Regeneración / revitalización pulpar en dientes permanentes inmaduros / Pulp regeneration / revitalization in immature permanent teeth

Introducción: El tratamiento pulpar de dientes inmaduros es un procedimiento desafi ante. Los dientes inmaduros tienen unos conductos anchos, paredes dentinarias delgadas y ápices abiertos, además de ser más propensos a la fractura y con mal pronóstico a largo plazo. La revascularización de un diente inmaduro intenta preservar los dientes el mayor tiempo posible, pero hay fracasos porque es difícil lograr una desinfección óptima del sistema de conductos radiculares. Métodos: Se realizó una búsqueda bibliográfi ca consultando las bases de datos electrónicas PubMed y Web of cience de los últimos 10 años, utilizando palabras clave y criterios de elegibilidad. Resultados: El proceso de búsqueda arrojó 635 artículos totales. Tras aplicar fi ltros, eliminar duplicados y seleccionar artículos por título y resumen, solo 27 fueron para el estudio. Conclusiones: La revitalización pulpar tiene altas tasas de supervivencia en el tratamiento de dientes permanentes inmaduros necróticos. Son necesarios ensayos clínicos aleatorios para comparar el efecto de la fi brina rica en plaquetas, el plasma rico en plaquetas y el sangrado inducido sobre la revitalización de un diente con pulpa necrótica. Uno de los principales problemas de la revitalización pulpar es la decoloración coronal. La triple pasta antibiótica es un agente antimicrobiano muy efi caz, pero las altas concentraciones podrían tener un efecto perjudicial sobre la supervivencia de las células madre. (AU)

Introduction: Treatment of affected immature teeth is a challenging procedure. Immature teeth have wide canals, thin dentin walls and open apices, in addition to being more prone to fracture and with a poor long-term prognosis. Revascularization of an immature tooth attempts to preserve the teeth as long as possible, but there are failures because it is diffi cult to achieve optimal disinfection of the root canal system. Methods: An exhaustive search was carried out by consulting the electronic databases PubMed and Web of Science of the last 10 years, using keywords and eligibility criteria. Results: The search process yielded 635 total articles. After applying fi lters, eliminating duplicates and selecting articles by title and abstract, only 27 were for the present study. Conclusions: Pulp revitalization has high survival rates in the treatment of necrotic immature permanent teeth. Randomized clinical trials are needed to compare the effect of platelet-richfi brin, platelet-rich plasma, and induced bleeding on the revitalization of a tooth with necrotic pulp. One of the main problems of pulp revitalization is coronal discoloration. Triple antibiotic paste is a very effective antimicrobial agent, but high concentrations could have a detrimental effect on stem cell survival. (AU)

Edpuzzle versus Moodle: Learning Tools in Pediatric Dentistry Practice: A Study Pilot.

The aim of the present study was to compare the results of two educational platforms for the development of Flipped Learning (FL) in the preclinical practices of paediatric dentistry: Edpuzzle and Moodle 3.4. Methods: Fifty students filled out a questionnaire on knowledge of pulp treatments in primary dentition (Pre-Q). They were divided into two groups: one watched a video on the pulpotomy technique before preclinical practice using Moodle 3.4 (group A) and the other used Edpuzzle (group B). On the day of practice, the students resolved any doubts with the teacher. Next, they performed a pulpotomy on an artificial tooth and answered the questionnaire again (Post-Q) together with a satisfaction survey. Results: In both groups, an increase in the number of correct answers was found in the Post-Q compared to the Pre-Q (p < 0.001), but with no significant differences between groups. The pulpotomy practice ratings were higher in group B, which used Edpuzzle (p < 0.001). In the satisfaction survey, we only found significant differences (p = 0.003) in access to the video, since 100% of the students in group A found it easy to view it through Moodle, unlike in group B. Conclusions: Our results suggest that the use of educational platforms specially designed for FL, such as Edpuzzle, can improve the qualifications of students in paediatric dentistry practices.

Evaluation of the Severity of Malocclusion in Children with Osteogenesis Imperfecta.

