Developing a protocol for a preventive oral health exam for elderly people (EDePAM) using E-Delphi methodology.

The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

Developing a protocol for a preventive oral health exam for elderly people (EDePAM) using E-Delphi methodology

Abstract The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

Radiopacidad de Resinas Acrílicas y Bisacrílicas Usadas como Restauraciones Provisionales / Radiopacity of Acrylic and Bisacrylic Resins Used as Provisional Restorations

Una adecuada radiopacidad de los materiales para restauraciones provisorias permite su evaluación en el examen radiográfico. Sin embargo, existe gran desconocimiento sobre el cumplimiento de los requerimientos establecidos por la norma ISO 4049. El objetivo del siguiente estudio fue determinar la radiopacidad de los materiales para provisionalización presentes en el mercado nacional y corroborar si estos cumplen con el valor mínimo requerido por la normativa. Se realizó un estudio experimental in vitro, en el cual se prepararon muestras en forma de discos de 10 mm de diámetro y 1 mm de espesor de resinas acrílicas: Acrílico Autocurable (Marché®), Duralay (Reliance), Caulkâ (Dentsply), ALIKE™ (GC) y resinas bisacrílicas: Protemp™4 (3M, 2008), LuxatempStar (DMG), Luxacrown (DMG), Structur Premium (VOCO), ExperTemp™ (Ultradent) y Acrytemp (Zhermack). Las muestras fueron radiografiadas junto a una cuña de aluminio escalonada. Las imágenes fueron analizadas para determinar el valor en escala de grises y su respectivo valor en mm de aluminio. Los datos fueron analizados para verificar si cumplen con la normativa ISO. Se encontraron diferencias estadísticamente significativas. La radiopacidad equivalente de las resinas acrílicas en mm de Al en orden descendente fue de 0,85 ± 0,08 para ALIKE™, 0,72 ± 0,32 para acrílico Marché®, 0,65 ± 0,25 para Caulkâ y 0,56 ± 0,05 para Duralay, siendo todos menores a lo requerido por la norma. La radiopacidad equivalente de las resinas bisacrílicas fue de 1,75 ± 0,2 para Acrytemp, 1,51± 0,27 para Luxacrown, 1,47 ± 0,14 para Structur Premium, 1,43 ± 0,23 para LuxatempStar, 1,02 ± 0,28 para Protemp™4 y 1± 0,1 para ExperTemp™, los cuales son mayores a lo exigido por la norma. En conclusión, las resinas bisacrílicasevaluadas en este estudio cumplen con el requisito de radiopacidad exigido, a diferencia de las acrílicas que no lo cumplen.

An adequate radiopacity of materials for provisionalization allows its proper evaluation on the radiographicexam. However, there is a lack of knowledge about compliance with the requirements established by the ISO 4049 norm. The aim of this study was to determine the radiopacity of provisionalization materials available in the national market and verify if they comply with the minimum requirements of ISO regulations. An in vitro experimental study was carried out, samples of 10 mm in diameter and 1 mm thickness of acrylic resins: Self-Cure Acrylic (Marché®), Duralay (Reliance), Caulkâ (Dentsply), Alike™ (GC) and by sacrilic resins: Protemp™4 (3M), Luxatemp Star (DMG), Luxacrown (DMG), Structur Premium (VOCO), ExperTemp™ (Ultradent), Acrytemp (Zhermack) were prepared. The samples were x-rayed together with a stepped aluminum wedge. The images were analyzed to determine the gray scale value and its equivalent value in mm of Aluminum. The data was analyzed to verify compliance with the ISO standard. Statistically significant differences were found. The equivalent radiopacity of acrylicresins in mm of Al in descending order was 0.85± 0.08 for ALIKE™, 0.72 ± 0.32 for acrylic Marché®, 0.65 ± 0.25 forCaulkâ and 0.56 ± 0.05 forDuralay, all being less than the required by norm. The equivalent radiopacity of by sacrilic resins was 1.75 ± 0.2 for Acrytemp, 1.51± 0.27 for Luxacrown, 1.47 ± 0.14 for Structur Premium, 1.43 ± 0.23 for LuxatempStar, 1.02 ± 0.28 forProtemp™4 and 1± 0.1 forExperTemp™,which are greater than the requirements. In conclusion, the bisacrylic resins evaluated in this study comply with the radiopacity standard, however the acrylic resins evaluated do not comply.

Sinopsis de la Situación de Salud Oral en Chile - Parte III: Encuestas Nacionales de Salud / Synopsis or the Oral Health Situation in Chile - Part III: National Health Surveys

RESUMEN: Este artículo realiza una revisión y síntesis de las principales encuestas poblacionales de salud en Chile. Se describen sus principales características y hallazgos con el objetivo de orientar a los profesionales odontólogos en el conocimiento de material existente para el diagnóstico odontológico objetivo, así como el impacto de la salud oral en la calidad de vida, a nivel poblacional.

ABSTRACT: This article makes a brief review and synthesis of national health surveys in Chile. The article describes the main characteristics and findings in order to guide dental professionals with the knowledge of the existing material for an objective population oral health diagnosis, as well as the impact of oral health on quality of life of the population.

