Clinical evaluation of a new chemically-cured bulk-fill composite in posterior restorations: 6-month multicenter double-blind randomized clinical trial.

OBJECTIVE: To evaluate the postoperative sensitivity (POS), as well as the clinical performance of posterior restorations using a new chemically-cured bulk-fill composite (Stela Automix and Stela Capsule, SDI) comparing with a light-cured bulk-fill composite after 6 months. METHODS: Fifty-five participants with at least three posterior teeth needing restoration were recruited. A total of 165 restorations were performed on Class I or Class II cavities. After the application of Stela primer, the chemically-cured composite (Stela Automix or Stela Capsule) was inserted. For the light-cured composite group, a universal adhesive (Scotchbond Universal) was applied with a bulk-fill composite (Filtek One). Participants were evaluated for spontaneous and stimulated POS in the baseline, after 48 h, 7 days, and 6 months. Additionally, each restoration was assessed using the updated version of FDI criteria after 6 months. The differences in the proportions of the groups were compared by Cochran test statistics (α = 0.05). RESULTS: Both chemically-cured composites showed a lower risk of POS compared to the light-cured composite at baseline and up to 48 h (p < 0.04). A significantly lower surface luster and texture was observed for the Stela Capsule composite compared to the light-cured bulk-fill composite (baseline and 6 months; p = 0.03). A significant color mismatch was observed for the light-cured bulk-fill composite compared to the chemically-cured composites (baseline and 6 months; p = 0.03). No significant differences were observed in any other item evaluations (p > 0.05). CONCLUSION: Chemically-cured composites exhibit lower postoperative sensitivity and less color mismatch compared to a light-cured bulk-fill composite after 6 months of clinical service. CLINICAL SIGNIFICANCE: The chemically-cured composites appear to be an appealing option for restoring posterior teeth, as they exhibit lower postoperative sensitivity compared to a light-cured bulk-fill composite, both at baseline and up to 48 h, and less color mismatch.

Level of knowledge of Covid-19 among students, teachers and administrative staff belonging to the Facultad de Odontología, Universidad Central del Ecuador / Nivel de conocimiento de Covid-19 entre estudiantes, docentes y personal administrativo que pertenecen a la Facultad de Odontología de la Universidad Central del Ecuador

Introducción: Covid-19, una enfermedad letal que ha provocado estragos a nivel mundial causó una pandemia, afectando a casi todos los aspectos de la vida humana, por lo cual, se debe adquirir conocimientos sobre prevención, formar actitudes y comportamientos positivos para evitar más contagios y muertes. El objetivo fue determinar el nivel de conocimiento de Covid-19 entre estudiantes, docentes y personal administrativo que pertenecen a la Facultad de Odontología de la Universidad Central del Ecuador. Métodos: estudio observacional, analítico transversal, con una muestra conformada por 275 participantes entre docentes odontólogos, personal administrativo, estudiantes de pregrado y posgrado. Previo al estudio se realizó la traducción del cuestionario: Covid-19 Awareness Among Healthcare Students and Professionals in Mumbai Metropolitan Region: A Questionnaire-Based Survey, de inglés a español, siguiendo los debidos procesos de preparación, conciliación, retrotraducción, e informe final. Una vez establecida la fiabilidad del cuestionario (consistencia interna CCI= 0,89 y Alpha de Cronbach α= 0,63) se aplicó a la muestra total previo diseño en Google Forms y enviado a través de correo electrónico. Los datos fueron analizados en el programa estadístico SPSS v. 26 mediante la prueba de Chi-Cuadrado. Resultados: el promedio establecido del valor de la mediana mostró que los estudiantes de pregrado y los profesionales con un nivel educativo de tercer nivel tuvieron un mayor nivel de conocimientos que los otros grupos (p=0,014 y 0,012) respectivamente. Conclusiones: el grupo etario de 18 a 30 años, los estudiantes de universitarios de pregrado y los profesionales con el título de tercer nivel tuvieron un mejor nivel de conocimientos sobre Covid-19.

Introduction: Covid-19, a lethal disease that has wreaked havoc worldwide caused a pandemic, affecting almost all aspects of human life, therefore, it is necessary to acquire knowledge about prevention, form positive attitudes and behaviors to avoid more contagions and deaths. The objective was to determine the level of knowledge of Covid-19 among students, teachers and administrative personnel belonging to the Faculty of Dentistry of the Central University of Ecuador. Methods: observational, cross-sectional analytical study, with a sample of 275 participants including dental teachers, administrative personnel, undergraduate and graduate students. Prior to the study, the questionnaire Covid-19 Awareness Among Healthcare Students and Professionals in Mumbai Metropolitan Region: A Questionnaire-Based Survey was translated from English into Spanish, following the due processes of preparation, reconciliation, back-translation and final report. Once the reliability of the questionnaire was established (internal consistency CCI= 0,89 and Cronbach's Alpha α= 0,63), it was applied to the total sample after being designed in Google Forms and sent via e-mail. The data were analyzed in the SPSS v. 26 statistical program using the Chi-Square test. Results: the established average of the median value showed that undergraduate students and professionals with a third level education had a higher level of knowledge than the other groups (p=0,014 and 0,012) respectively. Conclusions: the age group 18-30 years, undergraduate university students and professionals with third level degree had a better level of knowledge about Covid-19.

