Traumatic dental injuries sustained during Chile's civil unrest: A case series study.

BACKGROUND/AIM: During Chile's period of social unrest, numerous people suffered physical trauma due to the use of police force. However, there have been no reports regarding traumatic dental injuries (TDIs) suffered in this context. This study aims to describe the dental trauma of patients injured by police during the social unrest period in Chile from 2019 to 2021. MATERIAL AND METHODS: A case series methodology was employed. Following informed consent, clinical records of patients admitted to the Ocular and Dentomaxillofacial Prosthetic Care and Rehabilitation Program, who were affected by the violence of state agents during social mobilizations, were reviewed from October 2019 to December 2021. Information on the sociodemographic characteristics of the patients and the TDI diagnoses with their treatment needs were collected. A descriptive analysis was performed. RESULTS: Forty-six patients were identified, nine of whom agreed to the informed consent. Most were male, with a mean age of 28 years, public health insurance, and a high educational level. The most common causes of injury were kinetic impact projectiles (KIPs) and the use of physical force (punches, kicks, or pushes). Of the nine cases described, 26 teeth were affected by TDI. The most affected teeth were the central upper incisors and, in most cases, they presented lesions in both injury categories: NA0D.0 (the tooth and pulp) and NA0D.1 (periodontal tissues). Treatment needs varied and included some complex procedures, such as implant-retained crowns and removable dental prostheses. CONCLUSIONS: The use of force by police during the period of social unrest in Chile caused TDIs among demonstrators, which were mainly due to physical force from less-than-lethal weapons. Most cases presented injuries affecting the incisors with multiple teeth requiring complex treatments.

Terapia Pulpar Vital en Diente con Fractura Coronaria Complicada

La fractura coronaria es el traumatismo dentoalveolar (TDA) más frecuente en la dentición permanente. Cuando existe exposición pulpar, se conoce como fractura coronaria complicada (FCC). Actualmente, en estos casos, se recomienda realizar terapias que permitan preservar la vitalidad del tejido pulpar, tanto en dientes maduros como inmaduros. El presente reporte describe el caso de un paciente de 9 años con FCC en diente 2.1, donde se realizó tratamiento con terapia pulpar vital (pulpotomía de Cvek), y adhesión de fragmento dentario. En los controles posteriores al TDA (1 semana, 4 meses, 1 y 2 años) el diente estaba asintomático, se observó formación de puente dentinario y continuación de desarrollo radicular con cierre apical, indicios de que el tejido pulpar se mantuvo vital. En este caso se destaca la importancia del diagnóstico, tratamiento adecuado, junto al seguimiento de un diente con desarrollo radicular incompleto.

Crown fracture is the most frequent dental traumatic injury (DTI) in permanent dentition. When there is pulp exposure, it is known as a complicated crown fracture. Currently, in these cases, it is recommended to carry out therapies that allow preserving the vitality of the pulp tissue, both in mature and immature teeth. This report describes the case of a 9-year-old patient with a complicated crown fracture in tooth 2.1, who underwent treatment with vital pulp therapy (Cvek pulpotomy), and adhesion of the dental fragment. In follow-up sessions (after 1 week, 4 months, 1 and 2 years), the tooth was asymptomatic. It was observed dentin bridge formation and the continuation of root development with apical closure, indications that the pulp tissue has remained vital. In this case, the importance of proper diagnosis and treatment is highlighted, together with the follow-up of a tooth with incomplete root development.

Sinopsis de la Situación de Salud Oral en Chile - Parte IV: Traumatismo Dentoalveolar / Synopsis of the Oral Health Situation in Chile - Part IV: Traumatic Dental Injuries

RESUMEN: Objetivo: Sintetizar los resultados de estudios epidemiológicos sobre Traumatismo Dentoalveolar (TDA) en la población chilena. Material y métodos: Se realizó una revisión sistemática de la literatura para identificar estudios poblacionales a nivel nacional, regional, provincial y comunal, además de datos de servicios dentales de atención primaria y secundaria sobre TDA en Chile. Resultados: Se incluyeron 2 estudios con representatividad nacional y 8 realizados en centros de atención en salud. A nivel nacional, la prevalencia de TDA a los 6 años fue de un 2.57%, y a los 12 años, 4.97%. En los estudios realizados en centros de salud, el diagnóstico más prevalente en dentición primaria fueron las lesiones de tejidos de soporte y en dentición permanente, la fractura coronaria. Fue más frecuente la afectación de un solo diente, y los incisivos centrales superiores fueron los dientes más afectados. Conclusiones: Los estudios representativos de la población en Chile son escasos, realizados hace más de una década y representativos sólo de la población de 6 y 12 años, lo cual pone de manifiesto la necesidad de mayor información epidemiológica sobre el TDA en la población chilena.

