Factors associated with indication of prophylactic extraction of the lower third molar in orthodontic practice.

Background: To date, there is no consensus on the factors that influence on indication for prophylactic extraction of the third molar, however it is a common indication in orthodontics. Aim: To determine the factors associated with indication of prophylactic extraction of the lower third molar in orthodontic practice. Material and Methods: This cross-sectional analytical study used an online survey to obtain responses from 100 professionals with clinical practice in orthodontics. The Survey Monkey software was used to enter a valid and reliable questionnaire of 11 questions to obtain demographic and clinical information of the professional, as well as some patient conditions that could be considered in a possible indication for prophylactic extraction. The questionnaire was sent through social networks and instant messaging applications. Chi Square test was used to evaluate associated factors and binomial logistic regression to identify risk or protective factors. Results: Factors significantly associated with indication of prophylactic extraction of the lower third molar were experience in orthodontics (p-value = 0.060; OR=0.325), characteristics of impaction (p-value = 0.012; OR=3.689), prevention of pericoronitis (p-value = 0.014; OR=3.769) and help stability of treatment results (p-value = 0.002; OR=6.074). Conclusions: The risk factors to indication for prophylactic extraction of the lower third molar were impaction of the third molar, prevention of pericoronitis and helping the stability of the results after treatment. Furthermore, experience in orthodontics was identified as a protective factor for this indication. Key words:Orthodontics, risk factors, third molar, tooth extraction.

Root canal conicity determination of primary second molars using nanotomography: An in vitro study.

BACKGROUND: The conicity of the root canals of primary teeth is an important measure for endodontic therapies. However, determining this conicity depends on the methods employed, which requires further investigation. AIM: The aim of this study was to determine the conicity of the root canals of the upper and lower primary second molars using nanotomography (nCT). DESIGN: An in vitro study was performed using nine primary second molars, both upper and lower, subjected to nCT. Comparisons between the diameters of root canals were performed between the thirds (cervical-D0, middle-D5, and apical-D7). The conicity (%) was determined for each root canal from cervical to apical. Data were statistically analyzed with a significance level of 5%. RESULTS: The conicity ranged from 2% to 8% for the upper primary second molars. Significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in the mesio- and distobuccal roots (p < .05), but not in the palatal roots (p > .05). For the lower primary second molars, the conicity ranged from 2% to 17%, as well as significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in all roots (distal, mesiobuccal, and mesiolingual; p < .05). CONCLUSION: The conicity of the upper primary second molars was different from that of the lower ones, which showed a greater variability.

Association between developmental defects of enamel and early childhood caries in children under 6 years old: A systematic review and meta-analysis.

Early childhood caries (ECC) are an oral health problem worldwide in children under 6 years of age. This disease of rapid development has a multifactorial etiology, and one of the possible risk factors is developmental defects of enamel (DDE), such as hypoplasia and opacities. The aim of this systematic review was to evaluate the association between DDE and ECC in children under 6 years of age. An electronic search was conducted until March 2022 using Medline (PubMed), Scopus, Science-Direct, LILACS, Web of Science, Cochrane Library, EBSCO-Host, EMBASE, and Google Scholar and complemented with a manual search, with no restrictions on language or date of publication. Longitudinal studies of children under 6 years of age with primary dentition were included. A total of 1158 studies were found, of which 651 records were reviewed by title and abstract, and 24 articles were selected for full-text evaluation. Finally, nine studies that met the selection criteria were included in the qualitative synthesis. Study quality and certainty were assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Three cohort studies of good quality were included in the meta-analysis. A risk associated with DDE (RR = 1.94; 95% CI: 1.52-2.49) and a risk associated with enamel hypoplasia (RR = 5.45; 95% CI: 1.84-16.14) were found. The results for diffuse opacity (RR = 1.21; 95% CI: 0.18-8.15) and demarcated opacity (RR = 1.26; 95% CI: 0.43-3.65) were not significant. GRADE analysis presented low and very low certainty of evidence. It was concluded that there is an association between DDE and ECC. However, the results should be interpreted with caution because of the limitations of the study. The protocol for this study has been registered in PROSPERO under identification number CRD42021238919.

Validity and Reliability of questionnaires measuring attitudes to oral health: A review of the literature.

Background: The instruments used to assess attitudes to oral health must be validated in order for their results to be reliable and comparable with other variables. The aim of this review was to analyze the ability of self-administered questionnaires to validly and reliably measure attitudes to oral health. Material and Methods: A bibliographic review was carried out using the following databases, Medline (PubMed), SCOPUS and Web of Science from the year 2016 to 2021, using the keywords: (questionnaire* OR survey*) AND (attitude* OR behav*) AND ("oral health" OR "dental care") AND (validity OR reliability). Results: A total of 234 original articles were found in the databases, only 22 met the selection criteria, of which 13 were aimed at patients and nine at health professionals. Evidence of validity and reliability was determined using "COnsensus-based Standards for the selection of health status Measurement INstruments" (COSMIN). Conclusions: Most of the articles partially meet the validity and reliability criteria. Key words:Questionnaire, attitude, behavior, oral health, validity and reliability.