Prevalence of Dental Caries in Schoolchildren from the Galapagos Islands: ESSO-Gal Cohort Report.

Objective: Dental caries remains a prevalent disease worldwide. Several epidemiological studies have shown that it affects the oral health of the pediatric population, and the Galapagos population in Ecuador is no exception. The aim of this study was to determine the prevalence of dental caries and its association, based on baseline information from the Galapagos Oral Health Study (ESSO-Gal), in children of the Galapagos Islands, Ecuador. Methods: A cross-sectional study was conducted involving 804 children aged 2-11 years. The prevalence of dental caries was assessed using the International Caries Detection and Assessment System (ICDAS II) criteria, while the presence of dental biofilm was assessed using the Silness-Löe index. Descriptive statistics, including frequency analysis and measures of central tendency and dispersion, were performed. Inferential statistical analyses were conducted to identify associations between variables. Statistical analyses were performed using the SPSS version 25.0 statistical program. Results: The caries prevalence rates based on ICDAS II codes 1-6, 1-2, and 3-6 were 98.01%, 96.9%, and 85%, respectively. A statistically significant difference was observed among the different islands regarding the cutoff point for ICDAS II codes 3-6 (p ≤ 0.001). Participants aged 6-11 years had the highest caries prevalence. Conclusions: The results show a high prevalence of dental caries among children in the Galapagos Islands, which increases with age. Contrary to expectations, the study did not find a significant correlation between the severity of dental caries and the presence of dental biofilm.

Distribution of Dental Fluorosis in the Southern Zone of Ecuador: An Epidemiological Study.

In recent decades, the increase in fluoride exposure has raised the numbers of dental fluorosis in fluoridated and non-fluoridated communities In Ecuador, but the last national epidemiological study on DF was conducted more than a decade ago. The objective of this cross-sectional descriptive study was to determine the prevalence, distribution and severity of dental fluorosis (DF) using the Dean index in 1606 schoolchildren aged 6 to 12 years from urban and rural environments in provinces that make up the Southern Region of Ecuador. Participants met the inclusion criteria which were age, locality, informed consent document and no legal impediment. The results are presented using percentage frequency measures and chi-square associations. The prevalence of dental fluorosis was 50.1% in the areas of Azuay, Cañar and Morona Santiago, with no significant differences (x2 = 5.83, p = 0.054). The types of DF found most frequently were very mild and mild in all provinces; a moderate degree was more prevalent in Cañar (17%). There was no significant association (p > 0.05) between sex and the presence of dental fluorosis and, with respect to severity, the most frequent degree was moderate at the age of 12 years. The prevalence of dental fluorosis in the area evaluated is high, especially in the light and very light degrees, with a tendency toward moderate levels. It is necessary to carry out studies on the factors that are predisposing to the development of this pathology in the population studied. This research is an update regarding this pathology in Ecuador, so it is concluded that it is necessary to continue developing studies based on the findings obtained, thus contributing to the public health of the country.

Developmental Enamel Defects in Children from the Southern Region of Ecuador.

Developmental defects of enamel (DDEs) are widely observed in children and are related to the appearance of dental caries, malocclusion, tooth sensitivity, and unfavorable esthetic conditions. The objective of this cross-sectional study was to determine the prevalence and distribution of enamel defects present in children aged 6 to 12 years in the provinces located in southern Ecuador. A total of 1606 schoolchildren were examined under the World Health Organization criteria for diagnosis of DDEs. The results are presented using percentage frequency measures and chi-square associations. Some types of DDEs were presented by 50% of the schoolchildren, mainly diffuse opacity, with no statistical differences according to place of residence and/or environment, sex, and age (p > 0.05). In Ecuador, it is necessary to carry out studies on the factors that trigger enamel defects, since they may be associated with the high prevalence of caries already reported in other studies in the country.

Caries Experience and Treatment Needs in Urban and Rural Environments in School-Age Children from Three Provinces of Ecuador: A Cross-Sectional Study.