Sinopsis de la Situación de Salud Oral en Chile - Parte II: Diagnósticos Poblacionales de Salud Oral / Synopsis or the Oral Health Situation in Chile - Part II: Oral Health Surveys

RESUMEN: Objetivo: Sintetizar los resultados sobre los estudios epidemiológicos de caries dental, enfermedad periodontal, desdentamiento y lesiones de mucosa oral de base poblacional con representatividad nacional y regional en adultos chilenos (≥15 años). Materiales y métodos: Se realizó una revisión narrativa para identificar aquellos estudios de diagnóstico de salud bucal, a nivel nacional y/o regional, en población adulta de Chile (≥15 años), con el objetivo de establecer prevalencias para las patologías bucales de mayor relevancia nacional. Resultados: Se identificaron 6 estudios de representatividad nacional y 7 estudios de representatividad regional. Se reporta una disminución en la prevalencia de caries cavitadas y de dentición no funcional, correspondiendo a un 54.6% y 27.0%, respectivamente. La prevalencia de pérdida de inserción clínica ≥4mm., es cercana al 100%. La lesión de mucosa oral más prevalente fue la estomatitis subprotésica (22.3%). Se observaron inequidades socieconómicas y culturales en la distribución de las patologías orales en la población adulta chilena. Conclusiones: Existe una alta prevalencia de enfermedad periodontal, caries, desdentamiento y lesiones de mucosa oral en adultos y adultos mayores chilenos.

ABSTRACT Aim: To synthesize results of epidemiologic national and regional studies about dental caries, periodontal diseases, tooth loss and oral mucosa lesions in Chilean adults (≥15 years- old). Methods: A narrative revision was made in order to identify epidemiologic national or regional studies in Chilean adults (≥15 years- old). The objective was to establish the prevalence of the most common oral diseases. Results: Six national and seven regional studies were identified. The prevalence of non-treated caries and non- functional dentition was reduced to 54.6% and 27.0%, respectively. The prevalence of periodontal attachment loss ≥4mm. was almost 100%. The most frequent oral mucosa lesion was denture stomatitis (22.3%). Socioeconomic and cultural disparities were observed in the distribution of oral diseases in Chilean adults. Conclusions: The prevalence of dental caries, periodontal diseases, tooth loss and oral mucosa lesions was high in Chilean adults and elderly people.

Radiopacity and Chemical Assessment of New Commercial Calcium Silicate-Based Cements / Radiopacidad y Evaluación Química de Cementos Comerciales en Base a Silicato de Calcio

ABSTRACT: The aim of the study was to evaluate the chemical composition and radiopacity of new calcium-silicatebased cements. Discs of 10 mm x 1 ± 0.1mm were prepared of BiodentineTM, TheraCal, Dycal and GC Fuji IX (n=5). The samples were radiographed directly on an PSP occlusal plate adjacent to an aluminium step wedge. The radiopacity of each specimen was determined according to ISO 9917/2007. Statistical analyses were carried out using ANOVA and Tukey's test at a significance level of 5 %. The chemical constitution of materials was determined by scanning electron microscopy (SEM) and energy dispersive x-ray element mapping. The radiopacities of the materials in decreasing order were: GC Fuji IX (3.45 ± 0.16 mm), Dycal (3.18 ± 0.17), BiodentineTM (2.79 ± 0.22), and TheraCal (2.17 ± 0.17). TheraCal showed the lowest radiopacity compared to the other materials, followed by BiodentineTM. Dycal and GC Fuji IX radiopacity values did not present significant statistical differences. Scanning electron microscopy and energy dispersive X-ray analysis revealed the presence of zirconium in BiodentineTM; and strontium, barium and zirconium in TheraCal as radiopacifying elements. The new calcium silicate cements present distinctive chemical composition. BiodentineTM contains zirconium as a radiopacifying element and has higher radiopacity values than TheraCal, which contains barium and strontium as radiopacifiers.

RESUMEN: El objetivo de este estudio fue evaluar la composición química y la radiopacidad de nuevos cementos en base a silicato de calcio. Discos de 10 mm x 1 ± 0,1 mm fueron preparados con BiodentineTM, TheraCal, Dycal y GC Fuji IX (n=5). Las muestras fueron radiografiadas directamente en una película PSP oclusal adyacente a una cuña escalonada de aluminio. La radiopacidad de cada espécimen fue determinada de acuerdo a la norma ISO 9917/ 2007. Se realizaron los análisis estadísticos con las pruebas ANOVA y test de Tukey con un nivel de significancia de 5 %. La constitución química de los materiales fue determinada con microscopía electrónica de barrido y con mapeo por análisis con dispersión de energía de rayos X. La radiopacidad de los materiales en orden decreciente fue: GC Fuji IX (3,45 ± 0,16 mm), Dycal (3,18 ± 0,7 mm), BiodentineTM (2,79 ± 0,22 mm), y TheraCal (2,17 ± 0,17 mm). TheraCal mostró la menor radiopacidad comparada con los otros materiales, seguido de BiodentineTM. Los valores de radiopacidad de Dycal y GC Fuji IX no presentaron diferencias estadísticas significativas. Los análisis de microscopía electrónica de barrido y mapeo por análisis con dispersión de energía de rayos X revelaron la presencia de zirconio en BiodentineTM; y de estroncio, bario y zirconio en TheraCal, como elementos radiopacos. Los nuevos cementos en base a silicato de calcio presentan una composición química distintiva. BiodentineTM contienen zirconio como elemento que provee radiopacidad y tiene mayor valor de radiopacidad que TheraCal, el cual contiene bario y estroncio como agente radiopaco.

