Childhood Obesity and Delayed Gratification Behavior: A Systematic Review of Experimental Studies.

OBJECTIVE: To evaluate the extent of the association between instant gratification behavior and childhood obesity. STUDY DESIGN: PubMed, Scopus, EMBASE, EBSCOhost, and Cochrane databases were searched for the terms delayed gratification, children, and obesity. Studies were eligible if they included a sample of at least 100 children who were made to choose between an immediate reward and a larger one later, with the authors comparing the response in different populations and observing some relationship with obesity. A specifically designed data extraction form was used, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodologic quality of the included studies was assessed with the methodologic index for nonrandomized studies. RESULTS: Nine articles were included after we applied the inclusion and exclusion criteria. Almost all studies conducted the test in populations of preschool children and offered food and/or nonfood rewards. The studies found a clear relationship between an inability to defer gratification and overweight and obesity. The quality assessment of the publications was ranked high in 5 studies and medium in 4. CONCLUSIONS: Children with the inability to delay gratification are more likely to be overweight or obese. Observation of such trends is useful in its implications for reeducation programs. Although the methodologic quality of the eligible studies was acceptable, additional experimental controlled studies are required to associate these behaviors with other aspects.

Effectiveness of biologic methods of inhibiting orthodontic tooth movement in animal studies.

INTRODUCTION: A number of biologic methods leading to decreased rates of orthodontic tooth movement (OTM) can be found in the recent literature. The aim of this systematic review was to provide an overview of biologic methods and their effects on OTM inhibition. METHODS: An electronic search was performed up to January 2016. Two researchers independently selected the studies (kappa index, 0.8) using the selection criteria established in the PRISMA statement. The methodologic quality of the articles was assessed objectively according to the Methodological Index for Non-Randomized Studies scale. RESULTS: We retrieved 861 articles in the initial electronic search, and 57 were finally analyzed. Three biologic techniques were identified as reducing the rate of OTM: chemical methods, low-level laser therapy, and gene therapy. When the experimental objective was to slow down OTM, pharmacologic modulation was the most frequently described method (53 articles). Rats were the most frequent model (38 of 57 articles), followed by mice (9 of 57), rabbits (4 of 57), guinea pigs (2 of 57), dogs (2 of 57), cats (1 of 57), and monkeys (1 of 57). The sample sizes seldom exceeded 25 subjects per group (6 of 57 articles). The application protocols, quality, and effectiveness of the different biologic methods in reducing OTM varied widely. CONCLUSIONS: OTM inhibition was experimentally tested with various biologic methods that were notably effective at bench scale, although their clinical applicability to humans was rarely tested further. Rigorous randomized clinical trials are therefore needed to allow the orthodontist to improve the effect of translating them from bench to clinic.

Dental fear in children: the role of previous negative dental experiences.

OBJECTIVES: The aims of this study were to determine the potential main sources of anxiety in children visiting the dental office and to examine whether negative experiences influence the development of dental fear. METHODS: Six hundred six subjects from the same pediatric dental office were consecutively invited to participate in the study (303 children/303 parents). An adapted version of the Wong-Baker FACES Pain Rating Scale and Corah's Dental Anxiety Scale were used to rate anxiety in children and parents. Clinical variables were collected by the same experienced pediatric dentist, with a view to determining their potential influence upon the development of fears. Descriptive statistics (mean, standard deviation), along with the Mann-Whitney U test, were used to determine the association between clinical variables and anxiety levels. Correlations were established using the Spearman coefficient (r) (p < 0.05). RESULTS: No statistical differences were observed in anxiety levels with respect to patient gender (p > 0.05). Greater anxiety levels were observed in 4- and 5-year-old children (n = 56/55, respectively), with a negative correlation between age and anxiety level (r = -0.176; p = 0.002) and between parent anxiety level and patient age (r = -0.154; p = 0.007). A strong positive correlation was found between the anxiety levels of the parents and children (r = 0.954; p < 0.001). In addition, a moderate positive correlation was found between elevated anxiety levels in children (r = 0.381; p < 0.001) and parents (r = 0.454; p < .001) and the number of previous treatments in other dental offices. CONCLUSIONS: Dental fear in children is strongly associated with inadequate dental management, causing anxiety levels to increase in both the children and parents.

