Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners

The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.

Trabalho de conclusão de curso de Odontologia: uma análise de perfil / Dentistry course monograph: a profile analysis

Este estudoavaliouo perfil de pesquisa acadêmica do Curso de Odontologia do Centro Universitário Uninovafapi por meio da análise de todososTrabalhos de Conclusão de Curso (TCC)apresentados no período de 2014/1 a 2019/1. Trata-se de pesquisa documental de caráter exploratório realizada no repositório de TCC da instituição. Dos 267 TCC defendidos no período pesquisado, 262atenderam aos critérios de inclusão. Os resultados apontaram que anota média foi 9,3±0,9 pontos. Observou-se que a área mais escolhida pelos alunos foia Ortodontia (17,2%). Apenas 19(7,3%)foram publicados em periódicos científicos. Conclui-se que a Ortodontia é a especialidade que desperta maior interesse nos acadêmicos de Odontologia para escrita do seu trabalho de conclusão. Além disso, verificou-se a necessidadede reflexão do corpo docente e discente para a concretização de publicações cientificas ainda na graduação (AU).

This study analyzed the academic research profile of the Dentistry Course at UninovafapiUniversity Centre through the analysis of all monographs presented in the period from 2014.1 to 2019.1. This is an exploratory research carried out in institution's monograph repository. The collected data were tabulated and analyzed with Microsoft Excel®software. Of the 267 monographs, 262 were included. The results showed that mean grade was 9.3 ± 0.9 points. It was observed that the area most chosen by students is Orthodontics (17.2%). Only 19 were published in scientific journals. We conclude that Orthodontics is the specialty with the greatest interest. In addition, it is important for teaching staff and students to think about achieving scientific publications during the undergraduate course (AU).

Habilidades investigativas en estudiantes del ciclo clínico de la carrera de Estomatología / Research skills in students of the clinical cycle of Stomatology pre-graduate studies

RESUMEN Introducción: las habilidades investigativas se insertan en la formación del profesional de estomatología como una de las dimensiones claves del proceso de formación. Objetivo: evaluar la percepción de los estudiantes acerca del estado actual de desarrollo de las habilidades investigativas en el ciclo clínico de la carrera de Estomatología de la Universidad de Ciencias Médicas de Matanzas. Materiales y métodos: se realizó una investigación descriptiva, de corte transversal, en la que participaron 68 estudiantes de tercer a quinto año, durante la culminación del curso 2018-2019. Fueron seleccionados a través de un muestreo intencional. Se empleó un cuestionario de percepción del dominio de las habilidades relacionadas con el manejo de la información científica, el diseño y ejecución de investigaciones, y el análisis de situación de salud bucal. Resultados: los estudiantes reconocieron tener dominio de la habilidad para el manejo de la información científica y para el análisis de situación de salud bucal. Las acciones menos dominadas fueron la recopilación de información y el diseño de un perfil de proyecto de investigación. La Jornada Científica Estudiantil y el trabajo de curso fueron las vías más empleadas para la divulgación científica. Predominaron los obstáculos externos, seguidos de obstáculos asociados al propio dominio de la habilidad para el diseño y la ejecución de la investigación científica. Conclusión: los estudiantes del ciclo clínico de la carrera de Estomatología reconocen poseer un adecuado dominio de las habilidades investigativas, lo cual contribuye de modo satisfactorio a la formación profesional. No obstante, resulta necesario promover acciones educativas que tributen a las operaciones menos dominadas y estimulen la inserción estudiantil en proyectos de investigación para la sistematización de estas habilidades (AU).