Retrospective Study of Traumatic Dental Injuries of Patients Treated at a Dental Trauma Clinic in Santiago, Chile / Estudio retrospectivo de Casos Atendidos en Clínica de Traumatología Dentoalveolar en Santiago, Chile

ABSTRACT: The aim of this study was to carry out a retrospective study of cases seen at the Child and Adult Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile, Santiago. A retrospective study was carried out analysing the records of patients seen at the Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile from January 2012 to March 2017. The inclusion criteria was that patient complaint was due to dental trauma. Data were tabulated indicating age and sex of the patient, cause, day, and tooth involved and the initial diagnosis of the dental trauma. Chi-square, Shapiro Wilk normality test and Mann-Whitney test were used for frequency analyses. A total of 117 dental records were analysed, 90 of these met the inclusion criteria. The age range of the sample was 5 to 60 years, and the average age was 14.3 years. Most injuries occurred in patients during the first and second decades of their life. Of the patients, 59.3 % were men and 40.7 % were women. The most frequent dental traumas were complicated and uncomplicated crown fractures, followed by root fractures. In the majority of the cases analysed, only one tooth was affected, and the tooth most frequently traumatized was the right upper central incisor, followed by the left upper central incisor. The most frequent dental trauma of the cases treated at the Child and Adult Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile, Santiago, between 2012 and 2017 were crown fractures.

RESUMEN: El objetivo fue realizar un estudio retrospectivo de los casos que acuden a la clínica de Traumatología Dentoalveolar (TDA) Pediátrica y del Adulto de la Clínica de Odontología de la Universidad de Chile. Se realizó un estudio retrospectivo analizando las fichas de pacientes atendidos en la Clínica de TDA de la Facultad de Odontología, Universidad de Chile desde enero 2012 hasta marzo 2017. El criterio de inclusión fue motivo de consulta por traumatismo dentoalveolar inmediato. Se tabularon datos consignando sexo y edad del paciente, causa, día, diente involucrado y diagnóstico inicial del TDA. Para los análisis de frecuencia se utilizó Chi-cuadrado, el test de normalidad de Shapiro Wilk y test de Mann-Whitney. Se analizaron un total de 117 fichas, donde 90 cumplieron con los criterios de inclusión. El rango de edad de la muestra fue de 5 a 60 años, con un promedio de 14,3 años. Siendo la primera y la segunda década de vida donde ocurren con mayor frecuencia los traumatismos. El 59,3 % eran hombres y 40,7 % mujeres. El TDA más frecuente fueron las fracturas coronarias complicadas y no complicadas, seguido por fracturas radiculares. En la mayoría de los casos analizados sólo un diente se encontraba afectado. El diente más frecuentemente traumatizado fue el incisivo central superior derecho, seguido por el izquierdo. Las causas más frecuentes de traumatismo fueron por caída y golpe. De los casos atendidos en la clínica de TDA de la Universidad de Chile entre 2012 y 2017 el traumatismo más frecuente es la fractura coronaria.

Protector bucal por laminado a presión en paciente deportista / Pressure lamination technique mouthguard for athlete patient

RESUMEN: El traumatismo dentoalveolar incluye un conjunto de lesiones que afectan a los dientes y/o estructuras de soporte a consecuencia de un impacto violento directo o indirecto. Debido a que por lo general comprometen el sector anterior generan cambios físicos, fonéticos, psicológicos y dietarios, que pueden afectar significativamente la calidad de vida de pacientes afectados por este traumatismo. Los protectores bucales son considerados la principal medida para minimizar y/o evitar estos traumatismos. El presente artículo describe el tratamiento y procedimientos para realizar un protector bucal por laminado a presión en un paciente deportista con historia previa de traumatismo dentoalveolar en incisivos centrales superiores.

ABSTRACT: Traumatic dental injuries involve lesions that affect teeth and/or adjacent supporting structures as a consequence of direct or indirect violent impact. Due to As it affects the anterior teeth, in most of the cases, it provokes changes in the physical appearance, altering phonetics, psychology and the diet of the affected subject. These changes may significantly alter the quality of life of patients affected by this type of trauma. Mouthguards are considered the primary appliance for minimizing and/or avoiding dental trauma. The present article describes the treatment and procedures to perform a mouthguard by pressure lamination technique in a patient that who practices sports and with a history of trauma affecting the upper central incisors.