Improving oral health in nursing home residents: A process evaluation of a shared oral care intervention.

AIMS AND OBJECTIVES: To evaluate the process of implementing an oral care intervention in nursing homes in a Danish municipality. BACKGROUND: Older people with aged natural dentition require preventive and curative oral health care. An intervention based on principles of situated learning was implemented to establish closer cooperation between dental and nursing staff in nursing homes, leading to improved oral hygiene in nursing home residents. DESIGN: An embedded multiple-case study combined with principles of realist evaluation unfolded in three phases: Formulation of initial programme theory, Testing and Refining the programme theory. The COREQ checklist is followed in reporting. METHODS: Observations, six group interviews and 22 face-to-face interviews with dentists, dental practitioners, nursing home managers, care professionals and residents were conducted in three nursing homes (n = 41). RESULTS: Three main outcomes of a programme theory were identified, relating to (a) residents, in the form of new oral care routines; (b) interdisciplinary working, in the form of professional pride in performing sufficient oral care; (c) organisational level changes, in the form of increased interdisciplinary knowledge sharing. The overarching supportive mechanisms were the creation of relationships between residents, dental practitioners and care professionals as well as nursing home management taking responsibility for structure, planning and knowledge sharing. CONCLUSION: The situated learning perspective supported residents and care professionals' competencies in performing sufficient oral care. The shared oral care intervention supports an individual and multidisciplinary assessment of nursing home residents' ability to self-care concerning oral care. Contextual factors, supportive and restraining mechanisms influence the intervention's success. RELEVANCE TO CLINICAL PRACTICE: Understanding the complexity within interdisciplinary cooperation in primary nursing and unravelling the necessary properties to enhance nursing home residents' oral health care are areas of improvement for care service in nursing homes.

The effects of 1-year treatment with a haemodiafiltration with on-line regeneration of ultrafiltrate (HFR) dialysis on biomarkers of oxidative stress in patients with chronic renal failure.

In the last few years haemodiafiltration with on-line regeneration of ultrafiltrate (HFR) has been shown to have a positive impact on inflammation and oxidative stress biomarkers, but its effect on antioxidant levels and on oxidative damage to biomolecules in the long-term is still unknown. This is a randomised clinical study over 12 months involving 40 patients on haemodialysis, comparing the effect of HFR (n=25) dialysis with haemodialysis with polysulfone (HD-PS, n=15) on oxidative stress. Total antioxidant capacity, enzymatic antioxidant [superoxide dismutase (SOD), catalase and glutathione peroxidase], non-enzymatic (GSH) and biomarkers of oxidative stress (TBARs, carbonyl groups and 8-OH-dG) were evaluated. The antioxidant activity decreased in the lymphocytes of patients dialysed with HFR, with a significant decrease in the enzyme SOD. In the oxidative stress biomarkers, an increase was seen in the levels of 8-OH-dG in patients on HD-PS dialysis but not in those treated with HFR. Throughout the year the changes in antioxidant levels and biomarkers of oxidative damage in patients dialysed with HFR were generally more modest and fluctuated less than those dialysed with HD-PS. Our study indicates that, in general, long-term dialysis with HFR does not modified antioxidant parameters or increases the oxidative damage to biomolecules. The HFR showed to be a biocompatible technique for long-term dialysis.

Tooth Color Change and Erosion: Hydrogen Peroxide Versus Non-peroxide Whitening Strips.