ABSTRACT Introduction: research skills are inserted in the training of the stomatology professional as one of the key dimensions of the training process. Objective: to evaluate the perception of students about the current state of development of research skills in the clinical cycle of the pre-graduate studies of Stomatology of the University of Medical Sciences of Matanzas. Materials and methods: a descriptive, cross-sectional research was carried out, involving 68 third to fifth year students, during the co a descriptive, cross-sectional research was carried out, involving 68 third to fifth year students, during the completion of the 2018-2019 course. They were chosen through intentional sampling. A perception questionnaire was used for the mastering skills related to the management of scientific information, the design and execution of research, and oral health situation analysis. Results: the students recognized to master the ability of handling scientific information and oral health situation analysis. Less mastered actions were the collection of information and the design of a research project profile. The Student Science Day and the course work were the most widely used ways for scientific dissemination. External difficulties predominated, followed by difficulties associated with the own mastery of the ability to design and execute scientific research. Conclusion: the students in the clinical cycle of the pre-grade studies of Stomatology recognize having an adequate mastery of research skills, which contributes satisfactorily to professional training. However, it is necessary to promote educational actions that contribute to the less dominated operations and stimulate the insertion of students in research projects for the systematization of these skills (AU).

El desafío de la publicación científica / The challenge of scientific publication

No disponible

FaceBase 3: analytical tools and FAIR resources for craniofacial and dental research.

The FaceBase Consortium was established by the National Institute of Dental and Craniofacial Research in 2009 as a 'big data' resource for the craniofacial research community. Over the past decade, researchers have deposited hundreds of annotated and curated datasets on both normal and disordered craniofacial development in FaceBase, all freely available to the research community on the FaceBase Hub website. The Hub has developed numerous visualization and analysis tools designed to promote integration of multidisciplinary data while remaining dedicated to the FAIR principles of data management (findability, accessibility, interoperability and reusability) and providing a faceted search infrastructure for locating desired data efficiently. Summaries of the datasets generated by the FaceBase projects from 2014 to 2019 are provided here. FaceBase 3 now welcomes contributions of data on craniofacial and dental development in humans, model organisms and cell lines. Collectively, the FaceBase Consortium, along with other NIH-supported data resources, provide a continuously growing, dynamic and current resource for the scientific community while improving data reproducibility and fulfilling data sharing requirements.

Health Data in Dentistry: An Attempt to Master the Digital Challenge.

BACKGROUND: Biomedical research has recently moved through three stages in digital healthcare: (1) data collection; (2) data sharing; and (3) data analytics. With the explosion of stored health data (HD), dental medicine is edging into its fourth stage of digitization using artificial intelligence (AI). This narrative literature review outlines the challenge of managing HD and anticipating the potential of AI in oral healthcare and dental research by summarizing the current literature. SUMMARY: The basis of successful management of HD is the establishment of a generally accepted data standard that will guide its implementation within electronic health records (EHR) and health information technology ecosystems (HIT Eco). Thereby continuously adapted (self-) learning health systems (LHS) can be created. The HIT Eco of the future will combine (i) the front-end utilization of HD in clinical decision-making by providers using supportive diagnostic tools for patient-centered treatment planning, and (ii) back-end algorithms analyzing the standardized collected data to inform population-based policy decisions about resource allocations and research directions. Cryptographic methods in blockchain enable a safe, more efficient, and effective dental care within a global perspective. Key Message: The interoperability of HD with accessible digital health technologies is the key to deliver value-based dental care and exploit the tremendous potential of AI.

Measurement of Early Childhood Oral Health for Research Purposes: Dental Caries Experience and Developmental Defects of the Enamel in the Primary Dentition.

Epidemiological investigations of early childhood oral health rely upon the collection of high-quality clinical measures of health and disease. However, ascertainment of valid and accurate clinical measures presents unique challenges among young, preschool-age children. The paper presents a clinical research protocol for the conduct of oral epidemiological examinations among children, implemented in ZOE 2.0, a large-scale population-based genetic epidemiologic study of early childhood caries (ECC). The protocol has been developed for the collection of information on tooth surface-level dental caries experience and tooth-level developmental defects of the enamel in the primary dentition. Dental caries experience is recorded using visual criteria modified from the International Caries Detection and Assessment System (ICDAS), and measurement of developmental defects is based upon the modified Clarkson and O'Mullane Developmental Defects of the Enamel Index. After a dental prophylaxis (toothbrushing among all children and flossing as needed), children's teeth are examined by trained and calibrated examiners in community locations, using portable dental equipment, compressed air, and uniform artificial light and magnification conditions. Data are entered directly onto a computer using a custom Microsoft Access-based data entry application. The ZOE 2.0 clinical protocol has been implemented successfully for the conduct of over 6000 research examinations to date, contributing phenotype data to downstream genomics and other "omics" studies of ECC and DDE, as well as traditional clinical and epidemiologic dental research.