ABSTRACT: Aim: To summarize the evidence on epidemiological studies about traumatic dental injuries (TDI) in Chile. Methods: A systematic literature review was carried out in two databases to identify population studies at national, regional, provincial and community levels, as well as reports from primary and secondary dental care services, regarding TDI in Chile. Results: Two studies with national representation and eight studies from primary and secondary healthcare centers were included in the analysis. National prevalence for 6-year-old children was 2.57%, and 4.97% for 12-year-old children. While the most frequent diagnosis in primary dentition was traumatic injury involving tooth-supporting tissues, the most commonly reported diagnosis in permanent dentition was crown fracture. Single tooth affection was more frequent, and the upper central incisors were the most affected teeth. Conclusions: Data on representative studies about TDIs in Chile are scarce. Few studies, carried out more than a decade ago and only on 6- and 12-year-old children are available. There is a need for further epidemiological information about TDIs in Chile.

Traumatismo Dentoalveolar en Personas con Parálisis Cerebral. Revisión Sistemática y Metaanálisis

RESUMEN: La parálisis cerebral (PC) es un trastorno neurológico que afecta aproximadamente 2 de cada 1000 nacidos vivos. Se describe como un grupo de trastornos del desarrollo del movimiento, equilibrio y postura, que causan limitación de actividad. Algunos estudios han planteado que la PC podría aumentar el riesgo de traumatismos dentoalveolares (TDA). El objetivo de este estudio fue revisar la evidencia científica disponible sobre prevalencia y tendencias de TDA en pacientes con PC, y compararla con la prevalencia de TDA en sujetos sin PC. Se realizó una búsqueda sistemática en Pubmed, Scielo y Lilacs. Se evaluaron títulos y resúmenes, excluyendo casos clínicos, revisiones sistemáticas, artículos duplicados y/o no atingentes al tema. Se incluyeron artículos que reportan prevalencia de TDA en personas con PC y se extrajo la información sobre el tipo estudio, metodología, prevalencia, tipo de diente, de TDA más frecuente en PC y datos de prevalencia de grupo control. Se identificó un total de 32 artículos, de los cuales se seleccionaron e incluyeron 12 estudios para la revisión sistemática y de ellos cuatro se utilizaron en el metaanálisis. La prevalencia de TDA en personas con PC reportada en estos estudios mostró un rango entre 10,6-76,5 %. Los incisivos superiores fueron el tipo de diente más afectado por TDA. Sólo cuatro estudios comparan con un grupo control. La prevalencia de TDA fue mayor en sujetos con PC que en sujetos sanos (odds ratio 1,58 [95 % IC= 0,66 - 3,77]). Sin embargo, esta diferencia no fue estadísticamente significativa y los estudios incluidos presentaron una alta heterogeneidad.

ABSTRACT: Cerebral palsy (CP) is a neurological disorder that affects approximately 2 out of every 1,000 live births. It is described as a group of developmental disorders of movement, balance, and posture, which cause activity limitation. Some studies have suggested that CP may increase the risk of dental trauma injuries (DTI). The objective of this study was to review the available scientific evidence on the prevalence and trends of DTI in people with CP, and to compare it with the prevalence of people without it. A systematic search was carried out in Pubmed, Scielo and Lilacs. Titles and abstracts were evaluated, excluding clinical case reports, systematic reviews, duplicate articles and/ or not relevant to the topic. Articles reporting the prevalence of DTI in people with CP were included. It was extracted information about the study type, methodology, prevalence of DTI, type of tooth, type of DTI in CP subjects and the prevalence of DTI from the control group, when available. A total of 32 articles were identified, of which 12 studies were selected and included for the systematic review and of these four were used in the meta-analysis. The prevalence of DTI in people with CP reported in these studies showed a range between 10.6-76.5 %. The upper incisors were the type of tooth most affected by DTI. Only four studies compared the DTI prevalence with a control group. The prevalence of DTI was higher in subjects with CP than in people without it (odds ratio 1.58 [95 % CI = 0.66 - 3.77]). However, this difference was not statistically significant and the included studies were highly heterogeneous.

