Diagnostic assessment of tooth maturation of the mandibular second molars as a skeletal maturation indicator: A retrospective longitudinal study.

INTRODUCTION: Our aim was to analyze the correlation between growth status in height and chronological age, carpal maturation, cervical maturation, and dental maturation, and assess the diagnostic performance of Demirjian's dental maturation as an indicator of the pubertal growth spurt, through a retrospective longitudinal study. METHODS: Records of 60 Canadian patients obtained from the Burlington Growth Centre, which included height and weight charts and a set of x-rays at 6 points in time, were analyzed. The images at each point in time included 1 hand and wrist radiograph, a lateral cephalometric x-ray, and one 45° oblique cephalometric radiograph of each side, which were analyzed using the methods of Fishman, Baccetti, and Demirjian on the mandibular left and right second molars, respectively. The onset of the pubertal growth peak in height (distance to growth peak [DGP]) was identified, and the correlation between methods with DGP was assessed. RESULTS: High levels of correlation were obtained between the methods of Fishman, Baccetti, and Demirjian with DGP. The cutoff point between prepubertal and postpubertal stages was F stage for women and G stage for men, with statistically significant levels of sensitivity and specificity for the test. CONCLUSIONS: The use of the method of Demirjian applied to mandibular second molars is plausible as a predictor of the occurrence of the DGP for the studied population.

Molecular signatures of extracellular vesicles in oral fluids of periodontitis patients.

OBJECTIVE: To characterize extracellular vesicles (EVs) in gingival crevicular fluid (GCF) and saliva samples from healthy/gingivitis and periodontitis patients and correlate them with clinical inflammatory periodontal parameters. MATERIAL AND METHOD: An exploratory study, including 86 subjects, was conducted. Clinical and periodontal data were recorded, and oral fluid samples were obtained. EVs were precipitated by ExoQuick-TC™ and characterized by nanoparticle tracking (NanoSight™), Western blot (WB), transmission electron microscopy (TEM), and ELISA analysis. RESULTS: TEM showed nanoparticles morphologically compatible with EVs, and WB analysis revealed bands of specific EV markers (CD9, TSG101, and Alix) in both oral fluids of periodontitis and healthy/gingivitis subjects. The total concentration of EVs in GCF was increased in periodontitis patients compared to healthy/gingivitis subjects (p = .017). However, we did not observe differences in the EV concentration of saliva samples (p = .190). The size of GCF-EVs was 144.2 nm in periodontitis and 160.35 nm in healthy/gingivitis patients (p = .038). The CD63 exosome marker was increased in GCF of periodontitis patients (p = .00001). The total concentration of EVs in GCF was correlated with bleeding on probing (rho = 0.63, p = .002), periodontal probing depth (rho = 0.56, p = .009), and clinical attachment level (rho = 0.48, p = .030). CONCLUSION: Periodontitis patients have an increased concentration of EVs in GCF, and their role in periodontitis should be clarified.

Contenidos de cariología impartidos por escuelas dentales chilenas: Estudio transversal / Contents of cariology taught by Chilean dental schools: Cross-sectional study

RESUMEN: Objetivo: determinar los contenidos impartidos en cariología, su aplicación clínica y metodología educativa empleada, en las escuelas dentales chilenas de pregrado. Método: Se efectuó un estudio de corte transversal, en una muestra por conveniencia de docentes de cariología y/o asignaturas relacionadas con cariología en 23 de 29 escuelas de odontología chilenas (año 2015), n=13 acreditadas ante la Comisión Nacional de Acreditación y n=10 de 16 no acreditadas. Se envió un cuestionario de 55 preguntas por vía electrónica, basado en los dominios propuestos por la Asociación para la Educación Dental Europea. El cuestionario fue sometido al análisis y evaluación previa de contenido y lenguaje por un comité de expertos, los resultados fueron tabulados y analizados utilizando STATA v14.2. Resultados: La tasa de respuesta del cuestionario fue de 86,95%. En promedio el 70% de los contenidos encuestados son impartidos, de ellos, el 65% se impartieron en clases teóricas, el 14% en práctica de laboratorio y se realizó aplicación clínica en el 24% de los contenidos impartidos. Conclusiones: La actual enseñanza de la cariología en las escuelas dentales chilenas es alta en contenidos teóricos, los que mayoritariamente no se imparten a través de práctica de laboratorio y la aplicación clínica de los contenidos desarrollados es escasa.