Tecnologias digitais de informação e comunicação como suporte ao Estágio em Odontologia / Digital information and communication technologies as a support to the Internship in Dentistry

O estudo visou aplicar as Tecnologias Digitais de Informação e Comunicação (TDIC) como suporte ao ensino no campo estágio em Odontologia através de um ambiente virtual de ensino (AVE) aberto, que atendesse às necessidades do estágio. Foi elaborado um sistema de avaliação que analisou os diversos aspectos da aprendizagem em campo. Foi implementado um portfólio de atividades como estratégia educativa no AVE e elaboradas categorias e critérios para sua análise. As ferramentas mais usadas no AVE foram o portfólio, o fórum de discussão e o diário de bordo, segundo a opinião dos estudantes. Aproximadamente 80% dos estudantes e 100% dos preceptores afirmaram que a inserção do AVE favoreceu o processo de ensino-aprendizagem. As ferramentas digitais criadas foram consideradas facilitadoras da aprendizagem pelos estudantes e preceptores avaliados. As TDIC contribuíam para a melhoria dos cursos de graduação, envolvendo de forma mais intensa alunos e professores, integrando-os às estratégias de comunicação, muitas vezes já tão utilizadas em contextos diversos fora da universidade. Foi possível caracterizar os estudantes analisados como sendo a maioria do sexo feminino, solteiros e sem filhos. Além disso, a maioria dos discentes somente estuda. Os estudantes avaliaram como positivo o desempenho dos preceptores. Não foram relatadas dificuldades vivenciadas pelos estudantes e preceptores com a utilização do AVE. O uso dessas tecnologias focou nos componentes curriculares do curso envolvidos, priorizando o acesso síncrono e assíncrono aos conteúdos, a autonomia dos discentes e a disseminação de uma cultura digital. A adequação das metodologias de ensino, permitiu melhorias no desempenho acadêmico dos alunos, professores e preceptores e estimulou o processo de educação permanente, facilitando o ensino-aprendizagem no Estágio em Odontologia (AU).

This study aimed to apply the Digital Information and Communication Technologies (DICT) as a support to the teaching in the training ground of Dentistry through an open virtual teaching environment (VTE), that meets the needs of the internship. An evaluation system has been developed that has analyzed many aspects of field learning. A portfolio of activities was implemented as an educational strategy in the VTE and categories and criteria for its analysis were elaborated. The most used tools in the VTE were the portfolio, the discussion forum and the logbook, according to the students' opinion. Approximately 80% of the students and 100% of the tutors stated that the insertion of the VTE favored the teachinglearning process. The digital tools created were considered to be learning facilitators by the evaluated students and tutors. DICT has contributed to the improvement of undergraduate courses, involving students and teachers more intensely, integrating them into communication strategies, often already used in diverse contexts outside the university. It was possible to characterize the analyzed students as being the majority female, single and childless. In addition, most students only study. The students evaluated the performance of the tutors as positive. No difficulties experienced by students and tutors with the use of the VTE were reported. The use of these technologies focused on the curricular componentes of the course involved, prioritizing synchronous and asynchronous access to content, student autonomy and the dissemination of a digital culture. The adequacy of teaching methodologies allowed for improvements in the academic performance of students, teachers and tutors and stimulated the process of permanent education, facilitating teaching-learning in the Internship in Dentistry (AU).

Use of the Dental Electronic Health Record for Research: Assessing Demographic and Oral Health Characteristics Data for Clinic Patients.