Tratamiento estético de defecto de esmalte utilizando tratamiento combinado con resina infiltrante: Reporte de caso / Aesthetic treatment of enamel defect using combined therapy with resin infiltration: Case report

RESUMEN: La presencia de defectos en el esmalte puede afectar negativamente la autoestima de pacientes jóvenes, haciendo muchas veces necesario realizar un tratamiento estético. El tratamiento con resinas infiltrantes, permite obtener resultados estéticos sin realizar remoción del tejido dentario. Sin embargo, en casos de defectos de esmalte con fracturas post-eruptivas, la resina infiltrante por sí sola, no permite obtener un resultado óptimo. El presente reporte utiliza la combinación de resina infiltrante con resina compuesta directa para obtener resultados estéticos. De esta manera, al infiltrar primero, se mejora el aspecto estético de la lesión y también las características adhesivas del esmalte defectuoso, para posteriormente restaurar el contorno perdido aplicando una delgada capa de resina compuesta de translucidez media.

ABSTRACT: The presence of enamel defects can affect negatively the self-esteem of young patients, making it necessary to carry out an aesthetic treatment. Resin infiltration treatment provides aesthetic results without the necessity of removing the defective dental tissue. However, in cases of enamel defects with post-eruptive fractures, the treatment with resin infiltration by itself does not achieve optimal results. This report uses the combination of resin infiltration with direct resin composite to obtain an aesthetic result. This way, by first infiltrating, the aesthetic appearance of the lesion is improved, as well as the adhesive characteristics of the enamel, and subsequently the contour is restored by applying a thin layer of medium translucency resin composite.

Nanoparticles of Bioactive Glass Enhance Biodentine Bioactivity on Dental Pulp Stem Cells.

This study aimed to investigate the cytotoxicity and bioactivity of a novel nanocomposite containing nanoparticles of bioactive glass (nBGs) on human dental pulp stem cells (hDPSCs). nBGs were synthesized by the sol-gel method. Biodentine (BD) nanocomposites (nBG/BD) were prepared with 2 and 5% wt of nBG content; unmodified BD and glass ionomer cement were used as references. Cell viability and attachment were evaluated after 3, 7 and 14 days. Odontogenic differentiation was assessed with alkaline phosphatase (ALP) activity after 7 and 14 days of exposure. Cells successfully adhered and proliferated on nBG/BD nanocomposites, cell viability of nanocomposites was comparable with unmodified BD and higher than GIC. nBG/BD nanocomposites were, particularly, more active to promote odontogenic differentiation, expressed as higher ALP activity of hDPSCs after 7 days of exposure, than neat BD or GIC. This novel nanocomposite biomaterial, nBG/BD, allowed hDPSC attachment and proliferation and increased the expression of ALP, upregulated in mineral-producing cells. These findings open opportunities to use nBG/BD in vital pulp therapies.

Mechanical Properties of Teeth Restored after Selective Caries Excavation. Systematic Review and Meta-Analysis / Propiedades Mecánicas de Dientes Restaurados tras la Remoción Selectiva de Caries: revisión Sistemática y Metaanálisis

The aim of this study was to systematically review the literature of in vitro studies comparing the mechanical properties of teeth restored after selective caries excavation (SCE) and complete caries excavation (CCE). The PubMed/MEDLINE and EMBASE electronic databases were searched systematically. In vitro studies investigating the mechanical properties of teeth restored after SCE, were independently checked by two authors. Inclusion criteria were: (1) performing SCE (2) mentioning the teeth were later restored, and (3) evaluating mechanical properties of the restored teeth. Meta-analysis was performed with and without discriminating between shallow and deep lesions. From 1,859 potentially eligible studies, 14 were selected for full text analysis and 5 were included in the meta- analysis. Fracture resistance was significantly lower after SCE than after CCE in overall analysis (SMD[95%CI]=-1.62[-3.04,-0.20]) and for deep lesion (SMD[95%CI]=-1.62[-2.62,-0.61]), whereas cuspal deflection at 200 and 400N was significantly higher after SCE than after CCE for discriminated and non- discriminated analyses. Furthermore, for shallow lesions the risk of catastrophic fracture was significantly lower after SCE than CCE (RR[95%CI]=0.58[0.43,0.78]). The included studies presented low and medium risk of bias. The mechanical behavior of restored teeth seems to be affected by the excavation strategy. Although there is a tendency for lower fracture resistance and higher cuspal deflection after SCE, there is a lower risk of catastrophic failure when compared to CCE. However, this conclusion is based on very few in vitro studies.