Occlusion is the way in which the dental arches are related to each other and depends on craniofacial growth and development. It is affected in patients with Osteogenesis Imperfecta (OI) who present altered craniofacial development. The malocclusion present in 49 patients diagnosed with different types of OI aged between 4 and 18 was studied. The control group of healthy people was matched for age, sex, and molar class. To study the mixed and permanent dentition, the American Board of Orthodontics (ABO) discrepancy Index was applied. The primary dentition was evaluated with a Temporary Dentition Occlusion Analysis proposed for this study. The OI group obtained higher scores in the Discrepancy Index than the control group, indicating a high difficulty of treatment. The most significant differences were found in types III and IV of the disease. Regarding the variables studied, the greatest differences were found in the presence of lateral open bite in patients with OI, and in the variable "others" (agenesis and ectopic eruption). The analysis of primary dentition did not show significant differences between the OI and control groups. Patients with OI have more severe malocclusions than their healthy peers. Malocclusion is related to the severity of the disease and may progress with age.

Skeletal and Dental Morphological Characteristics of the Maxillary in Patients with Impacted Canines Using Cone Beam Computed Tomography: A Retrospective Clinical Study.

The aim of this study is to analyze the skeletal and dentoalveolar morphological characteristics of the maxillary in subjects with a unilateral palatally impacted canine using Cone Beam Computed Tomography (CBCT). A retrospective clinical study was conducted of 100 adult patients divided into two groups: one consisting of patients with a unilaterally palatally impacted maxillary canine (GI), with the subgroups in the right and left hemiarches (GI-R and GI-L), and the second, without impacted canine, as the control group (CG). The CBCT measured skeletal variables (maxillary basal width and alveolar crest height) and dentoalveolar variables (inclination of the upper incisor, tooth lengths of incisors and canines, arch length, tooth size and bone dental discrepancy). In skeletal variables, statistically significant differences were found in alveolar crest height (ACH) in all groups and subgroups (p < 0.01). In the dentoalveolar variables, there were differences in the angle of the upper incisor (II) and lateral incisor length (LLIL) between the GI and GC and the angle of the upper incisor (II'), arch length (AL') and arch length-tooth size discrepancy (ATD') among the GI subgroups (p < 0.01). There are skeletal and dentoalveolar differences in patients with unilateral palatally impacted maxillary canines, with lower angular and linear measurements compared with patients without impaction.

Análisis de la simetría ósea mandibular mediante el trazado de líneas angulares en niños con mordida cruzada unilateral / Analysis of the skeletal symmetry of the mandible by the drawing of angular lines in children with unilateral crossbite

Introducción: Los pacientes con mordida cruzada pueden desarrollar a largo plazo una asimetría esquelética. Considerando esta premisa, nos planteamos si la mordida cruzada puede llegar a provocar cambios óseos cuantificables en edad infantil. El objetivo fundamental de este estudio es determinar si la mordida cruzada unilateral puede producir precozmente, alteraciones óseas cuantificables a nivel del ángulo mandibular. Métodos: Se utilizaron en el estudio las radiografías panorámicas de 217 niños con mordida cruzada unilateral, de edades comprendidas entre 6-9 años y cuyo estadio de dentición fue mixto 1ª fase. Se trazaron, se midieron y se compararon los ángulos goniacos del lado de la mordida cruzada y del lado de la mordida no cruzada, mediante el programa informático tpsDig2 y posteriormente, se realizó un análisis estadístico descriptivo y comparativo. Resultados: Los pacientes con mordida cruzada unilateral derecha presentaban un ángulo mandibular de mayores dimensiones en el lado izquierdo siendo esta diferencia estadísticamente significativa. Los pacientes con mordida cruzada unilateral izquierda presentaban también mayor el ángulo mandibular izquierdo, aunque en este caso dicha diferencia no fue estadísticamente significativa. Conclusiones: No existió una relación entre el lado de la mordida cruzada y el tamaño óseo mandibular a nivel del ángulo mandibular en niños en dentición mixta 1ª fase

Introduction: Patients with crossbite may develop skeletal asymmetry in the long term. The fundamental aim of this study is to determine whether the unilateral crossbite may produce precocious skeletal alterations that may be quantifiable at the angle of the mandible. Method: 217 panoramic radiographies of children with crossbite were used. The children used in the study were between 6 and9 years old and in the first stage of mixed dentition. All the goniac angles of the cross-bite side and the non-crossbite side were drawn, measured and compared with the computer program tpsDig2. Afterwards, a descriptive and comparative statistical analysis was done. Results: The patients with a right unilateral crossbite presented a bigger goniac angle on their left side, being this difference statistically significant. The patients with a left unilateral crossbite also showed a bigger goniac angle on their left side, but in this case the difference was not statistically significant. Conclusions: There was no relationship between the side of the crossbite and the size of the mandibular bone at the goniac angle in children in their first stage of mixed dentition