ABSTRACT: The objective: was to determine the current contents of cariology taught, its clinical application and educational methodology used in Chilean undergraduate dental schools. Materials and Method: A cross-sectional study was carried out in a convenience sample of cariology teachers and/or teachers of cariology-related subjects belonging to 23 of the 29 Chilean Dental Schools (year 2015), including n=13 out of 13 schools accredited by the National Accreditation Commission, and n=10 out of 16 non-accredited schools. A questionnaire of 55 questions was sent electronically, based on the domains proposed by the Association for European Dental Education (ADEE). The survey was subjected to prior analysis and evaluation of content and language by a panel of experts, the results were tabulated and analyzed using STATA v14.2. Results: The response rate o was 86.95%. On average, 70% of the contents surveyed are taught, of which 65% were taught in didactic classes, 14% were in laboratory practice and 24% were taught in the clinical setting. Conclusions: The current teaching of cariology in chilean dental schools includes a large number of subjects taught mainly in didactic settings, with less in the laboratory practice, while the clinical application of the contents developed is scarce.

Laser Biophotomodulation in Patients with Neurosensory Disturbance of the Inferior Alveolar Nerve After Sagittal Split Ramus Osteotomy: A 2-Year Follow-Up Study.

OBJECTIVE: To evaluate the effect of the application of photobiomodulation in a 2-year follow-up period in patients who have been intervened with a sagittal ramus split osteotomy and present neurosensory disturbance of the inferior alveolar nerve. BACKGROUND: Photobiomodulation is a common clinical tool in dentistry, for its beneficial effects have been shown in surgical and periodontal wound healing, reducing of swelling and pain, neurosensory recovery, and treatment of temporomandibular joint disorders. METHODS: This is a 2-year follow-up study with an experimental (Laser) group (n = 33) that received photobiomodulation, and a control (Sham) group (n = 9), placebo. All patients from the Laser group received laser applications (continuous wave of 0.353 W/cm2, 27 J in 270 sec per session) on days 1, 2, 3, 5, 10, 14, 21, and 28 after surgery. Neurosensory disturbance was evaluated with five tests: Visual Analog Scale (VAS) for pain and sensitivity, sensitivity threshold test, two-point discrimination, and thermal discrimination. All tests were performed before (24 h before surgery) and after surgery (24 h, 28 days, 60 days, 6 months, 1 year, 2 years, more than 2 years). Participants and evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages, and medians. Ordinal and dichotomous variables were compared with Mann-Whitney's and Fisher's tests, respectively. RESULTS: Clinical improvement was observed during the follow-up period for the Laser group; general VAS for sensitivity was normal in 11 participants from the Laser group at 2 years postsurgery (40.74%), while no participants from the Sham group achieved this (p = 0.0341). Twenty-three participants recovered initial values for two-point discrimination (69.7%) after 2 years of follow-up (p = 0.0025) as well as sensitivity threshold test. General VAS for pain was normal in 31 patients from the Laser group after 2 years of follow-up (93.94%, p = 0.0254). CONCLUSIONS: Photobiomodulation was effective for neurosensory recovery on sample studied.

Frecuencia, severidad y ubicación de erupciones acneiformes en hombres y mujeres tras una cirugía ortognática: estudio descriptivo longitudinal / Frequency, severity and location of acneiform eruptions in men and women after orthognathic surgery: longitudinal descriptive study

Describir la frecuencia de erupciones acneiformes y/o exacerbaciones de un acné previo tras una cirugía ortognática. La muestra consta de 57 pacientes (n=57) de ambos sexos, sometidos a una cirugía ortognática, los cuales fueron evaluados en: el preoperatorio (0-7 días previos); en distintas etapas de la cirugía; postoperatorio inmediato (7 ­ 15 días post cirugía) y postoperatorio mediato (30 ­ 40 días postquirúrgicos). En todos los controles clínicos mencionados se determinó la presencia/ausencia, ubicación, severidad y diagnóstico de las erupciones acneiformes. El 52,6 % de los pacientes sometidos a cirugía ortognática presentaron erupciones acneiformes, siendo mayores en las mujeres en comparación con los hombres. La severidad de las erupciones acneiformes es mayor en el postoperatorio inmediato en comparación al preoperatorio y postoperatorio mediato. La ubicación más frecuente del acné corresponde a la región frontal, tanto en el preoperatorio (22,8 %) como en el postoperatorio inmediato (31,6 %). En el postoperatorio mediato la zona más frecuente es la geniana (39 %). La frecuencia de acné post cirugía ortognática es elevada, siendo mayor en mujeres que en hombres. La severidad de este acné es mayor en el postoperatorio inmediato. La región frontal corresponde a la zona más frecuente de aparición de las erupciones acneiformes en el postoperatorio inmediato y la zona geniana en el postoperatorio mediato. El diagnóstico de estas erupciones acneiformes corresponde a un acné esteroidal, por lo que se puede sugerir un posible plan de tratamiento, con el fin de mejorar el postoperatorio de las pacientes y evitar, en lo posible, futuras manifestaciones en nuevas pacientes sometidas a este tipo de cirugía.