El objetivo de este estudio fue revisar sistemáticamente la literatura de estudios in vitro que comparan las propiedades mecánicas de los dientes restaurados después de la excavación selectiva de caries (ESC) y la excavación de caries completa (ECC). Se realizaron búsquedas sistemáticas en las bases de datos electrónicas PubMed / MEDLINE y EMBASE. Los estudios in vitro que investigan las propiedades mecánicas de los dientes restaurados después de la ESC fueron verificados de forma independiente por dos autores. Los criterios de inclusión fueron: (1) realizar ESC (2) mencionar que los dientes fueron posteriormente restaurados y (3) evaluar las propiedades mecánicas de los dientes restaurados. El metanálisis se realizó con y sin discriminación entre lesiones superficiales y profundas. De 1.859 estudios potencialmente elegibles, se seleccionaron 14 para el análisis de texto completo y 5 se incluyeron en el metanálisis. La resistencia a la fractura fue significativamente menor después de ESC que después de CCE en el análisis general (DME [IC del 95 %] = - 1,62 [-3,04, -0,20]) y para la lesión profunda (DME [IC del 95 %] = - 1,62 [-2,62, - 0,61]), mientras que la deflexión de las cúspides a 200 y 400 N fue significativamente mayor después de ESC que después de CCE para análisis discriminados y no discriminados. Además, para las lesiones superficiales, el riesgo de fractura catastrófica fue significativamente menor después de ESC que de CCE (RR [IC 95 %] = 0,58 [0,43,0,78]). Los estudios incluidos presentaron riesgo de sesgo bajo y medio. El comportamiento mecánico de los dientes restaurados parece verse afectado por la estrategia de excavación. Aunque existe una tendencia a una menor resistencia a la fractura y una mayor deflexión de la cúspide después de la ESC, existe un menor riesgo de falla catastrófica en comparación con la CCE. Sin embargo, esta conclusión se basa en muy pocos estudios in vitro.

Impact of COVID-19 Pandemic on Quality of Life of Type II Diabetes Patients With Periodontitis.

Background: Confinement due to the COVID-19 pandemic has made dental treatments impossible in Chile and many other countries, including diabetic patients with periodontitis. The aim of the present study was to evaluate the impact of periodontal therapy in terms of oral health-related quality of life (OHRQoL) during the COVID-19 pandemic in a cohort of diabetic patients with periodontitis. Material and Methods: Thirty-eight diabetic patients with stage III-IV periodontitis, enrolled for periodontal therapy, were screened. Periodontal clinical parameters including clinical attachment loss (CAL), probing pocket depth (PPD) and bleeding on probing (BOP) as well as glycated hemoglobin (HbA1c) were evaluated at baseline and 3 months follow-up prior the pandemic. The OHRQoL changes by means of Oral Health Impact Profile (OHIP-14) and a self-reported oral health questionnaire were assessed at baseline (prior pandemic) and during the pandemic via telemonitoring. Results: Thirty-one patients received non-surgical periodontal therapy prior to the pandemic. Out of the 31 patients, four died due to COVID-19 resulting in 27 patients available for telemonitoring at the time of the pandemic. Periodontal therapy significantly improved CAL, PPD and BOP (p < 0.05) but not HbA1c (p > 0.05) between baseline and 3 months follow-up pior to the pandemic. Total OHIP-14 scores significantly improved between baseline and the middle of pandemic (intragroup comparison p = 0.00411). In particular, OHIP-14 scores related to the "Physical pain" (intragroup comparison p = 0.04) and "Psychological disability" (intragroup comparison p = 0.00) significantly improved between baseline and the middle of pandemic. Conclusions: In diabetic type II patients with periodontitis periodontal therapy tends to improve the oral health-related quality of life despite the COVID-19 pandemic.