Estudio de la erupción de la dentición permanente en niños y adolescentes de la Comunidad de Madrid (España) / Study of eruption of permanent teeth in children and adolescents in Madrid (Spain)

Introducción: El momento de aparición de un diente en la cavidad oral ha sido estudiado, a lo largo de los años, por diversos autores, por su relación con distintos factores (sistémicos y ambientales) y debido a su influencia en diversos ámbitos de la odontología. Material y método: Con el fin de analizar el patrón eruptivo de nuestra población decidimos realizar un estudio descriptivo de tipo transversal sobre las características de la erupción de la dentición permanente en 752 niños y adolescentes de la Comunidad de Madrid (España), de los que el 46,2% eran del sexo masculino y el 53,8% del femenino. Resultados: Observamos que los dientes permanentes emergen en la cavidad oral entre los 6,99 y los 12,45 años de edad en las niñas y entre los 7,06 y los 12,81 años de edad en los niños. En general, no encontramos diferencias estadísticamente significativas en cuanto al momento de emergencia entre dientes homólogos contra laterales. Observamos que los dientes de la arcada inferior erupcionan antes que los de la superior y que la erupción de la dentición permanente ocurre antes en las niñas que en los niños. Conclusiones: El orden de aparición de los dientes permanentes en ambos sexos fue: primer molar, incisivo central (en el lado derecho; en el izquierdo el incisivo central precede al primer molar), incisivolateral, primer premolar, segundo premolar, canino y segundo molar en la arcadasuperior. Y en la arcada inferior: incisivocentral, primer molar, incisivo lateral, canino, primer premolar, segundo premolar y segundo molar (..) (AU)

Introduction: The moment of appearance of a tooth in the oral cavity has been studied, over the years, by different authors, for its relation to different factors (systemic and environmental) and due to its influence on different areas of dentistry. Material and method: With the aim of analyzing the eruptive pattern of our population, we decided to carry out a descriptive transversal-type study on the characteristics of the eruption of permanent dentition in 752children and adolescents of the Community of Madrid (Spain), of which 46.2% were males and 53.8% were females. Results: We observe that the permanent teeth emerge in the oral cavity between 6.99and 12.45 years of age in the girls and between 7.06 and 12.81 years of age in the boys. In general, we did not find statistically significant differences as regards the moment of emergence of the (..) (AU)

How to improve communication with deaf children in the dental clinic

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It may be difficult for hearing-impaired people to communicate with people who hear. In the health care area, there is often little awareness of the communication barriers faced by the deaf and, in dentistry, the attitude adopted towardsthe deaf is not always correct.A review is given of the basic rules and advice given for communicating with the hearing-impaired. The latter are classified in three groups – lip-readers, sign language users and those with hearing aids. The advice given varies for the different groups although the different methods of communication are often combined (e.g. sign language plus lip-reading,hearing-aids plus lip-reading).Treatment of hearing-impaired children in the dental clinic must be personalised. Each child is different, depending on the education received, the communication skills possessed, family factors (degree of parental protection, etc.), theexistence of associated problems (learning difficulties), degree of loss of hearing, age, etc (AU)

Valoración de la microfiltración de Compoglass® en molares temporales / Evaluation of Compoglass® microleakage in primary molars

El propósito de este estudio ha sido evaluar el sellado marginal que proporciona Compoglass® (Vivadent), una resina compuesta modificada con poliácidos, en molares temporales. Se realizaron 12 cavidades de clase II en la superficie distal de 12 molares temporales exodonciados sanos, obturándolas con Compoglass. Tras someterlas a un proceso de envejecimiento, se sellaron los dientes excepto en la zona de las restauraciones y se sumergieron en azul de metileno al 5 por ciento durante 4 horas. Después, se seccionaron longitudinalmente y se fotografiaron a 40 aumentos. La microfiltración se limitó al esmalte dentario en todas las muestras. Sólo se observó filtración en los márgenes gingivales y únicamente en el 36,36 por ciento de las muestras. Compoglass proporciona un sellado marginal aceptable para su uso clínico en la dentición temporal (AU)