In Ecuador, national epidemiological surveys have not been updated; however, some regional studies in the northern areas of the country still report a high prevalence of dental caries. The aim of this study was to determine the experience, severity, and need for treatment of dental caries in school children aged 6 to 12 years in urban and rural settings in three provinces of southern Ecuador. This cross-sectional, relational study examined 1938 schoolchildren in the provinces of Azuay, Cañar, and Morona Santiago. The survey instruments were based mainly on the WHO manual Methods of Oral Health Surveys (dmft) for primary and permanent dentition (DMFT), as well as the prevalence, severity, and Significant Caries Index (SCI). The parametric Student's t-test was used to compare two groups, and the Spearman's Rho and Tau-c Kendall correlation coefficients were used to associate the categorical variables. Results: The prevalence of caries in the primary dentition was 78% and 89.2% in the permanent dentition. The dmft (M = 4.12, SD = 2.86) and DMFT (M = 3.62: SD = 3.07) placed the general group in a moderate caries index. The need for treatment was 90.68% in the primary dentition, while it was 87.99% in the permanent dentition. Caries severity in both dentitions was high (M = 7.74; SD = 3.42). Conclusions. Alarming indicators of caries experience and the need for treatment were observed in the population studied.

Frecuencia de fuorosis dental y su asociación con el nivel socioeconómico en parroquia rural de Cotopaxi, Ecuador / Dental fuorosis frequency and its association with the socio- economic level at a rural area in Cotopaxi province, Ecuador

Objective: To determine dental fluorosis frequency by using the DEAN and TF Indexes on 4- and 15-years old children, and its correlation with the socioeconomic level reported by their parents. Methods: A descriptive and analytical cross-sectional study were proposed and applied to a 115 students (4-15 years old) sample, enrolled in an educational institution located in Pujilí, Cotopaxi, Ecuador. After fulflling the inclusion criteria, underwent a clinical assessment of their four permanent incisors, registered by photographic examination using the DEAN and Thylstrup and Fejerskov (TF) Indexes, to detect the presence of dental fuorosis. Having the children's legal representatives flled out the INEC socio-economic survey, the collected data were analyzed through the statistical package SPSS v24. Results: Results showed the presence of fluorosis in low or moderate rates according to DEAN and 2 in TF without any diference in the fidelity detection between the two indexes; and no economic factor influence on the fluorosis causes was detected. Conclusions: There was not diference between the indexes used in the detection of fuorosis, with moderate rates found; the economic factor was not relevant.

Objetivo: determinar la frecuencia de fluorosis dental mediante el empleo del índice DEAN y TF en escolares entre 4 a 15 años, y su correlación con el nivel socioeconómico reportado por sus padres. Métodos: se plantea un estudio transversal descriptivo, en una muestra de 115 estudiantes entre 4 a 15 años, matriculados en una unidad educativa de Pujilí, Cotopaxi, Ecuador. Tras cumplimiento de los criterios de inclusión los menores fueron sometidos a una valoración clínica de sus cuatro incisivos permanentes, registrados mediante fotografías y estas evaluadas empleando los índices DEAN y Thylstrup and Fejerskov (TF), para detectar la presencia de fluorosis dental. Sus representantes legales llenaron la encuesta socio económica INEC. Los datos recolectados fueron analizados a través del paquete estadístico SPSS v24. Resultados: los resultados mostraron presencia de fluorosis en grados leves según DEAN y 2 en TF, sin una diferencia en cuanto a la fidelidad de detección entre los dos índices; la influencia del factor económico en la presencia de fluorosis no fue detectada. Conclusiones: no existió diferencia entre los índices empleados en la detección de fluorosis, encontrándose grados leves; el factor económico no fue relevante.

Rehabilitation of a Child with Denari Prosthesis after Dental Avulsion.

Prosthetic rehabilitation in cases of premature loss of temporary teeth always is a procedure that must be carried out in a planned and integral manner. The avoidance of opposing tooth extrusion, loss of horizontal space, and acquisition of bad oral habits are fundamental to not trigger alterations in the child's occlusal development and psychological development. The purpose of this document is to report the clinical case of a 4-year-old patient with avulsion of the anterior primary teeth secondary to severe automobile trauma. In this case, we describe the use of a Denari-type fixed partial prosthesis. This prosthesis can recover the function and aesthetics of the superior anterior sector of the oral cavity, thus preventing lingual interposition. The treatment with the Denari prosthesis allowed satisfactory results relating to the transverse growth of the maxillary bone in this case report.

Prevalence of Caries According to the ICDAS II in Children from 6 and 12 Years of Age from Southern Ecuadorian Regions.