Radiopacidad de Cementos de Resina Compuesta Evaluados con Técnica Radiográfica Digital / "Radiopacity of Resin Cements Evaluated with Digital Radiographic Technique"

RESUMEN: Objetivo: comparar la radiopacidad de distintos cementos de resina y corroborar si cumplen con los requisitos de normativas ISO. Material y método: Se prepararon muestras de 1 mm de grosor de los cementos de resina: RelyX U200 (3M ESPE), Calibra (Dentsply Sirona), Calibra Universal (Dentsply Sirona) y Bifix SE (VOCO). 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 Al. Los datos fueron analizados para comparar la radiopacidad de los materiales entre sí y con los requisitos establecidos por normas ISO. Resultados: La radiopacidad equivalente en mm de Al en orden descendiente fue de 2,84 ± 0,18 para Calibra, 2,37 ± 0,15 para Bifix SE, 2,26 ± 0,14 para Calibra Universal y de 1,67 ± 0,07 para RelyX U200. Estos valores son todos mayores al mismo grosor de aluminio exigido por la norma ISO 4049. Se establecieron diferencias estadísticamente significativas entre los cementos. Conclusiones: Se determinó que existen diferencias en la radiopacidad entre los cementos de resina compuesta estudiados. Sin embargo, todos los cementos evaluados cumplen con la norma ISO-4049 de radiopacidad.

ABSTRACT: Objective: Compare the radiopacity of different resin cements and verify their compliance with the requirements of ISO regulations. Material and method: Samples -10 mm in diameter and 1 mm thickness- of the resin cements RelyX U200 (3M ESPE), Calibra (Dentsply Sirona), Universal Calibra (Dentsply Sirona) and Bifix SE (VOCO) were prepared. Radiographies of the samples with a stepped aluminum wedge were obtained. For each sample, the grayscale and mm of Al values were calculated. The data were analyzed to compare the radiopacity of the materials and to contrast them with the requirements established by ISO standards. Results: The equivalent radiopacity in mm of Al in descending order was 2.84 ± 0.18 for Calibra, 2.37 ± 0.15 for Bifix SE, 2.26 ± 0.14 for Calibra Universal and 1.67 ± 0.07 for RelyX U200. These values exceed the value required by ISO 4049 standard. Statistically significant differences were established between the cements. Conclusion: There are differences in the radiopacity of the resin cements studied. However, all the cements complied with ISO 4049 radiopacity standards.

A 4-year follow-up case of extrusive luxation in a patient with cerebral palsy.

Cerebral palsy (CP) is a condition caused by brain damage before, during, or shortly after birth. Communication can be a challenge when treating patients with CP. Some patients can communicate verbally, while others use augmentative alternative communication tools or have individualized means of communication. Therefore, professional dental treatment in individuals with CP is challenging, especially if the patient is affected by dental trauma and requires emergency treatment. This report shows how individualized communication skills assessment allowed us to successfully manage a 9-year-old patient with CP, who suffered extrusive luxation of the permanent lower incisor. In the present case, the teeth were repositioned briefly after the trauma had occurred and then stabilized with a flexible splint according to international guidelines. The teeth remained vital and periodontal repair was observed during the 4-year follow-up.

Effect of Clinical Experience on Accuracy and Reliability of Radiographic Caries Detection / Efecto de la Experiencia Clínica en la Precisión y Concordancia de Detección de Caries en Radiografías

ABSTRACT: The purpose of this study was to investigate the accuracy and interobserver reliability of examiners with different levels of clinical experience, when diagnosing radiographic proximal caries lesions. Bitewing radiographs were selected from a patient attending Operative Dentistry Clinic, Universidad de Chile. Radiographic examination was performed by three different groups: A: third year dentistry students, B: fourth year dentistry students, and C: dentist recently graduated. Thirty-two proximal surfaces were scored as: 0, sound; 1: enamel caries; and 2: dentinal caries. The data were analysed and accuracy and interexaminer reliability were calculated. Accuracy values for enamel caries were: A (0.54), B (0.55) and C (0.58), and dentinal caries were: A (0.55), B (0.61) and C (0.63). Interexaminer reliability denoted marginal agreement for all groups, A (0.249), B (0.213) and C (0.282) for enamel caries and A (0.058), B (0.102), and C (0.344) for dentinal caries. The results of this study indicate that the accuracy and interexaminer reliability of bitewing radiographic examination were influenced by the clinical experience when detecting radiographic proximal caries, however low values of accuracy and interexaminer reliability were noted, reinforcing the necessity of improving education and training in radiographic caries detection.

