and meaningful opportunities throughout training that encourage residents to consider all career options and to discover how their individual interests mesh with their clinical learning.

Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization.

The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to discussion by those bodies in 2007. At the EB120 and WHA60, the Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further in research capacity building in developing countries, and in strengthening the work so that research is recognized as the foundation of oral heath policy at global level.