Correlation between cervical vertebrae maturation and midpalatal suture fusion in patients aged between 10 and 20 years: A cross-sectional and 3D study.

OBJECTIVE: This study aimed to correlate the cervical vertebrae maturation (CVM) stages with the bone fusion stages of the midpalatal suture (MPS). MATERIALS AND METHODS: The sample consisted of 351 cone-beam computed tomographies (CBCTs) of patients divided into two groups: 10-15 years old and 16-20 years old. Both CVM and MPS stages were correlated using Spearman's correlation analysis. To assess the diagnostic performance of the CVM stages in identifying the bone fusion stages of the MPS, the likelihood ratio (LHR) test was applied. RESULTS: In the whole sample, a low positive correlation was found between CVM and MPS bone fusion level (P<0.001; Rho=0.395). In the younger age group, the correlation was moderate in the male (P<0.001; Rho=0.616) and low in the female (P<0.001; Rho=0.394) patients. In the 16-20 years age group, there was no correlation between CVM and MPS fusion. A moderate increase in the probability of determining CS1 for stage A (38%) and CS2 for stage B (42.2%) of MPS ossification was found among the 10-15 year old female patients. CONCLUSION: A low and moderate positive correlation was found between CVM and MPS level of bone fusion in female and male patients respectively, but the diagnostic performance of the CVM stages in the identification of MPS bone fusion stages did not have a high correlation. Therefore, the CVM stages indicated no conclusive probability of determining the MPS bone fusion stage.

Evaluation of the suture ossification level according to age and sex in children, adolescents, and adults. A cross-sectional and observational 3D study.

OBJECTIVE: To determine the ossification level of the midpalatal suture (MPS) in children, adolescents and adults from a Peruvian sample; according to the method proposed by Angelieri et al. with cone-beam computed tomographies (CBCTs). MATERIAL AND METHODS: The sample consisted of 315 CBCTs of 168 females and 147 males. The total sample was divided into 3 groups according to age and sex: children (n=77), adolescents (n=113) and adults (n=125). The images were mainly assessed in the axial plane using the Real Scan 2.0 software. The different periods of ossification of the MPS at the level of the vertical half of the palate was defined according to the five stages of Angieleri method (from A to E). The Student t-Test, Chi-square test, Kruskal-Wallis test and Spearman's Rho test were applied. RESULTS: Chi2 test results showed that the stages of MPS ossification depended on the age of the patient by age ranges (P<0.005). Multiple comparison tests affirmed that male and female subjects in the children group had fewer ossification stages than the adolescent and adult groups (P<0.001). Meanwhile, there were no statistically significant differences between the two older age groups. Finally, there was a moderate positive correlation between the stages of ossification of the MPS and the age in the male group (Rho=0.511). CONCLUSIONS: The onset of MPS ossification was significantly related to subjects up to 12 years of age and more frequently in stages B and C in both sexes. There was no difference in MPS ossification in adolescents and adult subjects.

Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: a cone-beam computed tomographic study.

BACKGROUND: After sinus floor augmentation, a thickening of the sinus mucosa has been described. The aim of the present study was to evaluate the involvement of the maxillary sinus ostium in the edematous processes after a sinus floor augmentation procedure. METHODS: Seventy-two cone-beam computerized tomographies (CBSTs) were taken before sinus floor augmentation and after 1 week and 9 months from surgery and analyses. Sinus mucosa thickness and area, ostium diameter and patency, and extension of the post-surgical transient mucosal thickening in relation to the ostium were evaluated on the CBCTs for all three periods. The term "virtual" when referring to sinus mucosa thickness and area was introduced because of the edema and bleeding that both contributed to a transient thickening and additional elevation of the sinus mucosa. RESULTS: The mean virtual thickness of the sinus mucosa was 2.7 ± 4.0 mm, 7.7 ± 7.1 mm, 1.7 ± 2.0 mm before surgery, and after 1 week and 9 months. The virtual mucosa area was 37.2 ± 52.5 mm2, 184.5 ± 153.8 mm2, and 34.0 ± 50.7 mm2. The ostium diameter at the three periods evaluated was 1.8 ± 0.5 mm, 1.1 ± 0.6 mm, 1.5 ± 0.8 mm, respectively. Three infundibula (4.2%) were found out of patency before surgery while this number increased to 14 (19.4%) after 1 week. Nine months after surgery, only one infundibulum (1.4%) was out of patency, however, without presenting signs of sinus pathologies. The extension of the mucosal edema on the palatal sinus was reduced after 9 months of healing. CONCLUSIONS: One week after sinus floor augmentation, the maxillary sinus mucosa increased in dimensions and in several cases involved the ostium, reducing its diameter and producing a transient loss of patency. After 9 months of healing, the initial conditions were recovered.