RESUMEN:El objetivo de este trabajo fue evaluar la precisión y concordancia entre examinadores con distinto nivel de experiencia clínica, al diagnosticar lesiones de caries proximales en radiografías. Un set de radiografías bitewing fue seleccionado de un paciente que acudió a la Clínica de Operatoria de la Facultad de Odontología, Universidad de Chile. El examen radiográfico fue realizado por tres grupos distintos: A: estudiantes de Odontología de tercer año, B: estudiantes de Odontología de cuarto año, y C: dentistas recientemente graduados. Treinta y dos superficies proximales fueron analizadas y evaluadas como: 0, sana; 1: lesión de caries de esmalte, 2: lesión de caries dentinaria. Los datos obtenidos fueron analizados y la precisión y concordancia entre examinadores fueron calculadas. Los valores de precisión en lesiones de esmalte fueron: A (0,54), B (0,55) y C (0,58), y para lesiones dentinarias fueron: A (0,55), B (0,61) y C (0,63). La concordancia entre examinadores denotó ser marginal para todos los grupos, A (0,249), B (0,213) y C (0,282) en lesiones de esmalte y A (0,058), B (0,102), y C (0,344) en lesiones dentinarias. Los resultados de este estudio indican que la precisión y la concordancia entre examinadores está influenciada por la experiencia clínica, sin embargo los valores encontrados fueron bajos, lo que refuerza la necesidad de mejorar la educación y entrenamiento en detección de lesiones de caries en radiografías

Enhanced bioactive properties of BiodentineTM modified with bioactive glass nanoparticles.

OBJECTIVE: To prepare nanocomposite cements based on the incorporation of bioactive glass nanoparticles (nBGs) into BiodentineTM (BD, Septodent, Saint-Maur-des-Fosses Cedex, France) and to assess their bioactive properties. MATERIAL AND METHODS: nBGs were synthesised by the sol-gel method. BD nanocomposites (nBG/BD) were prepared with 1 and 2% nBGs by weight; unmodified BD and GC Fuji IX (GIC, GC Corporation, Tokyo, Japan) were used as references. The in vitro ability of the materials to induce apatite formation was assessed in SBF by X-ray diffraction (XRD), attenuated total reflectance with Fourier transform infrared spectroscopy (ATR-FTIR), and scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis. BD and nBG/BD were also applied to dentine discs for seven days; the morphology and elemental composition of the dentine-cement interface were analysed using SEM-EDX. RESULTS: One and two percent nBG/BD composites accelerated apatite formation on the disc surface after short-term immersion in SBF. Apatite was detected on the nBG/BD nanocomposites after three days, compared with seven days for unmodified BD. No apatite formation was detected on the GIC surface. nBG/BD formed a wider interfacial area with dentine than BD, showing blockage of dentine tubules and Si incorporation, suggesting intratubular precipitation. CONCLUSIONS: The incorporation of nBGs into BD improves its in vitro bioactivity, accelerating the formation of a crystalline apatite layer on its surface after immersion in SBF. Compared with unmodified BD, nBG/BD showed a wider interfacial area with greater Si incorporation and intratubular precipitation of deposits when immersed in SBF.

Enhanced bioactive properties of BiodentineTM modified with bioactive glass nanoparticles