In Ecuador, national data on dental caries are scarce and the detection of incipient enamel lesions has been omitted. The objective of this study was to determine the prevalence of caries in school children aged 6 and 12 years of both sexes, belonging to urban and rural areas of three provinces of the country, using the International Caries Detection and Assessment System (ICDAS II). The sample consisted of 665 children from public schools, examined according to ICDASII. Caries prevalence and caries index were established using ICDAS II 2-6/C-G and ICDAS II 4-6/E-G criteria for comparison with WHO indicators. The Mann−Whitney U statistical test was used for comparison of two groups, the effect size was measured with the correlation coefficient. and the Kruskal−Wallis H test (p < 0.05) for multiple comparisons. Caries prevalence exceeded 87% for primary and permanent dentition. There were no significant differences according to province (p ≤ 0.05). The caries index at 6 years was 6.57 and at 12 years 9.21. The SIC was high at 12 years in rural areas. The prevalence of caries in the population studied was high despite the preventive measures established by health agencies.

General Labor Well-Being in Latin American Dentists during the COVID-19 Pandemic.

This study aimed to determine the general labor well-being of Latin American dentists according to sociodemographic characteristics during the COVID-19 pandemic. A cross-sectional study was conducted in a final sample of 2214 participants from 11 countries. A validated online questionnaire on general work well-being was used (data collection period from 1 June to 10 July 2021), containing two dimensions: psychosocial well-being and collateral effects. The sociodemographic characteristics of the dentists and their perception of the economic impact of the pandemic were also recorded. A multivariate linear regression analysis was performed (hierarchical regression model) to evaluate the joint effect of the explanatory variables on labor well-being and the changes in the variance between each model. A score of psychosocial well-being of 233.6 + 40.2 and collateral effects of 45 + 20.1 was found. Psychosocial well-being was associated with sex, country of origin, academic training achieved, type of dental activity, and perceived impact during the pandemic (p < 0.05). Somatization was frequently manifested through back pain (88.2%) and muscular tensions (87.2%). Women, those who worked 41 or more hours and had between 1 to 15 years of professional experience presented a greater collateral effect (p < 0.001). The impact of the COVID-19 pandemic a year and a half after it began on the labor well-being of Latin American dentists was evidenced with important interactions with social characteristics.

Impact of mandatory social isolation measures due to the COVID-19 pandemic on the subjective well-being of Latin American and Caribbean dentists.

BACKGROUND: With the spread of the COVID-19 virus, containment measures such as home confinement were implemented, generating stress, anxiety, depression and aggravation of pre-existing diseases in the population, including dentists, who have also been affected due to the risk involved in practicing their profession. Objective: To determine the impact of mandatory social isolation measures on the subjective well-being of Latin American and Caribbean dentists during the community quarantine due to the COVID-19 pandemic in 2020. MATERIAL AND METHODS: A Cross-sectional study in a sample of 1195 dentists from 21 countries in Latin America and the Caribbean. The main outcome was Subjective Well-Being, evaluated through the World Health Organization Well-Being Index (WHO-5). In addition, sociodemographic characteristics, variables related to the community quarantine due to the COVID-19 pandemic and health variables were considered. A descriptive, bivariate and multivariate (multiple linear regression) analysis was performed to observe the behavior of the variables. RESULTS: A multiple linear regression analysis was performed, where all the variables included within dimensions, were distributed in a single model, observing an R2% of 9.000 (p<0.001), where the R2% change was significant (p<0.001) and a constant of 44.190; likewise, within this model, the variable follow-up of preventive measures against COVID-19 reported an unstandardized regression coefficient (b) of 2. 316 (95%CI:1.133-3.499;p<0.001), the self-perceived level of concern against COVID-19 obtained a (b) of -5.470 (95%CI:-7.509--3.430; p<0.001), the biological sex variable manifested a (b) of -5.417 (95%CI: - 1.157-1.910; p<0.001); finally, the level of economic income during compulsory social isolation presented a (b)=5.354 (CI95%:3.461- 7.247; p<0.001). CONCLUSIONS: An association was found between subjective well-being and variables related to the social impact of the COVID-19 pandemic, such as following preventive measures, concern about the pandemic and economic factors (decrease in income level), in addition to biologic sex. Follow-up strategies are required for these dental professionals, considering that social isolation measures have continued in many of the countries. Key words:Quarantine, Coronavirus infections, WHO-5, Cross-sectional studies, Latin America, Caribbean Region.