Dental schools in the United States increasingly emphasize community-based practice targeting underserved populations. However, the impact on target populations remains largely undocumented. East Carolina University School of Dental Medicine (ECU SoDM) developed an integrated electronic health record database that aggregates patient data from all clinics in the ECU SoDM system and enables longitudinal assessment of the impact of clinical care on oral health outcomes. The aim of this study was to analyze the demographic and oral health characteristics data for eligible patients from June 2012 to March 2016. Data from 28,029 eligible patients were included. Except for expected variations in racial composition, the demographic data were similar across ECU SoDM clinics and indicated that the patient population represents a geographically diverse sample of outpatients. The mean decayed, missing, and filled teeth (DMFT) index was elevated in this population. Among the trends identified across subgroups were higher DMFT index in older patients and lower DMFT index for individuals of Hispanic or Latino ethnicity. Although the percentage of patients with dental caries overall rose steadily with age, the percentage with untreated dental caries generally fluctuated around 33%±5% without age-related trends. These data provide a baseline for evaluating changes over time and the impact of oral health care introduced to areas served by the ECU SoDM. These findings highlight the need for access to care and support the ECU SoDM's core mission.

Population-Based Linkage of Big Data in Dental Research.

Population-based linkage of patient-level information opens new strategies for dental research to identify unknown correlations of diseases, prognostic factors, novel treatment concepts and evaluate healthcare systems. As clinical trials have become more complex and inefficient, register-based controlled (clinical) trials (RC(C)T) are a promising approach in dental research. RC(C)Ts provide comprehensive information on hard-to-reach populations, allow observations with minimal loss to follow-up, but require large sample sizes with generating high level of external validity. Collecting data is only valuable if this is done systematically according to harmonized and inter-linkable standards involving a universally accepted general patient consent. Secure data anonymization is crucial, but potential re-identification of individuals poses several challenges. Population-based linkage of big data is a game changer for epidemiological surveys in Public Health and will play a predominant role in future dental research by influencing healthcare services, research, education, biotechnology, insurance, social policy and governmental affairs.

Docencia e Investigación en Odontología Legal en Chile: Situación y Desafíos Actuales / Teaching and Research in Legal Dentistry in Chile: Current Situation and Challenges

RESUMEN: El objetivo de este estudio es describir las características de las instituciones y el equipo de investigación y docencia que imparten Odontología Legal (OL) a nivel pregrado en Chile. Estudio cualitativo realizado durante el 2017. Desde las páginas web institucionales de las universidades que imparten la carrera de odontología en Chile, se obtuvo información sobre el cuerpo docente del ramo de OL a nivel pregrado. Cuando la información no estuvo disponible, se solicitó vía correo electrónico. Se realizó una búsqueda de publicaciones chilenas sobre OL y Forense en las bases de datos Medline, SciELO, Lilacs y Cochrane, y se identificó aquellas realizadas por docentes ejerciendo en Chile. La asignatura de OL se imparte a nivel pregrado en 17 de las 21 universidades que imparten la carrera de Odontología, siendo un curso obligatorio en 16 de ellas, y electivo en una de ellas. De los 29 docentes que imparten el ramo a nivel pregrado en Chile, sólo tres tiene la especialidad de OL. Se encontraron sólo 28 publicaciones científicas en el área en los últimos diez años, cuya autoría corresponde a cinco de los docentes del ramo a nivel pregrado. En Chile, la docencia de OL, a nivel pregrado, es impartida mayoritariamente por cirujano-dentistas no especializados en el área, en concordancia con que la especialidad comenzó a impartirse en el año 2015. Es imperioso aumentar la investigación en OL entre los docentes, de manera de desarrollar el área a nivel universitario, aumentando el conocimiento en la disciplina y consolidándola como ciencia.