Root canal conicity estimation of primary maxillary central and lateral incisors-A study by Nano-CT.

AIM: The objective of the study was to estimate the conicity of the root canals of maxillary central and lateral incisors by computed nanotomography (Nano-CT). DESIGN: This in vitro study included nine extracted primary maxillary central incisors and 12 maxillary lateral incisors, which were subjected to Nano-CT analysis. The resulting images of each tooth were reconstructed using the OnDemand3D software, and root canal area, volume, and taper analysis were performed using the free FreeCAD 0.18 software for the 3D computer-aided design (CAD) model. Data were statistically analysed using the Stata v14.0 software, adopting a significance level of 5%. RESULTS: The results presented the mean value of the diameter and area of the root canal of primary central and lateral incisors. In addition, the taper values for both dental groups between points D0-D5, D5-D7, and D7-D10 were determined. Considering the diameters obtained over the entire length of the root, with a length of 12 mm, a conical model was constructed. CONCLUSION: Detailed knowledge of root morphology of maxillary central and lateral incisors of primary dentition by means of Nano-CT is important to achieve faster, more accurate, and efficient endodontic treatments.

Estudio de la longitud y diámetro radicular de incisivos laterales primarios utilizando la tomografía computarizada cone beam: un estudio in vitro

Objetivo: Determinar la longitud y el diámetro radicular de los incisivos laterales superiores deciduos a través de la Tomografía Computarizada Cone Beam. Metodología: Estudio descriptivo y transversal. Se recolectaron 20 incisivos deciduos laterales superiores recién extraídos o avulsionados de la clínica odontológica de la Universidad Nacional Mayor de San Marcos, en el año 2016. Los dientes fueron escaneados utilizando la Tomografía Cone Beam, se empleó el equipo OP300 Maxio, Orthopantomograph ®. Las imágenes resultantes fueron analizadas en el software de análisis de imagen ONDEMAND3DDENTAL. Se midió el eje axial, la longitud de la corona, raíz y la longitud total de la pieza dentaria. Para el análisis estadístico se utilizó el software Stata v14 (Stata Corporation College Station, Texas), previo al análisis los datos obtenidos fueron sometidos a la prueba de normalidad de Shapiro-Wilk, cumpliendo con esto, se usaron las pruebas paramétricas ANOVA y T de Student. Resultados: El 100% de los incisivos laterales superiores deciduos presentó un único canal radicular. La longitud promedio de la corona y de la raíz fue de 3.8mm y 11,86mm respectivamente. El diámetro medio del canal radicular según profundidad fue de 1.11 mm a nivel cervical, de 0.94 mm a nivel medio y de 0.74 mm a nivel apical, estos mostraron diferencias estadísticamente significativas (p<0.05).Conclusiones: La longitud promedio de los incisivos laterales superiores deciduos fue de 15,68mm y el diámetro radicular disminuyo de cervical a apical.

Influencia de los factores sociodemográficos, familiares y el estado de la salud bucal en la calidad de vida de adolescentes peruanos / Influence of socio-demographic, familial factors and the state of oral health in the quality of life of

Evaluar la influencia de los factores familiares, sociodemográficos y el estado de salud bucal en la Calidad de Vida Relacionada a la Salud Bucal (CVRSB) de adolescentes peruanos. Materiales y métodos: En este estudio descriptivo y transversal se tomó una muestra aleatoria constituida por 131 adolescentes peruanos de 11 a 14 años de edad. El cuestionario de CVRSB utilizado fue el Child Perceptions Questionnaire (CPQ11- 14). Se registró el estado de salud bucal de los adolescentes como la presencia de caries dental a través del índice de piezas cariadas, perdidas y obturadas en dentición permanente (CPOD), sangrado gingival, trauma dental, defecto del esmalte y necesidad de tratamiento ortodóntico. Adicionalmente, se registró los factores familiares y sociodemográficos mediante un cuestionario para padres. Resultados: El modelo de regresión de Poisson mostró los predictores que influyen en la CVRSB de los adolescentes (p<0.05). También se encontraron correlaciones entre los puntajes bajos del CPQ11-14 y cada dominio con la presencia de caries dental, sangrado gingival, el sexo femenino, el bajo ingreso familiar, no poseer una vivienda propia, no vivir con ambos padres, vivir en hacinamiento y el consumo de tabaco y/o alcohol (p<0.05). Conclusión: La CVRSB de los adolescentes peruanos evaluados se encuentra influenciada por diversos determinantes de la salud, no solo por las condiciones clínicas sino también por factores sociodemográficos y familiares en el cual está inmerso...