Prevalencia de fluorosis en menores de 4 a 15 años, según índice de Dean y su asociación con el nivel de flúor presente en el agua de consumo / Prevalence of fluorosis in children between 4 and 15 years of age according to Dean's index and its association with the level of fluoride present in drinking

Resumen Objetivo. Identificar la prevalencia de fluorosis en menores de 4 a 15 años de edad, según índice de Dean y su asociación con el nivel de flúor presente en el agua de consumo en la provincia de Cotopaxi. Previa una autorización de participación por parte de sus padres y aprobación del comité de la Universidad Central del Ecuador. Métodos. Fueron examinados 115 participantes en las edades de 4 a 15 años, siguiendo protocolos de registro fotográfico validados tras verificar y cumplimiento de criterios de inclusión. A su vez, se evaluaron muestras de agua de abastecimiento que fueron recolectadas según los protocolos adecuados y examinadas según la presencia de flúor. Las fotografías obtenidas fueron analizadas por tres evaluadores certificados y entrenados en la diferenciación de los grados de fluorosis según Dean mediante índice Kappa. Resultados. Los valores emitidos por cada evaluador fueron recolectados tabulados y procesados mediante el programa SPSS, y la prueba estadística de Chi cuadrado y correlación de Spearman, evidenciando ausencia de una relación estadísticamente significativa, entre las variables analizadas. Conclusión. La presencia de fluorosis de leve a moderada en la población analizada no guarda relación con el porcentaje de flúor presente en las aguas de consumo.

Abstract Objective. Identify the prevalence of fluorosis in children between 4 and 15 years of age according to the Dean's index, and determine its association with the level of fluoride present in drinking water from Cotopaxi province. Subsequent to the authorization by their parents and approval by the committee of the Central University of Ecuador Methods. 115 participants between the ages of 4 to 15 years old were examined following validated photographic registration protocols, after verifying and fulfilling the inclusion criteria, along with the supply water samples were collected following the adequate protocols and examined for the presence of fluoride. The obtained photographs were analyzed by three certified evaluators, who were trained in the differentiation of the degrees of fluorosis according to Dean by means of the Kappa index. Results. The values emitted by each evaluator were tabulated and processed through the SPSS program, using the statistical test of Chi-square and Spearman's correlation. The absence of a statistically significant relationship between the variables was observed. Conclusion: The presence of mild to moderate fluorosis in the analyzed population is not related to the percentage of fluoride present in drinking water.

Perceived Stress in Dentists and Dental Students of Latin America and the Caribbean during the Mandatory Social Isolation Measures for the COVID-19 Pandemic: A Cross-Sectional Study.

This study aims to determine the impact of the COVID-19 pandemic, specifically considering the mandatory social isolation measures implemented, on the perceived stress of a sample of dentists and dental students from Latin America and the Caribbean, as well as the associated sociodemographic and pandemic-related variables. A cross-sectional survey was conducted with a sample of 2036 dentists and dental students (1433 women). For the main outcome, the 14-item Perceived Stress Scale (PSS-14) was used. The survey also questioned sociodemographic aspects, questions on the COVID-19 pandemic, health variables, and habits. Descriptive, bivariate, and multivariate analyses (linear regression) were applied to observe the factors associated with perceived stress. The PSS-14 mean score was 24.76 (±11.76). Hierarchical regression models showed significant variables associated with the PSS-14 scores: income level during mandatory social isolation, having older adults under care during mandatory social isolation, self-perceived level of concern regarding COVID-19, self-perceived health, Coffee consumption during mandatory social isolation. In general terms, the pandemic has influenced the personal, social, labor, and everyday life of dental staff and affected the mental health of this population specifically when perceived stress is considered. Public policies, strategies, and mental health surveillance systems are required for this population.

Effect of Addition of Dimethyl Sulfoxide to Simplified Adhesives on Dentin Bond Durability after Three Years of Water Storage.

PURPOSE: To evaluate the effect of inclusion of two dimethyl sulfoxide (DMSO) concentrations in simplified etch-and-rinse adhesives on dentin bonding durability after three years of water storage. MATERIALS AND METHODS: Forty-two caries-free third molars were divided into six experimental groups (n = 7) according to the following factors: 1) adhesive (Adper Single Bond 2 [SB], 3M Oral Care; Prime&Bond 2.1 [PB], Dentsply Sirona); 2) concentration of DMSO (control group: 0.0% DMSO; addition of 0.2% DMSO [0.2] and 2% DMSO [2.0]). After completing restoration, specimens were stored in water (37°C) for 24 h, sectioned into adhesive-dentin sticks (0.8 mm2), tested for microtensile bond strength (µTBS) at 0.5 mm/min, and examined for nanoleakage (NL) using SEM immediately thereafter or after three years of water storage. Data were subjected to a three-way repeated-measures ANOVA and Tukey's test (α = 0.05) for each property evaluated. RESULTS: After three years of water storage, for both adhesives, the incorporation of 2% DMSO maintained the µTBS when compared to immediate µTBS (p > 0.05). In general, SB resulted in a statistically significantly higher mean of µTBS compared to PB, independent of the DMSO concentration after water storage (p < 0.05). Furthermore, the amount of NL was lower and practically limited to the hybrid layer given the concentrations of 0.2% and 2% DMSO for both tested adhesives after three years. CONCLUSION: The incorporation of DMSO in simplified etch-and-rinse adhesives maintains the long-term stability of the dentin bond.