Describe the frequency of acneiform eruptions and / or exacerbations of a previous acne after orthognathic surgery. The sample consisted of 57 patients (n = 57) of both genders, undergoing orthognathic surgery, who were evaluated with a follow-up of 2 postoperative months, at different stages of surgery; Preoperative (0-7 days), immediate postoperative (7-15 days) and mediate postoperative (30-40 days). The presence / absence, location, severity and diagnosis of acneiform eruptions were determined in all clinical controls. The frequency of acneiform eruptions corresponds to 52.6 % of patients undergoing orthognathic surgery, being higher in women compared to men in relation to the presence of acneiform eruptions and / or exacerbations of a previous acne after the intervention. The severity of acneiform eruptions is greater in the immediate postoperative period compared to the preoperative and mediate postoperative period. The most frequent location to be found in the facial region is in the frontal area, both in the preoperative (22.8 %) and in the immediate postoperative period (31.6 %). In the postoperative period, the most frequent is the genial area (39 %). The appearance of acneiform eruptions corresponds to steroidal acne. The frequency of acne post orthognathic surgery is high, being higher in women than in men. The severity of this acne is greater in the immediate postoperative period. The frontal region corresponds to the most frequent area of onset of acneiform eruptions in the immediate postoperative period and the genial area in the postoperative period. The diagnosis of these acneiform eruptions corresponds to a steroidal acne, so it is possible to suggest a possible treatment plan, in order to improve the postoperative of the patients and to avoid, as far as possible, future manifestations in new patients undergoing this type of surgery.

Low-level laser effect in patients with neurosensory impairment of mandibular nerve after sagittal split ramus osteotomy. Randomized clinical trial, controlled by placebo

OBJECTIVES: Evaluate the effect on the application of low level laser therapy, in patients that have been previously intervened with a sagittal ramus split osteotomy and present neurosensory impairment due to this surgery, compared with placebo. Study DESIGN: This preliminary study is a randomized clinical trial, with an experimental group (n=17) which received laser light and a control group (n=14), placebo. All participants received laser applications, divided after surgery in days 1, 2, 3, 5, 10, 14, 21 and 28. Neurosensory impairment was evaluated clinically with 5 tests; visual analog scale (VAS) for pain and sensitivity, directional and 2 point discrimination, thermal discrimination, each one of them performed before and after surgery on day 1, and 1, 2 and 6 months. Participants and results evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages and medians. Ordinal and dichotomous variables were compared with Mann Whitney's and Fisher's test respectively. RESULTS: Results demonstrate clinical improvement in time, as well as in magnitude of neurosensory return for laser group; VAS for sensitivity reached 5 (normal), 10 participants recovered initial values for 2 point discrimination (62,5%) and 87,5% recovered directional discrimination at 6 months after surgery. General VAS for sensitivity showed 68,75% for laser group, compared with placebo 21,43% (p-value = (0.0095). Left side sensitivity (VAS) showed 3.25 and 4 medians for placebo and laser at 2 months, respectively (p-value = (0.004). CONCLUSIONS: Low-level laser therapy was beneficial for this group of patients on recovery of neurosensory impairment of mandibular nerve, compared to a placebo

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Low-level laser effect in patients with neurosensory impairment of mandibular nerve after sagittal split ramus osteotomy. Randomized clinical trial, controlled by placebo.

OBJECTIVE: Evaluate the effect on the application of low level laser therapy, in patients that have been previously intervened with a sagittal ramus split osteotomy and present neurosensory impairment due to this surgery, compared with placebo. STUDY DESIGN: This preliminary study is a randomized clinical trial, with an experimental group (n=17) which received laser light and a control group (n=14), placebo. All participants received laser applications, divided after surgery in days 1, 2, 3, 5, 10, 14, 21 and 28. Neurosensory impairment was evaluated clinically with 5 tests; visual analog scale (VAS) for pain and sensitivity, directional and 2 point discrimination, thermal discrimination, each one of them performed before and after surgery on day 1, and 1, 2 and 6 months. Participants and results evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages and medians. Ordinal and dichotomous variables were compared with Mann Whitney's and Fisher's test respectively. RESULTS: RESULTS demonstrate clinical improvement in time, as well as in magnitude of neurosensory return for laser group; VAS for sensitivity reached 5 (normal), 10 participants recovered initial values for 2 point discrimination (62,5%) and 87,5% recovered directional discrimination at 6 months after surgery. General VAS for sensitivity showed 68,75% for laser group, compared with placebo 21,43% (p-value = (0.0095)). Left side sensitivity (VAS) showed 3.25 and 4 medians for placebo and laser at 2 months, respectively (p-value = (0.004)). CONCLUSION: Low-level laser therapy was beneficial for this group of patients on recovery of neurosensory impairment of mandibular nerve, compared to a placebo.