AIM: The study evaluated the efficacy and potential erosion of non-peroxide strips compared to hydrogen peroxide (HP) whitening strips (WSs). METHODS: Color evaluation samples (N=64) were distributed into four groups and treated according to manufacturer's directions. NC: Negative control treated with water; BT: Non-peroxide Brilliant Dissolving Strips; FM: Non-peroxide Fancymay Teeth WSs; WS: Crest 3D Brilliance HP White Strips. A contact-type spectrophotometer was used to measure color at baseline (T1), 1-day posttreatment (T2), and 1-week posttreatment (T3). Teeth were cut to a rectangular block for micro-CT erosion assessment. The samples (N=30) were divided into five groups. In addition to the four groups for color assessment, a positive control (PC) treated with 0.25% citric acid was added. The samples were scanned, reconstructed, and measured for erosion depth using a micro-CT analysis program software. Kruskal-Wallis test was used to determine differences in color change and erosion depth among the groups. Tests of hypotheses were two-sided with an alpha level of 0.05. RESULTS: The mean ΔE*ab at 1-day/1-week posttreatment were 2.4/2.5, 2.8/2.9, 2.8/3.2, and 8.6/11.0 for NC, BT, FM, and WS, respectively. There was a statistically significant difference for ΔE*ab at 1-day and 1-week posttreatment (p<0.001). Group WS had the highest color change, while the other three groups did not differ from each other (p>0.05). Mean erosion depths in microns were 0.52, 0.58, 0.42, 0.49, and 29.55 for NC, BT, FM, WS, and PC, respectively. There was a statistically significant difference among the groups (p=0.004). Group PC had the greatest erosion, while the other groups had negligible erosion that did not differ from each other (p>0.05). CONCLUSION: Peroxide WSs had superior whitening efficacy compared to non-peroxide strips. None of the tested products compromised tooth structure integrity through enamel erosion.

Associations between school-based peer networks and smoking according to socioeconomic status and tobacco control context: protocol for a mixed method systematic review.

BACKGROUND: Smoking remains a major public health concern. School-based social networks influence uptake of smoking among peers. During the past two decades, the UK macro-systemic context within which schools are nested and interact with has changed, with anti-smoking norms having become set at a more macro-systemic level. Whilst the overall prevalence of smoking in the UK has decreased, inequality has prevailed. It is plausible that the influence of school-based social networks on smoking uptake may vary according to socioeconomic status. Therefore, this study aims to understand how social influence on smoking among adolescents has changed in line with variance within and between contexts according to time and geography. METHODS: The following databases will be searched: Medline, PsycINFO, Embase, Applied Social Sciences Index and Abstracts (ASSIA), British Education Index, Sociological abstracts, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC) and Scopus. Additional searches will include reference checking of key papers, citation tracking, word of mouth and grey literature searches. The search strategies will incorporate terms relating to smoking, adolescents, schools, peers, network analysis and qualitative research. Titles and abstracts and full texts will be independently screened and assessed for quality by at least two researchers. Included studies will be assessed for quality, and data will be extracted for synthesis, including participant characteristics, setting and tobacco control context, study design and methods, analysis and results and conclusions. Quantitative findings will be narratively synthesised, whilst a lines of argument synthesis combined with refutational analysis will be employed to synthesise qualitative data. Both sets of findings will be charted on a timeline to add context to network findings and obtain an enhanced understanding of changes over time. DISCUSSION: This protocol is for a mixed methods synthesis of both social network findings, to investigate social structures and qualitative studies, to elicit contextual information. The review will synthesise changes in the context of social influence on adolescent smoking over time and geographically. As context is increasingly recognised as a key source of complexity, this enhanced understanding will help to inform future interventions targeting smoking through social influence. This will help to enhance their relevance to context, subsequent effectiveness and targeting of inequalities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019137358.

Effect of a hemodiafiltration session with on-line regeneration of the ultrafiltrate on oxidative stress. Comparative study with conventional hemodialysis with polysulfone.

BACKGROUND: The influence of a dialysis session using hemodiafiltration with on-line regeneration of the ultrafiltrate (HFR) is compared with that of a conventional hemodialysis session with polysulfone (HD-PS) and with a group of healthy individuals. METHODS: Total antioxidant capacity (TAC), antioxidants, i.e., superoxide dismutase (SOD) glutathione peroxidase (GPX), reduced glutathione (GSH) and catalase, and biomarkers of oxidative stress were evaluated in plasma, whole blood and lymphocytes. RESULTS: The study showed decreased plasma TAC, decreased activities of antioxidant enzymes and decreased GSH levels along with increased thiobarbituric-acid-reactive substances and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels in lymphocytes. The antioxidants and biomarkers of lipid and protein damage after dialysis sessions with HFR were similar or better than following HD-PS. Thus, the blood GPX activity was comparable to that of healthy controls and significantly better than following HD-PS. An increase in 8-OHdG levels was observed in the HD-PS group after dialysis but not in the HFR group. CONCLUSIONS: These results show that HFR induces less oxidative stress than HD-PS.