Pulp Vitality and Longevity of Adhesive Restorations Are Not Affected by Selective Carious Removal: A Multicenter Clinical Trial.

The aim of this multicenter randomized clinical trial was to evaluate the pulp vitality and survival rate of adhesive restorations performed on posterior deciduous teeth after non-selective (NSCR) or selective (SCR) carious tissue removal over 33 months. One hundred and seven children (average age 4-8 years, SD 1.4) with at least two active moderate cavitated lesions in dentin were included. Teeth were randomized and submitted to NSCR or SCR before composite resin restoration. Restorations were clinically and radiographically assessed at baseline, 6, 12, 18, 24, and 33 months by a blinded, trained, and calibrated operator in each center. The characteristics of the restorations were recorded according to FDI criteria and were considered as restorative failures when scores 4 or 5 were presented. Pulp vitality was measured by clinical and radiographic examinations, and those teeth that presented any signs or symptoms of irreversible pulpitis or pulp necrosis were considered as failure. Data were analyzed by a Cox regression model with shared frailty, considering two outcomes: pulp and restorative. A total of 278 restorations (137 after NSCR and 141 after SCR) were performed at baseline in four different centers and there was no loss in the follow-up period. Survival rate was 97.1 and 87.1% for pulp and for restorative outcome, respectively. The overall annual failure rate was 7%. There were no differences in the failure risk according to the treatment group, center, and all the clinical and demographic variables, regardless of outcome. Composite restorations of active moderate deep carious lesions performed on posterior primary teeth show satisfactory survival for restorative and pulp outcome after a 33-month follow-up, regardless of the technique executed for carious tissue removal.

Covid-19 y la odontología latinoamericana para pacientes con necesidades especiales / Covid-19 and latin american dentistry for patients with special needs / Covid-19 and dental care for patients with special needs in Latin America

Resumen La región de América Latina se ha convertido en la más afectada del mundo por la pandemia del COVID-19. Y personas con necesidades especiales, población ya vulnerable, están sufriendo un impacto significativo de la crisis actual. Dado que estas personas no pueden dejar de ser protegidas y cuidadas, un grupo de profesores de 10 países de América Latina se reunió para analizar la situación de la odontología para pacientes con necesidades especiales en la región. En todos los países, se evidenció que el confinamiento y las restricciones de desplazamiento están interrumpiendo el acceso a bienes y servicios esenciales para ellos. En cuanto a la odontología, la disposición general es posponer los procedimientos de rutina, a menos que sean clínicamente urgentes o de emergencia; adoptar estrictas medidas de protección personal y evitar o minimizar las intervenciones que puedan producir aerosoles. La atención odontológica remota, teleodontología, se considera como una herramienta fundamental en este momento, ya que permite evaluar la necesidad de atención presencial y ofrecer soporte, información y seguridad a los pacientes y familias. La pandemia nos ha demostrado, a todos, que impulsar la Promoción de la Salud es el verdadero camino, y que no debemos esperar a que se presenten condiciones que afecten la calidad de vida.

Resumo: A região da América Latina tem se tornado a mais afetada do mundo pela pandemia do COVID-19. E as pessoas com necessidades especiais, população já vulnerável, estão sofrendo um impacto significativo da crise atual. Uma vez que essas pessoas não podem deixar de ser protegidas e cuidadas, um grupo de professores de 10 países de América Latina se reuniu para analisar a situação da odontologia para pacientes com necessidades especiais na região. Em todos os países se verificaram que o confinamento e restrições de movimento estavam interrompendo o acesso a bens e serviços essenciais para eles. Para a odontologia, a orientação geral é adiar procedimentos de rotina, a menos que seja clinicamente urgente ou emergencial; adotar medidas rígidas de proteção individual e evitar ou minimizar intervenções que possam produzir aerossóis. O atendimento odontológico à distância, teleodontología, é considerada uma ferramenta fundamental neste momento, pois permite avaliar a necessidade de atendimento presencial e oferecer suporte, informação e segurança aos pacientes e famílias. A pandemia tem demostrado, para todos, que trabalhar na Promoção da Saúde é o verdadeiro caminho, e que não devemos esperar por condições que afetem a qualidade de vida.

Abstract Latin America has become the most affected region by the COVID-19 pandemic in the world. People with special needs-an already vulnerable population-are suffering terrible consequences on account of this crisis. These people need to be protected and cared for at all times. Therefore, a group of lecturers from ten Latin American countries came together to analyze the regional situation of dental care for patients with special needs. Every country shows evidence that lockdowns and movement restrictions interrupt these people's access to essential goods and services. The general course of action regarding dental care is to postpone routine procedures unless they are clinically urgent or an emergency, implement strict personal protection measures and avoid or minimize processes that may produce aerosols. Remote dental care is considered essential these days since it allows practitioners to assess the need for face-to-face care and offer support, information, and safety to patients and families. The pandemic has shown us all that supporting health promotion is the true path and that we should not wait until conditions that affect people's quality of life appear to act.

