RESUMEN
Background: Resin composite has been usually used for restoring primary teeth. Nevertheless, there is a lack of supporting clinical data regarding the survival of resin composite restorations and risk factors that may dictate the service time of the treatment in children. Aim: To evaluate the survival and factors associated with composite resin restoration failure in high caries risk children treated under risk-factor management clinical protocol for dental caries prior to restorative therapy. Design: A total of 230 restorations in primary teeth from records of 48 patients were included in the study. Restoration longevity, up to 3-year follow-up, was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (p<0.05). Results: Mean survival time was 2.7 -year (95 percent CI: 0.75-0.87). Restoration survival reached 82.5 percent up to 3-year evaluation, with an overall annual failure rate of 6.2 percent. The unadjusted model showed restorations performed in children with dmf-t greater than 10 had more restoration failure risk (HR 5.59, 95 percent CI 1.03-30.34; p=0.04) However, this association lost significance in the adjusted analysis (p=0.08). Conclusions: Composite resin restorations in primary teeth presented satisfactory survival after 3-year follow-up (AU)
Antecedentes: El composite de resina se ha utilizado habitualmente para restaurar dientes primarios. Sin embargo, se carece de datos clínicos de apoyo sobre la supervivencia de las restauraciones de resina compuesta y los factores de riesgo que pueden dictar el tiempo de servicio del tratamiento en los niños. Objetivo: Evaluar la supervivencia y los factores asociados al fracaso de las restauraciones de resina compuesta en niños con alto riesgo de caries tratados con un protocolo clínico de gestión de factores de riesgo de caries dental antes del tratamiento restaurador. Diseño: Se incluyeron en el estudio un total de 230 restauraciones en dientes primarios de registros de 48 pacientes. La longevidad de las restauraciones, hasta los 3 años de seguimiento, se evaluó mediante la prueba de supervivencia de Kaplan-Meier. Se utilizó un análisis multivariante de regresión de Cox con fragilidad compartida para evaluar los factores asociados a los fracasos (p<0,05). Resultados: El tiempo medio de supervivencia fue de 2,7 -años (IC95 por ciento: 0,75-0,87). La supervivencia de la restauración alcanzó el 82,5 por ciento hasta la evaluación a los 3 años, con una tasa global anual de fracasos del 6,2 por ciento. El modelo no ajustado mostró que las restauraciones realizadas en niños con dmf-t superior a 10 tenían más riesgo de fracaso de la restauración (HR 5,59; IC 95 por ciento: 1,03-30,34; p=0,04). Sin embargo, esta asociación perdió significación en el análisis ajustado (p=0,08). Conclusiones: Las restauraciones de resina compuesta en dientes primarios presentaron una supervivencia satisfactoria tras un seguimiento de 3 años (AU)
Asunto(s)
Humanos , Preescolar , NiñoRESUMEN
Understanding the mode of action of the different pollutants in human and wildlife health is a key step in environmental risk assessment. The aim of this study was to determine signatures that could link morphological phenotypes to the toxicity mechanisms of four Endocrine Disrupting Chemicals (EDCs): bisphenol A (BPA), perfluorooctanesulfonate potassium salt (PFOS), tributyltin chloride (TBT), and 17-ß-estradiol (E2). Zebrafish (Danio rerio) eleutheroembryos were exposed from 2 to 5 dpf to a wide range of BPA, PFOS, TBT and E2 concentrations. At the end of the exposures several morphometric features were assessed. Common and non-specific effects on larvae pigmentation or swim bladder area were observed after exposures to all compounds. BPA specifically induced yolk sac malabsorption syndrome and altered craniofacial parameters, whereas PFOS had specific effects on the notochord formation presenting higher rates of scoliosis and kyphosis. The main effect of E2 was an increase in the body length of the exposed eleutheroembryos. In the case of TBT, main alterations on the morphological traits were related to developmental delays. When integrating all morphometrical parameters, BPA showed the highest rates of malformations in terms of equilethality, followed by PFOS and, distantly, by TBT and E2. In the case of BPA and PFOS, we were able to relate our results with effects on the transcriptome and metabolome, previously reported. We propose that methodized morphometric analyses in zebrafish embryo model can be used as an inexpensive and easy screening tool to predict modes of action of a wide-range number of contaminants.