Complex Odontoma: A Case Report with Micro-Computed Tomography Findings.

Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.

Immunodetection of Parkin protein in vertebrate and invertebrate brains: a comparative study using specific antibodies.

Parkin is an intracellular protein that plays a significant role in the etiopathogenesis of autosomal recessive juvenile parkinsonism. Using immunoblot methods, we found Parkin isoforms varying from 54 to 58 kDa in rat, mouse, bird, frog and fruit-fly brains. Immunocytochemical studies carried out in rats, mice and birds demonstrated multiple cell types bearing the phenotype for Parkin throughout telencephalic, diencephalic, mesencephalic and metencephalic brain structures. While in some instances Parkin-containing neurons tended to be grouped into clusters, the majority of these labeled nerve cells were widely scattered throughout the neuraxis. The topographical distribution and organizational pattern of Parkin within major functional brain circuits was comparable in both rats and mice. However, the subcellular localization of Parkin was found to vary significantly as a function of antibody reactivity. A consistent cytoplasmic labeling for Parkin was observed in rodent tissue incubated with a polyclonal antibody raised against the human Parkin protein and having an identical amino-acid sequence with that of the rat. In contrast, rodent tissue alternately incubated with a polyclonal antibody raised against a different region of the same human Parkin protein but having 10 mismatched amino-acid sequence changes with those of the rat and mouse, resulted in nuclear labeling for Parkin in rat but not mouse neurons. This difference in epitope recognition, however, was reversed when mouse brain tissue was heated at 80 degrees C, apparently unmasking target epitopes against which the antisera were directed. Collectively, these results show a high degree of conservation in the cellular identity of Parkin in animals as different as drosophilids and mammals and points to the possibility that the biochemical specificities of Parkin, including analogous functional roles, may have been conserved during the course of evolution.

Salivary amylase promotes adhesion of oral streptococci to hydroxyapatite.

Recent studies have demonstrated that several species of oral streptococci, such as Streptococcus gordonii, bind soluble salivary alpha-amylase. The goal of the present study was to determine if amylase immobilized onto a surface such as hydroxyapatite can serve as an adhesion receptor for S. gordonii. Initially, human parotid saliva was fractionated on Bio-Gel P60, and fractions were screened for their ability to promote adhesion of S. gordonii to hydroxyapatite. Fractions containing alpha-amylase and proline-rich proteins promoted the adhesion of [3H]-labeled S. gordonii to hydroxyapatite. Similar findings were obtained with purified amylase and acidic proline-rich protein 1 (PRP1). Incubation of S. gordonii G9B in the presence of starch and maltotriose increased the binding of this strain to amylase-coated hydroxyapatite, while the adhesion of S. sanguis 10556 to amylase-coated hydroxyapatite was not affected by these saccharides. These results suggest that amylase may serve as a hydroxyapatite pellicle receptor for amylase-binding streptococci. Furthermore, starch and starch metabolites may enhance the adhesion of amylase-binding streptococci to amylase in dental pellicles to augment the formation of dental plaque.

Mesiodens en dentición primaria / Mesiodens in the primary dentition

Los dientes supernumerarios son alteraciones del desarrollo que aparecen en cualquier región de los maxilares. Su etiología no es bien conocida; sin embargo se postula que son el resultado de la "duplicación" de la lámina dental. Los mesiodens pueden causar varias complicaciones como apiñamiento, retraso en la erupción o desplazamiento de los órganos dentarios. El diagnostico se realiza de manera clínica y radiográfica. Se reporta el caso de manejo clínico en un paciente masculino de 5 años de edad con un mesiodens en el maxilar superior, que acudió al Hospital Dos de Mayo, servicio de odontopediatria. A la exploración intraoral se observó un diente supernumerario molariforme semi erupcionado, y el análisis de radiografía mostro la presencia de un órgano dentario en la línea media. Debido al desplazamiento observado de los órganos dentarios permanentes, se decidió realizar la extracción del supernumerario de manera convencional...