ABSTRACT: The aim of this study was to describe the characteristics of the universities and the research and education teams imparting "Forensic Odontology" at undergraduate level in Chile. A qualitative cross-sectional study was conducted during 2017. Information was sought from the institutional websites of universities that impart Dentistry degrees. When the information was not available, it was requested via email to the respective authorities. A search was conducted to identify Chilean publications that deal with the topic of forensic dentistry, in the Medline, SciELO, Lilacs and Cochrane databases. Those authored or co-authored by academic(s) teaching in Chile were identified. "Forensic Odontology" is taught at undergraduate level in 17 of the 21 universities that impart the career of Dentistry in Chile, being mandatory in 16 of schools, and an elective in one of them. Of the 29 academics who teach the subject at undergraduate level in Chile, only three have the specialty of OL. Only 28 scientific publications in the area were found in the last ten years, whose authorships correspond to five academics in the field, teaching at undergraduate level. In Chile, "Forensic Odontology" at the undergraduate level, is mainly imparted by dental surgeons not specialized in the subject, in accordance with the fact that the specialty began to be taught in Chile only in 2015. It is imperative to increase the amount of research in forensic odontology conducted by the academics, in order to develop the area at the university level, to improve knowledge in this discipline and consolidate it as a science.

Quality Assessment of Randomized Clinical Trials Reporting in Endodontic Journals: An Observational Study from 2012 to 2017.

INTRODUCTION: Reports on randomized clinical trials (RCTs) are of critical importance because readers of research often do not access the full text. This study aimed to assess the reporting quality of RCTs in 2 leading endodontic journals. METHODS: Issues of 2 endodontic journals, the Journal of Endodontics and the International Journal of Endodontics, dated from 2012 to 2017 were hand searched to identify RCT reports. A 37-item checklist based on the Consolidated Standards of Reporting Trials statement was used to examine the completeness of RCT reporting. RESULTS: One hundred nine RCT reports were included in this study. The majority were published in the Journal of Endodontics (82%). The mean overall reporting quality score was 65.0% (95% confidence interval, 77.3-66.5). Most (80%-100%) RCTs clearly reported the author/contact details, trial design, participant characteristics, number of participants, and recruitment status as well as the study's intervention(s), objective(s), outcome(s), and conclusions. Conversely, only 56 of the 109 articles (51%) satisfactorily reported all 5 items related to the randomization method. Registration of reviews was not reported in any of the included abstracts. Most of the studies included in this analysis did not report their RCT registration (22%), funding (35%), or protocols (23%). CONCLUSIONS: The results of this study suggest that the reporting quality of RCTs in endodontic journals requires further improvement. Better reporting of RCTs is particularly important for ensuring the reliability of research findings and ultimately promoting the practice of evidence-based dentistry. Optimal RCT reporting should be encouraged, preferably by complying with the Consolidated Standards of Reporting Trials guidelines.

O que podemos aprender com os Trabalhos de Conclusão de Curso de graduação em Odontologia? Um estudo bibliométrico / What can we learn from Undergratuate Final Project in Dental Schools? A bibliometric study

Buscou-se analisar a produção científica do curso de graduação em Odontologia da Universidade Federal de Santa Catarina, por meio do levantamento dos Trabalhos de Conclusão de Curso realizados nos primeiros seis anos de implantação do novo currículo. Realizou-se análise bibliométrica dos trabalhos defendidos até 2016 e disponíveis no website da biblioteca universitária. Coletaram-se as variáveis: ano de publicação, áreas de pesquisa, formato da publicação, tipo de trabalho, abordagem, método, objetivo, coleta dos dados, cenários de pesquisa e submissão a Comitês de Ética em Pesquisa. Foi procedida análise descritiva dos 413 trabalhos levantados, sendo em média, 68,83 trabalhos defendidos por ano. Do total, 63,68% foram categorizadas na área de "especialidades odontológicas", destacando-se a dentística restauradora com 23%. A área de Saúde Bucal Coletiva e afins representou 13% e as "ciências básicas" 3%. Um total de 84,75% dos TCC foram realizados no formato de monografia e 63,20% como "pesquisa científica". Destes, 92,34% foram de abordagem quantitativa, 65,90% com método observacional, 61% com objetivo descritivo, 70,75% com dados coletados de forma transversal, 67% submetidos a Comitês de Ética em Pesquisa, e 44,20% desenvolvidos em "serviços públicos". Considera-se que o perfil da produção científica ainda segue o modelo tradicional de Odontologia, coerente com sua histórica formação clínico-cirúrgico-tecnicista, a despeito das mudanças preconizadas pelas Diretrizes Curriculares Nacionais. Sugere-se um planejamento desta produção científica voltada a uma formação condizente com as necessidades em saúde bucal da maioria da população brasileira (AU).