Uso de bolsa adiposa de Bichat pediculada como recurso para el cierre de comunicaciones y fístulas bucoantrales: informe de caso / Use of pedicle Bichat fat pad as a resource for the closure of communications and oroantral fistulas: case report

Resumen Introducción: El uso de un colgajo de bolsa adiposa de Bichat en el cierre de comunicaciones buco sinusales y defectos óseos maxilares ha sido reportada en varios estudios con resultados positivos, al ser una técnica sencilla y bien tolerada, gracias a su riqueza vascular, volumen y versatilidad, mostrando una baja tasa de complicaciones. Objetivo: Reportar el caso clínico de un paciente que acudió a la clínica universitaria de la Universidad UTE con una comunicación buco sinusal y el tratamiento quirúrgico a través de un colgajo pediculado de la bolsa adiposa de Bichat, como alternativa satisfactoria en el cierre de la comunicación y corrección de los defectos óseos intraorales. Metodología: Se obtuvo un colgajo mucoperiostico trapezoidal de avance recto hasta el margen palatino, fue ejecutada una fistulectomía, y mediante una incisión horizontal se conseguió la exposición de la bolsa adiposa para obtener tejido suficiente para cerrar la comunicación. Conclusiones: El uso de un colgajo de bolsa adiposa de Bichat gracias a su riqueza vascular, volumen, versatilidad y capacidad para realizar una metaplasia a tejido epitelial, por la presencia de células madre, es muy confiable.

Abstract Introduction: The use of buccal fat pad flap in closure of oroantral communications and maxillary bone defects has been reported in several studies with positive results, being a simple and well-tolerated technique, thanks to its vascular richness, volume and versatility, showing a lower complication rate. Objective: Report the clinical case of a patient who went to university clinic of Universidad UTE with a sinus oral communication and surgical treatment through a pedicle flap of buccal fat pad, as a satisfactory alternative in the closure of the communication and correction of intraoral bone defects. Methods: A mucoperiosteal trapezoidal flap was made to reach the palatal margin, a fistulectomy was also performed, and using a horizontal incision the buccal fat pad was exposed in order to obtain enough tissue to close the oroantral communications. Conclusions: The use of the flap technique in the buccal fat pad seems reliable thanks to its vascular characteristics, volume, versatility and capacity to experience an epithelial metaplasia because of the presence of stem cells.

Effect of surface treatments on the adhesive properties of metallic brackets on fluorotic enamel.

OBJECTIVE: To compare the effectiveness of the pretreatment with sandblasting and deproteinization with NaOCl on bond strength (SBS), in situ conversion degree (CD) of brackets in fluorotic enamel, and enamel etching pattern. METHODS: A total of 90 non-carious maxillary premolars were used. The teeth were then assigned to six experimental groups according to: enamel surface (sound and fluorotic enamel); surface treatment (Regular etch with 37% phosphoric acid [RE]; 5.2% sodium hypochlorite + phosphoric acid [NaOCl + RE]; sandblasting + phosphoric acid [sandblasting + RE]). After storage in distilled water (37°C/24h), the specimens were tested at 1 mm/min until failure (SBS). Enamel-resin cement interfaces were evaluated for CD using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a scanning electron microscope. Data from SBS and in situ CD values were analyzed using ANOVA two-away and Tukey test (α=0.05). The enamel etching pattern was evaluated only qualitatively. RESULTS: For sound enamel, RE showed the highest SBS values, when compared to NaOCl + RE and Sandblasting + RE groups (p< 0.01). Regarding CD, only NaOCl + RE significantly compromised the mean DC, in comparison with other groups (p= 0.002). For fluorotic enamel, the Sandblasting + RE group significantly increased the mean SBS values, in comparison with RE group (p= 0.01) and no significant change was observed for CD (p> 0.52). CONCLUSIONS: The application of NaOCl or sandblasting associated to phosphoric acid improved the SBS of the brackets in fluorotic enamel without compromising the CD of the resin cement, with improving of enamel interprismatic conditioning.

Prevalence and incidence of dental caries associated with the effect of tooth brushing and fluoride varnishing in schoolchildren at Galapagos Islands, Ecuador: Protocol of the EESO-Gal study / Prevalencia e incidencia de caries dental y efecto del cepillado dental acompañado de barniz de flúor en escolares de Islas Galápagos, Ecuador: protocolo del estudio EESO-Gal.