Abstract Objective To prepare nanocomposite cements based on the incorporation of bioactive glass nanoparticles (nBGs) into BiodentineTM (BD, Septodent, Saint-Maur-des-Fosses Cedex, France) and to assess their bioactive properties. Material and Methods nBGs were synthesised by the sol-gel method. BD nanocomposites (nBG/BD) were prepared with 1 and 2% nBGs by weight; unmodified BD and GC Fuji IX (GIC, GC Corporation, Tokyo, Japan) were used as references. The in vitro ability of the materials to induce apatite formation was assessed in SBF by X-ray diffraction (XRD), attenuated total reflectance with Fourier transform infrared spectroscopy (ATR-FTIR), and scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis. BD and nBG/BD were also applied to dentine discs for seven days; the morphology and elemental composition of the dentine-cement interface were analysed using SEM-EDX. Results One and two percent nBG/BD composites accelerated apatite formation on the disc surface after short-term immersion in SBF. Apatite was detected on the nBG/BD nanocomposites after three days, compared with seven days for unmodified BD. No apatite formation was detected on the GIC surface. nBG/BD formed a wider interfacial area with dentine than BD, showing blockage of dentine tubules and Si incorporation, suggesting intratubular precipitation. Conclusions The incorporation of nBGs into BD improves its in vitro bioactivity, accelerating the formation of a crystalline apatite layer on its surface after immersion in SBF. Compared with unmodified BD, nBG/BD showed a wider interfacial area with greater Si incorporation and intratubular precipitation of deposits when immersed in SBF.

Impacto de la hipomineralización incisivo molar en la experiencia de caries en escolares de 6-12 años en Santiago, Chile / Molar incisor hypomineralisation and its impact on caries experienced by 6-12 year-old schoolchildren from Santiago, Chile

Objetivo: El objetivo de este estudio fue determinar las consecuencias clínicas expresadas en índices COPD y ceod y su relación con la presencia de hipomineralización incisivo molar (HIM) en una población de escolares de 6 a 12 años de la provincia de Santiago. Método: Este estudio de corte transversal fue realizado en 851 escolares de 6 a 12 años de la provincia de Santiago, quienes fueron evaluados por 2 dentistas calibrados. Con consentimiento de los tutores legales, los escolares fueron examinados, y se utilizaron los criterios diagnósticos para HIM de la Academia Europea de Odontopediatría (EAPD). La historia de caries fue determinada con COPD/ceod de acuerdo a los criterios de la OMS. Los datos fueron recolectados en una ficha especialmente diseñada para esto. Los datos fueron analizados con test «t¼ para muestras individuales (considerando p < 0,05). Resultados: Los escolares afectados por HIM tuvieron una media de COPD de 0,91 (±1,21) y una media de ceod de 1,98 (±2,48), el cual fue mayor que el COPD y ceod de escolares sin HIM (0,41 [±0,95] y 1,34 [±2,15] respectivamente). La diferencia entre ambos grupos fue estadísticamente significativa para COPD (p < 0,000) y ceod (p = 0,002). Conclusiones: Escolares de la provincia de Santiago de 6 a 12 años afectados con HIM presentaron mayor COPD/ceod que escolares sin HIM.

Objective. The aim of this study was to determine the clinical consequences, expressed in DMFT and dmft, and their relationship with Molar Incisor Hypomineralisation (MIH) in a population of schoolchildren of 6 to 12 years old in the Santiago Province. Method: A cross-sectional study was conducted on 851 schoolchildren between 6-12 years old from the Santiago Province were examined by two calibrated examiners. With informed consent from their parents, the schoolchildren were examined, and the European Academy of Paediatric Dentistry (EAPD) diagnostic criteria was used for MIH detection. Caries history was assessed with the DMFT/dmft score according to WHO criteria. Data was collected with a form specially designed for this study. Data was analysed using Student's t-test for individual samples and a post-hoc Bonferroni (P < .05). Results: The mean DMFT score in the MIH-affected schoolchildren was 0.91 (±1.21), with a mean dmft score of 1.98 (±2.48), which were greater than the scores in the non-MIH affected schoolchildren (mean DMFT score 0.41 [±0.95] and mean dmft 1.34 [±2.15]). The differences between DMFT and dmft scores in the two groups were statistically significant (P < .000 and P = .002, respectively). Conclusions: Schoolchildren of Santiago Province of 6-12 year old diagnosed with MIH had higher DMFT/dmft scores compared to schoolchildren not affected with MIH.

The current state of calcium silicate cements in restorative dentistry: a review / Revisión del estado actual de cementos de silicato de calcio en odontología restauradora

ABSTRACT Calcium silicate cements have been used as dental materials for more than twenty years; however, their use in restorative dentistry is more recent. Better mechanical properties and shorter curing times make them suitable for a variety of applications in which they are used as a substitute of dentin, including direct/indirect pulp capping and as cavity base/liner. These materials may also be used to restore enamel temporarily. This article seeks to review the available scientific evidence with a focus on their applications in restorative dentistry. The information was gathered by reviewing original scientific research articles and literature reviews published in journals available in databases such as Medline/Pubmed and Scielo, along with technical information provided by the manufacturers of these cements. This article describes the composition, instructions for use, and curing reaction of calcium silicate cements, as well as the scientific evidence on their applications in restorative dentistry.