The aim of thisstudy wasto analyze the scientific production of the undergraduate course in Dentistry at UFSC, by means of a survey of the Final Projects carried out in the first six years of implementation of the new curriculum. A bibliometric analysis of the works defended until 2016 and available on the university library website. The following data were collected: year of publication, research areas, publication format, type of work, approach, method, objective, data collection, research scenarios and submission to Research Ethics Committees. A descriptive analysis was carried out of the 413 papers surveyed, with an average of 68.83 works defended per year. Of the total, 63.68% were categorized in the area of "Dental Specialties", highlighting restorative dentistry with 23%. The area of Oral and Collective Health represented 13% and basic sciences 3%. A total of 84.75% of the Final Reports were performed in the monograph format and 63.20% as "Scientific Research". Of these, 92.34% were of a quantitative approach, 65.90% with observational method, 61% with descriptive purpose, 70.75% with cross-sectional data, 44.20% developed in "Public Services" and 67% submitted to Research Ethics Committees. It is considered that the profile of scientific production still follows the traditional model of Dentistry, consistent with its historical clinicalsurgical-technicist formation, in spite of the changes advocated by the National Curricular Guidelines. It is suggested a planning of this scientific production aimed at a training compatible with the oral health needs of the majority of the Brazilian population (AU).

Design Variability of the Push-out Bond Test in Endodontic Research: A Systematic Review.

INTRODUCTION: There is limited literature on the impact of testing variables on the push-out bond test (POBT). This review identified designs of the POBT used in the endodontic literature and aimed to determine which experimental variables may influence the push-out bond strength (POBS). METHODS: A systematic review based on PRISMA guidelines was performed by searching the PubMed, SCOPUS, and Cochrane library databases using terms including push-out and dislocation resistance and descriptions of endodontic materials. Test variables assessed included method of root preparation, timing of sectioning compared with filling, thickness, diameter and taper of sections, and plunger size and velocity. The POBS of 3 common materials (gutta-percha and AH Plus, mineral trioxide aggregate, and Biodentine) were collected from investigations, and a comparison was attempted. RESULTS: One hundred thirty-three studies assessed the POBS of root-filling materials, 68 assessed root repair cements/root-end filling materials, and 16 assessed orifice barrier materials other than mineral trioxide aggregate. There was significant variation in all of the assessed variables, resulting in a large range of reported values for the POBS of the various materials. Because of this heterogeneity in study design, no further statistical analysis of the impact of the test variables on POBS was possible. CONCLUSIONS: There was considerable variation in the POBT design used in endodontic research. Greater standardization is required for future research as well as accurate reporting for all test variables to assess the impact of specific design variables on POBS.

Use and misuse of mixed methods in population oral health research: A scoping review.

BACKGROUND: Despite the known benefits of a mixed methods approach in health research, little is known of its use in the field of population oral health. OBJECTIVE: To map the extent of literature using a mixed methods approach to examine population oral health outcomes. METHODS: For a comprehensive search of all the available literature published in the English language, databases including PubMed, Dentistry and Oral Sciences Source (DOSS), CINAHL, Web of Science and EMBASE (including Medline) were searched using a range of keywords from inception to October 2017. Only peer-reviewed, population-based studies of oral health outcomes conducted among non-institutionalised participants and using mixed methods were considered eligible for inclusion. RESULTS: Only nine studies met the inclusion criteria and were included in the review. The most frequent oral health outcome investigated was caries experience. However, most studies lacked a theoretical rationale or framework for using mixed methods, or supporting the use of qualitative data. Concurrent triangulation with a convergent design was the most commonly used mixed methods typology for integrating quantitative and qualitative data. The tools used to collect quantitative and qualitative data were mostly limited to surveys and interviews. CONCLUSION: With growing complexity recognised in the determinants of oral disease, future studies addressing population oral health outcomes are likely to benefit from the use of mixed methods. Explicit consideration of theoretical framework and methodology will strengthen those investigations.