GWAS of Post-Orthodontic Aggressive External Apical Root Resorption Identified Multiple Putative Loci at X-Y Chromosomes.

Personalized dental medicine requires from precise and customized genomic diagnostic. To conduct an association analysis over multiple putative loci and genes located at chromosomes 2, 4, 8, 12, 18, X, and Y, potentially implicated in an extreme type of external apical root resorption secondary to orthodontic forces (aEARR). A genome-wide association study of aEARR was conducted with 480 patients [ratio~1:3 case/control]. Genomic DNA was extracted and analyzed using the high-throughput Axiom platform with the GeneTitan® MC Instrument. Up to 14,377 single nucleotide polymorphisms (SNPs) were selected at candidate regions and clinical/diagnostic data were recorded. A descriptive analysis of the data along with a backward conditional binary logistic regression was used to calculate odds ratios, with 95% confidence intervals [p < 0.05]. To select the best SNP candidates, a logistic regression model was fitted assuming a log-additive genetic model using R software [p < 0.0001]. In this sample the top lead genetic variants associated with aEARR were two novel putative genes located in the X chromosome, specifically, STAG 2 gene, rs151184635 and RP1-30E17.2 gene, rs55839915. These variants were found to be associated with an increased risk of aEARR, particularly restricted to men [OR: 6.09; 95%CI: 2.6-14.23 and OR: 6.86; 95%CI: 2.65-17.81, respectively]. Marginal associations were found at previously studied variants such as SSP1: rs11730582 [OR: 0.54; 95%CI: 0.34-0.86; p = 0.008], P2RX7: rs1718119 [OR: 0.6; 95%CI: 0.36-1.01; p = 0.047], and TNFRSF11A: rs8086340 [OR: 0.6; 95%CI: 0.38-0.95; p = 0.024]), found solely in females. Multiple putative genetic variants located at chromosomes X and Y are potentially implicated in an extreme phenotype of aEARR. A gender-linked association was noted.

Uso de una checklist para reducir los errores cognitivos en la enseñanza práctica odontológica / Use of checklist to reduce cognitive errors in dental practice teaching

Introducción: Las estrategias de razonamiento heurístico predominan en el ámbito clínico. En odontología, y en particular en la práctica clínica diaria ortodóncica, se hace esencial diagnosticar bajo condiciones de presión, lo que fomenta los errores cognitivos por parte de los alumnos. El objetivo de este estudio fue proponer y validar una checklist como herramienta para disminuir los errores cognitivos diagnósticos por parte de los alumnos. Sujetos y métodos: Treinta y seis estudiantes posgraduados realizaron dos evaluaciones clínicas de pacientes, una de la manera tradicional y otra aplicando la checklist propuesta. Resultados: Se produjo una disminución estadísticamente significativa (p < 0,05) en los errores mediante la prueba de los rangos de Wilcoxon tras el uso de la checklist. Conclusiones: La checklist propuesta ha demostrado su eficacia y ha sido evaluada positivamente por los alumnos; sin embargo, se debe prestar especial atención a los errores cognitivos de comisión porque aumenta de manera considerable su proporción (AU)

Introduction: Heuristic reasoning often dominate clinical judgments. Decision-making process in dentistry, and especially in orthodontics, is carry out under conditions of complexity and uncertainty. Therefore, the student decision processes are flawed by cognitive biases. The aim of our study was suggest and validate a checklist to reduce student diagnostic cognitive biases. Subjects and methods: Thirty-six postgraduate students evaluated clinically patients without checklist and using the proposed checklist. Results: Statistically significant difference (p < 0.05) was found using the Wilcoxon matched signed-rank test between two evaluations. Conclusions: Effectiveness is prove by using the proposed checklist in reduce student cognitive errors and students have been positively evaluated it. Nevertheless, special attention is required to new increment of proportion of commission cognitive errors (AU)