Supernumerary teeth are developmental disorders that can appear in any maxillary region. Whilst their etiology is not well-known, it has been postulated that they are the result of a "doubling" of the dental lamina. Mesiodens can cause several complications, such as the crowding, delayed eruption or displacement of dental organs. Diagnosis is carried out clinically and radiographically. For clinical management is reported in a male patient of 5 years with a mesiodens in the maxilla, who was treated at Hospital Dos de Mayo, odontopediatry service. Intraoral examination revealed a molariform supernumerary tooth eruption, and x-ray analysis showed the presence of an dental organ in the midline. Due to the observed displacement of permanent teeth, it was decided that the supernumerary would be removed in the conventional manner...

Auto percepción del impacto de caries dental en al calidad de vida en escolares de 11 a 14 años de edad / Self-perception of the impact of dental caries on quality of life of school children 11 to 14 years old

El objetivo de este presente estudio descriptivo y transversal fue determinar la influencia de la caries dental en la calidad de vida relacionada a la salud bucal de los alumnos de 11 a 14 años de la LE.E. "José Granda" del distrito de San Martin de Porres. Para este prop6sito se evaluó una muestra aleatoria de 131 alumnos de 11 a 14 años de edad. El instrumento que se utilizó fue un cuestionario CPQ 11-14' el cual fue completado por los alumnos y se registró la caries dental en condiciones de campo a través del índice de CPOD. La consistencia interna se evaluó mediante el coeficiente alfa de Cronbach. Así mismo, se realiz6 el coeficiente de correlación de Spearman y la prueba de Mann-Whitney. El análisis estadístico se realiz6 en el software STA-TA12. Se obtuvo como resultado que la media del CPQn_14 fue de 28.99 (+/-16.76). La consistencia interna fue de 0.91 confirmado por el alfa de Cronbach. CPQn_14 fue capaz de discriminar entre los niños con y sin experiencia de caries (p= 0,0402). Los dominios de bienestar emocional y social mostraron una fuerte asociaci6n con la calidad de vida (p = 0.0583 Y P = 0.0205, respectivamente). Concluyendo que la experiencia de caries dental influye negativamente en la calidad de vida relacionada a la salud bucal, demostrando la necesidad de considerar la caries dental en las estrategias para la promoción de la salud bucal de los escolares...

The aim of the present descriptive cross-sectional study was to determine the influence of tooth decay in the quality of life related to oral health of students aged 11 to 14 years of the LE.E."Jose Granda" district of San Martin de Porres. For this purpose was evaluated a random sample of 131 students aged 11 to 14 years old. The instrument used was a questionnaire CPQn_14' which was completed by the students and was recorded the tooth decay under field conditions through the index of DMFT. Internal consistency was assessed using Cronbach's alpha coefficient. Likewise, the Spearman correlation coefficient and the Mann-Whitney test was performed. Statistical analysis was performed on the STATA12 software. Was obtained as a result that the mean CPQn_14 was 28.99 (+/- 16.76). Internal consistency was 0.91 confirmed by Cronbach's alpha. CPQn_14 was able to discriminate between children with dental caries experience and those without (p = 0.0402). The domains of emotional and social well-being showed a strong association with quality of life (p = 0.0583 and p = 0.0205, respectively). Concluding that tooth decay experience negative influence on the quality of life related to oral health, demonstrating the need to consider dental caries in strategies to promote oral health of schoolchildren...

Glosectomia parcial más vaciamiento de niveles cervicalesI, II, III en el manejo del cáncer de lengua móvil / Parcial glossectomy and neck dissection levels I, II, III in the management of the mobile tongue cancer