Introduction: Dental caries is the most prevalent oral disease in Ecuador. In our country, there are no studies that have included the population of the Galapagos Islands. Fluoride application to incipient lesions of dental caries has shown to be effective in avoiding the use of invasive restorative procedures. Objectives: The objective of the EESO-Gal study is to determine the prevalence and incidence of dental caries and to evaluate the effect of supervised dental brushing, accompanied by periodic applications of fluoride varnish on incipient precarious lesions of schoolchildren in the Galapagos Islands. This article presents the protocol of the EESO-Gal study. Methods: A cohort is planned with Galapagos Islands schoolchildren to determine the prevalence and incidence of dental caries, with assessments every six months, during twenty-four months. Results: We expect to determine the prevalence and incidence of caries every six months, for twenty-four months, in schoolchildren between three and ten years of age, and obtain data to show the state of the caries conditions in Galapagos schoolchildren, with the inclusion of daily brushing at school, supervised by the teacher, and with the application of fluoride varnish every six months. Conclusions: The prevalence of dental caries and incidence after the program will demonstrate the importance of implementing oral health prevention and promotion actions to create hygiene and health habits from an early age.

Introducción: La caries dental es la enfermedad bucal más prevalente en Ecuador. En nuestro país no existen estudios que hayan considerado a la población de las Islas Galápagos. La aplicación de flúor sobre lesiones incipientes de caries dental ha demostrado efectividad para evitar ejecutar procedimientos invasivos restauradores. Objetivos: El objetivo del Estudio de Salud Oral Galápagos, EESO-Gal, es determinar la prevalencia e incidencia de caries dental y evaluar el efecto de la acción del cepillado dental supervisado, acompañado de aplicaciones periódicas de flúor en barniz sobre lesiones cariosas incipientes en escolares de las Islas Galápagos. Con este informe se busca reportar el protocolo del Estudio de Salud Oral Galápagos. Métodos: Se plantea realizar una cohorte con los escolares de las Islas Galápagos para determinar la prevalencia e incidencia de caries con evaluaciones cada seis meses durante veinticuatro meses. Resultados: Se espera determinar la prevalencia e incidencia de caries cada seis meses durante veinticuatro meses en escolares de tres a diez años y obtener datos que permitan evidenciar el estado de las condiciones de caries en los escolares de Galápagos con la inclusión del cepillado diario en la escuela, supervisado por el docente, y con la aplicación semestral del barniz de flúor. Conclusiones: La prevalencia de caries dental e incidencia después de las acciones tomadas demostrará la importancia de aplicar acciones de prevención y promoción de la salud oral, para crear hábitos de higiene y salud desde edades tempranas.

Tratamiento estético en fluorosis dental grado 3 según índice Thylstrup y Fejerskov, mediante métodos conservadores / Tratamiento estético en fluorosis dental grado 3 según índice Thylstrup y Fejerskov, mediante métodos conservadores

La ausencia de armonía en la sonrisa de un paciente constituye una causa por la cual su autoestima y comportamiento con su entorno se ven afectados. Ecuador ha sido considerado una zona endémica de fluorosis, desencadenando alteraciones dentales estéticas y funcionales; la fluorosis se presenta como manchas opacas que siguen un patrón horizontal en su fase temprana y manchas marrones y pérdida de estructura en estado avanzado. El presente caso tiene como objetivo exponer el caso de un paciente joven, diagnosticado con fluorosis grado 3 según el índice Thylstup y Fejerskov (TF), en el cual se realizó blanqueamiento con peróxido de hidrógeno al 40%, seguido de blanqueamiento casero con peróxido de carbamida al 35%, 20 minutos diarios por 7 días. La combinación de procedimientos de blanqueamiento resultó idónea en pacientes con fluorosis grado 3 según el índice de TF, mimetizando el moteado característico de la fluorosis dental mejorando así la estética del paciente y garantizando el éxito del presente caso. La aplicación de tratamientos conservadores, es eficaz, para restablecer estética dental, función y confianza en el paciente al momento de sonreír.

The lack of harmony in a patient's smile affects their self-esteem and behavior with their environment. Ecuador has been considered an endemic zone of fluorosis, triggering aesthetic and functional dental alterations. Fluorosis appears as opaque spots that follow a horizontal pattern in its early phase and brown spots and loss of structure in an advanced stage. In this article we present the case of a young patient, diagnosed with dental fluorosis grade three of Thylstup-Fejerskov (TF) index, treated with 40% hydrogen peroxide bleaching, followed by 35% peroxide carbamide home whitening for 30 minutes daily, during 7 days. The combination of whitening procedures was ideal to mimic the mottling characteristic of dental fluorosis, thus improving the aesthetics of the patient and guaranteeing the success of the present case. The use of a conservative treatment was effective to restore dental aesthetics, function and confidence of the patient when smiling.