RESUMEN Los cementos de silicato de calcio se han aplicado como materiales dentales desde hace más de veinte años; sin embargo, su uso en el área de la odontología restauradora es más reciente. Mejores propiedades mecánicas y menores tiempos de endurecimiento le permiten ser indicados para una variedad de aplicaciones en las que este material se utiliza como sustituto dentinario, entre ellas el recubrimiento pulpar directo/indirecto y como base/liner cavitario. A su vez, también se podría utilizar como material para restaurar esmalte de manera temporal. El presente artículo busca revisar la evidencia científica disponible, enfocándola a sus aplicaciones en odontología restauradora. La información se obtuvo a partir de artículos originales de investigación científica y revisiones de literatura, publicados en revistas disponibles en bases de datos como Medline/Pubmed y Scielo, junto a la información técnica otorgada por los fabricantes de estos cementos. El presente trabajo describe la composición, el modo de empleo, la reacción de fraguado y la evidencia científica sobre las aplicaciones de los cementos de silicato de calcio en odontología restauradora.

State of the art of bulk-fill resin-based composites: a review / Revisión del estado actual de resinas compuestas bulk-fill

ABSTRACT. Introduction: ameloblasts are cells responsible for the production and mineralization of the organic matrix of enamel through several stages: pre-secretory, secretory, transition, and maturation. The organic matrix components are produced in the secretory phase. In the maturation phase, the organic component is removed and the mineralization process starts. This process requires the involvement of matrix metalloproteinase 20 (MMP-20), also called enamelysin. Several studies have shown the presence of MMP-20 in tooth development and its relationship to alterations in enamel formation. The objective was: to classify the different studies and laboratory techniques used to demonstrate the involvement of enamelysin in tooth development and its relation to pathologies during enamel formation. Methods: a systematic review was conducted with the following bibliographic databases: PubMed, Science-Direct, Hinari, and SciELO, in order to classify the different studies related to the involvement of MMP-20 in tooth development and the methods to detect its expression, between the years of 2009 and 2014. Results and conclusions: 11 in vitro models show that MMP-20 has specific cleavage sites for enamel matrix proteins. This process is altered by chemical composition, ions, and the presence of hydroxyapatite. Enamel morphology is altered in the knockout models. In human studies, MMP-20 has been associated with increased susceptibility to dental caries, enamel thickness, and dental agenesis.

RESUMEN. Introducción: el ameloblasto es la célula encargada de la producción y mineralización de la matriz orgánica del esmalte. Atraviesa varias etapas: la fase pre-secretora, secretora, de transición y maduración. En la fase secretora se producen los componentes de la matriz orgánica. En la fase de maduración se elimina el componente orgánico y se inicia el proceso de mineralización. Este proceso requiere de la participación de la metaloproteinasa de matriz 20 (MMP-20) o también llamada enamelisina. Diversos estudios demuestran la presencia de MMP-20 en el desarrollo dentario y su relación con alteraciones en la formación del esmalte. El objeto fue clasificar los diferentes estudios y técnicas de laboratorio empleadas que demuestren la participación de enamelisina en el desarrollo dentario y su relación con patologías en la formación del esmalte. Métodos: se realizó una revisión sistemática de la literatura con las siguientes bases bibliográficas: PubMed, Science-Direct, Hinari y SciELO, con el fin de clasificar los diferentes estudios relacionados con la participación de MMP-20 en el desarrollo dental y los métodos utilizados para detectar su expresión, entre los años de 2009 a 2014. Resultados y conclusiones: los modelos in vitro evidencian que MMP-20 tiene sitios específicos de escisión para las proteínas de matriz de esmalte. Este proceso se ve alterado por la composición química, iones, y la presencia de hidroxiapatita. En los modelos knockout la morfología del esmalte está alterada. En los estudios en humanos, se ha relacionado la MMP-20 con una mayor susceptibilidad de caries dental, el grosor completo de esmalte y agenesias dentales.