Introducción: La incidencia del cáncer escamocelular de lengua ha venido incrementándose en las últimas décadas. Su presentación más usual es en el borde lateral, en la unión entre el tercio medio y posterior. Es más frecuente en hombres y se asocia con ingesta de alcohol y tabaco, radiación ultravioleta, virus humanos (papilomavirus), entre otros. Objetivo: Presentar el caso y técnica quirúrgica realizada en una paciente con carcinoma escamocelular de borde lateral de lengua estadio III, requiriendo glosectomía parcial más vaciamiento cervical de niveles I, II y III ipsilateral y radioterapia postoperatoria. Diseño: Reporte de caso. Materiales y métodos: Se presenta el caso de una mujer de 60 años que consultó por 5 meses de presencia de masa en lengua con limitación para la protrusión lingual, dolor con la ingesta de alimentos y otalgia izquierda, con biopsia que reportó carcinoma escamocelular infiltrante moderadamente diferenciado. Resultados: El reporte de patología confirmó carcinoma escamocelular bien diferenciado queratinizante infiltrante con márgenes libres y vaciamiento ganglionar con 2 niveles ganglionares comprometidos por tumor, indicándose Radioterapia postoperatoria. Dos años después de tratamiento, paciente no ha presentado recurrencia de lesión tumoral. Conclusiones: Al igual que el manejo quirúrgico del tumor primario y las diversas formas de reconstrucción del defecto por la glosectomía, los autores apoyamos la disección electiva supraomohioidea de cuello en pacientes N0, ya que el control de la enfermedad del cuello y la supervivencia pueden mejorar significativamente, si se realiza la disección cervical antes que las metástasis se hagan clínicamente evidentes.

Introduction: The incidence of squamous cell tongue cancer has been increasing in recent decades. Its most common presentation is on the lateral edge, at the junction of the middle and posterior third. It is more common in men and is associated with intake of alcohol and snuff, ultraviolet radiation, human viruses (human papillomavirus), among others. Objective: To present the case and surgical technique performed on a patient with squamous cell carcinoma of the tongue side edge Stage III, requiring partial glossectomy's neck dissection of levels I, II and III ipsilateral and postoperative radiotherapy. Design: Case report. Materials and Methods: We present the case of a 60 year old patient with five months of presence of a mass on tongue with limitation for protrusion, pain with food intake and left otalgia, whose biopsy reported invasive squamous cell carcinoma is presented moderately differentiated. Results: The pathology confirmed invasive squamous cell carcinoma keratinizing, well differentiated with clear margins and lymph node dissection with 2 nodal levels involved by tumor, indicating postoperative radiotherapy. Two years after treatment, patient has had no recurrence of tumor lesion. Conclusions: As with the surgical management of the primary tumor and various forms of reconstruction of the defect by glossectomy, the authors support supraomohyoid elective neck dissection N0 patients as disease control and survival neck can improve significantly, if cervical dissection is performed before metastases are clinically apparent.

Relación entre el período de lactancia materna y el desarrollo del arco dentario superior deciduo / Relationship between breastfeeding and development of deciduous upper dental arch

El propósito de este estudio fue evaluar la relación que existe entre el periodo de lactancia materna y el desarrollo de la arcada dentaria superior. Se relacionaron 58 niños entre 3 y 6 años de edad, de la Clínica del Niño y del Bebe de la UIGV "Pueblo Libre" - Lima. Se midieron en los modelos de estudio el tipo de arco, presencia de espacios primate s, profundidad pala tina, forma, longitud, perímetro y ancho del arco superior; encontrándose diferencia estadísticamente significativa (p<0,05) mediante la prueba de Chi-cuadrado en la distancia intermolar en el arco dentario superior decidua para un periodo de lactancia mixta adecuada. Asimismo, en las restantes características mayor prevalencia sin diferencia estadísticamente significativa. En conclusión, en la siguiente investigación se encontró relación entre el período de lactancia materna y la distancia intermolar en el arco dentario superior decidua...

The purpose of this study was to evaluate the relationship between the period of breastfeeding and the development of the upper dental arch. Fifty-eight children between 3 and 6 years old were evaluated at the Children and Baby Dental Clinic of the UIGV "Pueblo Libre" - Lima. In the study casts were measured the type of arc, the presence of primate spaces, palatal depth, shape, length, perimeter and width of the upper arch, finding statistically significant difference (p <0.05) through chi-square test at intermolar distance in the deciduous upper dental arch for a suitable mixed breastfeeding. Further, the other characteristics show more prevalence with no statistically significant difference. In conclusion, in this research was found a relationship between the period of breastfeeding and the intermolar distance in the deciduous upper dental arch...