Secondary Caries in situ Models: A Systematic Review.

In situ caries research serves as a bridge between clinical research and laboratory studies. In this kind of research, volunteers wear a removable intraoral splint or prosthesis containing research samples. Many different in situ models exist to investigate secondary caries. This systematic review compared currently existing secondary caries models and their lesion progression per day values. MATERIALS AND METHODS: Three databases (Medline, Embase, and Cochrane) were searched for relevant literature. Bias risk was assessed and model parameters and caries-related outcomes were extracted by 2 independent researchers. Where possible, caries-related outcomes were normalized by estimating lesion progression per day by dividing lesion depth extracted from microradiographic or microhardness data by the number of days the study lasted. RESULTS: The literature search identified 335 articles. After eliminating duplicates and selection, 31 articles were included. The models differed greatly on factors such as sample location, presence of fluoride in the model, and analysis methods. Three main groups could be identified by sample placement; 68% of models placed samples palatally in the upper jaw, and the lower jaw model could be divided into the buccal (26%) and approximal (6%) areas. Average lesion progression in enamel next to composite was 4.3 ± 2.8 µm (range1.1-8.8 µm/day). DISCUSSION: Studies conducted with palatal models showed caries progression rates 2-5 times higher than the estimated clinical progression rates. Lesion progression per day could be a useful tool for future comparison of models and establishing a standardized model.

Methodological and Reporting Quality of Systematic Reviews and Meta-analyses in Endodontics.

INTRODUCTION: The aim of this systematic review (SR) was to evaluate the quality of SRs and meta-analyses (MAs) in endodontics. METHODS: A comprehensive literature search was conducted to identify relevant articles in the electronic databases from January 2000 to June 2017. Two reviewers independently assessed the articles for eligibility and data extraction. SRs and MAs on interventional studies with a minimum of 2 therapeutic strategies in endodontics were included in this SR. Methodologic and reporting quality were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), respectively. The interobserver reliability was calculated using the Cohen kappa statistic. Statistical analysis with the level of significance at P < .05 was performed using Kruskal-Wallis tests and simple linear regression analysis. RESULTS: A total of 30 articles were selected for the current SR. Using AMSTAR, the item related to the scientific quality of studies used in conclusion was adhered by less than 40% of studies. Using PRISMA, 3 items were reported by less than 40% of studies, which were on objectives, protocol registration, and funding. No association was evident comparing the number of authors and country with quality. Statistical significance was observed when quality was compared among journals, with studies published as Cochrane reviews superior to those published in other journals. AMSTAR and PRISMA scores were significantly related. CONCLUSIONS: SRs in endodontics showed variability in both methodologic and reporting quality.

Investigating societal determinants of oral health-Opportunities and challenges in multilevel studies.

The high prevalence of oral diseases and the persistent nature of socioeconomic inequalities in oral health outcomes across societies presents a significant challenge for public health globally. A debate exists in epidemiology on the merits of investigating population variations in health and its determinants over studying individual health and its individual risk factors. The choice of analytical unit for health outcomes at the population level has policy implications and consequences for the causal understanding of population-level variations in health/disease. There is a lack of discussion in oral epidemiology on the relevance of studying population variations in oral health. Evidence on the role of societal factors in shaping variations in oral health at both the individual level and the population level is also mounting. Multilevel studies are increasingly applied in social epidemiology to address hypotheses generated at different levels of social organization, but the opportunities offered by multilevel approaches are less applied for studying determinants of oral health at the societal level. Multilevel studies are complex as they aim to examine hypotheses generated at multiple levels of social organization and require attention to a range of theoretical and methodological aspects from the stage of design to analysis and interpretation. This discussion study aimed to highlight the value in studying population variations in oral health. It discusses the opportunities provided by multilevel approaches to study societal determinants of oral health. Finally, it reviews the key methodological aspects related to operationalizing multilevel studies of societal determinants of oral health.