Evaluate the influence of socio-demographic, familial factors, and the state of oral health on the OHRQoL (Oral health-related quality of life) in Peruvian adolescents. Methods: For this descriptive transversal study, a random sample of 131 Peruvian adolescents aged 11 to 14 years was taken. What was used to gauge the CVRSB was The Child Perceptions Questionnaire (CPQ11-14). The state of oral health was registered as the dental caries through the decayed, missing and filled teeth (DMFT) index, bleeding gum, dental trauma, dental enamel hypoplasia, and orthodontic treatment need. Additionally, socio-demographic and familial factors were recorded through a questionnaire for parents. Results: The Poisson regression model showed predictors that influence the CVRSB on adolescents (p<0.05). Correlations low scores on the CPQ11-14 was also found, with some presence of dental caries, bleeding gum, considering also females, low family income, not having their own home, not living with both parents, living in overcrowding and consuming snuff and/or alcohol (p<0.05). Conclusion: The OHRQoL of Peruvian adolescents is influenced by several health determinants, not only for the clinical conditions but also by the socio-demographic and familial factors in which it is immersed...

Gastos de atención odontológica de niños con caries de infancia temprana, ocasionados a la familia y al Estado Peruano, representado por el Instituto Nacional de Salud del Niño / Costs of dental care of children with Early Childhood Caries, caused to the family and the Peruvian government, represented by the Child Heath National Institute

Determinar los gastos de atención odontológica de niños con Caries de la Infancia Temprana (CIT) que ocasionan a sus familias y al Estado Peruano, representado por el Instituto Nacional de Salud del Nino (INSN) Lima-Perú. Material y Métodos: Estudio de tipo descriptivo, observacional y transversal. La muestra escogida aleatoriamente estuvo formada por 629 niños menores de 71 meses de edad atendidos en el Servicio de Atención del Infante del INSN, en el año 2009, dicha muestra fue estratificada según condición clínica (sanos o con CIT) y procedimiento realizado (tratamiento preventivo y tratamiento restaurador: con manejo de conducta, sedación, o anestesia general). Para determinar los gastos ocasionados a las familias se entrevistaron a las madres de los niños, y los gastos del hospital fueron calculados según el reporte económico del mismo. Para el análisis estadístico se utilizó el software Stata v12, aplicando las pruebas U. Mann-Whitney y Kruskal-Wallis para comparar y encontrar las diferencias en las variables estudiadas. Resultados: La frecuencia de CIT en la muestra evaluada fue de 82.19%. Según mediana: las familias de pacientes sanos gastan por encima de S/.30.00 (min=12, max=84) en procedimientos de prevención y las familias de los pacientes enfermos gastan por encima de S/.113.00 (min=26, max=761) en tratamientos restaurativos ocasionados por CIT, (Relación de 1:4). De acuerdo al tipo de tratamiento realizado, según la mediana, lo más resaltante se encontró en el rubro de anestesia general, donde las familias gastan por encima de S/.639.00 (min=440, max=761); es decir, 20 veces más que en procedimientos de prevención. Del gasto total, la mayor parte es asumida o subvencionada por el INSN, siendo estos gastos aún mayores. Conclusiones: La CIT, ocasiona importantes gastos directos e indirectos a las familias y al Estado representado por el INSN. Las medidas preventivas son altamente costo efectivas...

Objective: To determine the cost of dental care for children with Early Childhood Caries (ECC) that causes to their families and the Peruvian State, represented by the National Institute of Child Health (INSN) LimaPeru. Methods: A descriptive, observation and transversal study. The randomly selected sample consisted of 629 children under 71 months of age, treated at the Infant Care Service of the INSN in 2009, the sample was stratified according to clinical condition (healthy or Early Childhood Caries) and procedure performed (preventive and restorative treatment: with behavior management, sedation or general anesthesia). To determine the costs incurred by families, mothers of children were asked and hospital costs were calculated according to the economic report. For statistical analysis software was used Stata v12, applying the Mann-Whitney U test and Kruskal-Wallis test to compare and find the differences in the studied variables. Results: The frequency of ECC in the evaluated sample was 82.19%. According to the median, families of healthy patients spend over to S / .30.00 (min = 12, max = 84) in methods of prevention and families of sick patients spend over to S / .113.00 (min = 26, max = 761) in restorative treatments caused by CIT, (ratio 1: 4). According the type of treatment performed, as reported by the median, most interesting observation was found under general anesthesia; families spend over to S / .639.00 (min = 440, max = 761), ie 20 times more than in methods of prevention. The biggest part of total spending is taken or subsidized by the hospital, and these costs are even higher. Conclusions: ECC, cause significant direct and indirect costs to families and the State, represented by the hospital. Preventive measures are highly cost effective...