Fauna de flebotmmíneos (diptera: psychodidae) en acandí (chocó, Colombia) / Fauna of Phlebotominae (Diptera: Psychodidae) in Acandí (Chocó, Colombia)

La región geográfica denominada Chocó-Darién-Caribe es uno de los ecosistemas de bosque húmedo tropical de gran diversidad, pero aún poco explorado. El presente estudio documenta algunas especies de flebotomíneos colectados en un área de transmisión de leishmaniasis cutánea. Se realizó un estudio entomológico en la reserva natural el Aguacate, municipio de Acandí, Chocó. La metodología incluyó el uso de trampas de luz CDC y búsqueda activa en raíces tabulares, colectando con aspiradores bucales. Se recolectaron 1.205 individuos, de los cuales sobresalen Lutzomyia panamensis, Lutzomyia trapidoi, Lutzomyia gomezi, Lutzomyia sanguinaria, Lutzomyia olmeca bicolor y Lutzomyia hartmanni reconocidos como vectores potenciales de leishmaniasis cutánea en el nuevo mundo. Se relata el hallazgo de 16 especies del género Lutzomyia França y dos especies del género Brumptomyia Sherlock para la costa del Darién-Caribe colombiano, destacando la presencia de las especies Lutzomyia atroclavata (Knab) y Brumptomyia mesai (Sherlock) como nuevos registros para el departamento del Chocó. Este estudio aporta al conocimiento de la fauna de flebotomíneos del municipio de Acandí, Chocó.

The geographic region called Chocó-Darién-Caribe is a tropical forest ecosystem considered of great diversity but still a poorly known region. The current study focuses on some phlebotominae species collected in a geographic area where it has been documented cutaneous leishmaniasis transmission. An entomological study was conducted at the Natural Reserve El Aguacate, in Acandí municipality, Chocó. Sampling methods included light traps such as CDC and collections of adult sand flies in resting sites such as tree buttresses using mouth aspirators devices. The collection findings comprise a total of 1205 phlebotominae adults, with some species of note such as Lutzomyia panamensis, Lutzomyia trapidoi, Lutzomyia gomezi, Lutzomyia sanguinaria, Lutzomyia olmeca bicolor and Lutzomyia hartmanni which are recognized as potential vectors of cutaneous leishmaniasis in the new world. Sixteen species of the genus Lutzomyia França and two species of the genus Brumptomyia Sherlock are recorded for the colombian Darién-Caribe region. The species Lutzomyia atroclavata (Knab) and Brumptomyia mesai (Sherlock) are new findings in Chocó. This study is a contribution to the phlebotominae species of Acandí municipality in Chocó.

Salivary alpha-amylase: role in dental plaque and caries formation.

Salivary alpha-amylase, one of the most plentiful components in human saliva, has at least three distinct biological functions. The enzymatic activity of alpha-amylase undoubtedly plays a role in carbohydrate digestion. Amylase in solution binds with high affinity to a selected group of oral streptococci, a function that may contribute to bacterial clearance and nutrition. The fact that alpha-amylase is also found in acquired enamel pellicle suggests a role in the adhesion of alpha-amylase-binding bacteria. All of these biological activities seem to depend on an intact enzyme conformation. Binding of alpha-amylase to bacteria and teeth may have important implications for dental plaque and caries formation. alpha-Amylase bound to bacteria in plaque may facilitate dietary starch hydrolysis to provide additional glucose for metabolism by plaque microorganisms in close proximity to the tooth surface. The resulting lactic acid produced may be added to the pool of acid in plaque to contribute to tooth demineralization.

A new approach to combatting iodine deficiency in developing countries: the controlled release of iodine in water by a silicone elastomer.

OBJECTIVES: Four hundred million people or more may be exposed to iodine deficiency worldwide, in developing countries in particular. Because of the practical problems with existing methods for the large-scale prevention of iodine deficiency, the authors developed a new approach to collective prophylaxis. METHODS: This approach relies on the controlled diffusion of iodine into water from a silicone elastomer. Silicone matrices installed in a bore well released iodine at a rate sufficient to permit the daily per capita intake of at least 100 micrograms of iodine, the amount recommended by the World Health Organization. The matrices were tested over 1 year in a village in Mali, West Africa, an area in which goiter was highly endemic. The effects on the well water and population were compared with those of a placebo system in a control village. RESULTS: An increase in urinary iodine levels was observed in the treated population, and after 12 months the incidence of goiter had fallen from 53.2% to 29.2%. CONCLUSIONS: This new concept, adaptable to all sources of water supply, may contribute to the eradication of iodine deficiency.

[Community trial for the evaluation of the fluoride mouthwash program among students in Palma de Mallorca]. / Ensayo comunitario de evaluación del programa de enjuagues con flúor en los escolares de Palma de Mallorca.

It is presented the assessment of the weekly fluoride mouthwash program conducted among public primary school students in Palma de Majorca, Balearic Islands, Spain. It was carried out with students of 5th year (aged 10 years old) who had been participating in the program for four years. The prevalence of caries according to the CFLT index (Cavity Filling Lost Tooth) in those students who followed the program is compared with the rest of the 5th year students to whom the program was not applied. According to the CFLT index, the difference noticed between the two groups was 21.15%. This caused a 0.52% reduction of decayed pieces per child following the program. In the same way, the restoration index is 50% higher in the group of intervention than in that of control.

Sustitutivos óseos de fosfato tricálcico / Bone substitutes of tricalcium phosphate

Introduction: Tricalcium phosphate ceramics are biocompatible and biodegradable porous materials that can be formulated as bone cements or preformed as blocks, granules or powders. Material and method: The in vivo behaviour in an animal model was studied for a-tricalcium phosphate cement (CFalphaT) and for a-tricalcium phosphate ceramic (CFbetaT), materials which were compared with the fresh cancellous bone graft (AOEF). Eighteen New Zealand rabbits were used, which were implanted in cavitary defects created in the right distal femoral metaphysis, being evaluated microscopically at 12 weeks. Results: The histologic study demonstrated that the 3 implants were osteointegred and replaced by neoformed bone. The histomorphometric study determined that bone neoformation obtained at l2 weeks was equivalent, without significant statistically differences, for the 3 evaluated bone substitutes. The area of no reabsorbed biomaterial was lightly bigger for the CFbetaT, although without significant statistically differences (p < 0.05). Conclusion: Tricalcium phosphate ceramics are useful biomaterials in bone replacement, because they contribute to create an osteoconductive scaffold which is progressively replaced by neoformed bone.

Introducción: Las cerámicas de fosfato tricálcico son materiales porosos biocompatibles y biodegradables que pueden ser formuladas como cementos óseos o preformadas como bloques, gránulos o polvos. Material y Método: Se estudió el comportamiento in vivo, en un modelo animal, de un cemento de fosfato a-tricálcico (CFalfaT) y una cerámica de fosfato beta-tricálcico (CFbetaT), materiales que fueron comparados con el autoinjerto Óseo esponjoso fresco (AOEF). Se emplearon 18 conejos Nueva Zelanda los que fueron implantados en defectos cavitarios creados en la metáfisis femoral distal derecha, siendo evaluados microscópicamente a las 12 semanas. Resultados: El estudio histológico demostró que los 3 implantes se osteointegraron y fueron reemplazados por hueso neoformado. El estudio histomorfométrico determinó que la neoformación ósea obtenida a las 12 semanas fue equivalente, sin diferencias estadísticamente significativas, para los 3 sustitutivos óseos evaluados. El área de biomaterial no reabsorbido fue ligeramente mayor para la CFbetaT, aunque sin diferencias estadísticamente significativas (p < 0,(5). Conclusión: Las cerámicas de fosfino tricálcico son biomateriales útiles para rellenar defectos Óseos, dado que aportan un molde estructural osteoconductivo que en forma progresiva es reemplazado por tejido óseo neoformado.

Principios de administración odontológica / Dentistry administration principles

Plantea las dos dimensiones de la administración odontológica: la administración a través de instituciones públicas de salud y la administración de carácter privado. Aborda las actividades odontológicas tales como promoción y educación para la salud bucal, exámenes bucales, levantamiento de índices, aplicación de entrevistas y encuestas utilizando básicamente el método epidemiológico. Incluye la aplicación del proceso administrativo a las actividades de la clínica integral, el uso del método clínico y el epidemiológico. También se abordan algunas normas legales que regulan el ejercicio profesional del odontólogo