Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 45
Filtrar
2.
J Appl Microbiol ; 2021 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-34216534

RESUMEN

Numerous in vitro biofilm model systems are available to study oral biofilms. Over the past several decades, increased understanding of oral biology and advances in technology have facilitated more accurate simulation of intraoral conditions and have allowed for the increased generalizability of in vitro oral biofilm studies. The integration of contemporary systems with confocal microscopy and 16S rRNA community profiling has enhanced the capabilities of in vitro biofilm model systems to quantify biofilm architecture and analyse microbial community composition. In this review, we describe several model systems relevant to modern in vitro oral biofilm studies: the constant depth film fermenter, Sorbarod perfusion system, drip-flow reactor, modified Robbins device, flowcells and microfluidic systems. We highlight how combining these systems with confocal microscopy and community composition analysis tools aids exploration of oral biofilm development under different conditions and in response to antimicrobial/anti-biofilm agents. The review closes with a discussion of future directions for the field of in vitro oral biofilm imaging and analysis.

3.
Br Dent J ; 229(7): 483-486, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33037373

RESUMEN

Despite evidence strongly supporting use of non-invasive or minimally invasive procedures in caries management, there is still a large gap between evidence-based recommendations and application of these concepts in practice, with the practice of dentistry still largely dominated by invasive procedures in the US. This paper describes efforts in education and clinical practice in the US in the last decade to promote evidence-based cariology strategies, which support a minimum intervention dentistry (MID) philosophy. These include, for example: a competency-based core cariology curriculum framework which has been developed and disseminated. National education accreditation standards supporting caries management are likely to soon be changed to support assessment of best evidence in cariology. There are several ongoing efforts by organised dentistry and other groups involving dental educators, researchers and clinical practitioners to promote cariology concepts in practice, such as the development of evidence-based clinical practice guidelines for caries management by the American Dental Association. Within each of these strategies there are challenges, but also opportunities to expand the implementation of MID in the US, which create optimism for future improvements over time.


Asunto(s)
Caries Dental , Educación en Odontología , Curriculum , Caries Dental/prevención & control , Odontología , Humanos , Estados Unidos
4.
J Dent ; 102: 103467, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32916231

RESUMEN

OBJECTIVES: This in vitro study explored quantitative outcome measures as clinical indicators of simulated occlusal tooth wear progression. METHODS: Ten sound, extracted human premolars were selected and submitted to occlusal tooth wear simulation in 0.5-mm steps (0/0.5/1.0/1.5 mm). At each step, enamel thickness on the buccal cusp tips was evaluated using cross-polarization optical coherence tomography (CP-OCT) and micro-computed tomography (µ-CT). The occlusal surface of each premolar was also scanned at each step using a 3D digital intraoral scanner, followed by morphological characterization using standard topography attributes (Slope, Relief, RFI, OPCr). Repeated measures ANOVA assessed differences in simulated wear levels for the µ-CT and CP-OCT data as well as the topography values. Correlations were also calculated between the µ-CT/CP-OCT and topography data. RESULTS: Significant differences were observed for enamel thickness at each simulation wear stage, for both CP-OCT (p < 0.001) and µ-CT (p < 0.001), with good agreement between methods (intraclass correlation: 0.89). For topography analysis, as wear increased, the average Slope, RFI, and Relief values decreased, and average OPCr values increased, with more significant differences shown for Slope. Slope showed significant (p < 0.05) positive correlations with CP-OCT. OPCr showed significant negative correlations with µ-CT, and CP-OCT (p < 0.05). RFI and Relief were not correlated with either µ-CT or CP-OCT (p > 0.05). CONCLUSIONS: Our findings suggest the potential of PS-OCT for measuring enamel thickness changes in the cusp tips of the occlusal surface. Similarly, conventional intraoral scanners can serve effectively for monitoring overall tooth wear when combined with dental topographic analyses of resultant point clouds. CLINICAL SIGNIFICANCE: CP-OCT measures of enamel thickness and dental 3D topographic attributes showed potential as objective outcomes for the clinical monitoring of occlusal tooth wear. Their combination provided a comprehensive understanding of the tooth wear development process.


Asunto(s)
Atrición Dental , Desgaste de los Dientes , Esmalte Dental/diagnóstico por imagen , Humanos , Evaluación de Resultado en la Atención de Salud , Tomografía de Coherencia Óptica , Desgaste de los Dientes/diagnóstico por imagen , Microtomografía por Rayos X
5.
Dent Mater ; 35(10): 1464-1470, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31395451

RESUMEN

OBJECTIVES: Enamel thickness determination by Cross-Polarization Optical Coherence Tomography (CP-OCT) is a promising approach for quantitative monitoring of tooth wear progression. This study evaluated the ability of CP-OCT to quantify the thickness of natural enamel before, during and after tooth wear simulation. MATERIALS AND METHODS: Natural, unpolished human dental enamel slabs were submitted to five wear stages (Wear 1: to level the surfaces; Wear 2 to Wear 5: 0.05±0.02mm reduction each) simulated by an automatic grinding/polishing machine. Enamel thickness was evaluated with CP-OCT and a gold-standard method (micro-CT) at baseline and after every wear stage. Data were analyzed using ANOVA with pairwise comparisons for wear stages' impact on the thickness and wear depth measurements. The inter-method agreement was analyzed using intra-class correlation coefficients, the difference between means, and Bland-Altman plots. RESULTS: Enamel thickness measurements (mean±standard error, in mm) with natural (1.40±0.05) and worn surfaces (1.08±0.02) by CP-OCT did not differ significantly from those measured by micro-CT (natural=1.39±0.05; worn=1.09±0.02; p-values=0.30 and 0.39, respectively). CP-OCT and micro-CT showed excellent agreement on natural (ICC=0.98) and worn surfaces (ICC=0.98) enamel thickness measurements. Among and between wear stages, there were significant differences in enamel thickness and wear depth measurements for both methods (p-value <0.0001 for all). Both methods yielded similar measurements' mean (0.14±0.01; p-value=0.87) and were in good agreement (ICC=0.77) for wear depth estimation. SIGNIFICANCE: CP-OCT allows accurate measurement of enamel thickness on natural tooth surfaces. Enamel thickness measurement by CP-OCT allows quantitative monitoring of enamel thickness changes and wear depth following progressive wear.


Asunto(s)
Desgaste de los Dientes , Diente , Esmalte Dental , Humanos , Tomografía de Coherencia Óptica , Microtomografía por Rayos X
6.
Heliyon ; 5(4): e01551, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31049448

RESUMEN

Objectives: Lead (Pb) exposure is associated with dental caries. Whether Pb affects tooth microhardness, is unclear. Our objective was to assess whether Pb concentration is associated with microhardness. Methods: Exfoliated primary teeth were collected from 46 volunteers. Teeth were sectioned, one half of each tooth was tested for enamel Knoop microhardness. The remaining half was digested and Pb measured using an inductively coupled plasma-mass spectrometer. Results: The correlations between Pb levels and microhardness were very low, and were not statistically significant at p < 0.05. Conclusions: Previous exposure to high levels of Pb was not associated with decreased tooth microhardness. Clinical significance: This study assessed whether Pb in deciduous teeth is associated with tooth microhardness. As this was not the case, further studies are needed to identify the mechanisms behind the association between lead exposure and tooth decay.

7.
Microbiology (Reading) ; 165(5): 527-537, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30882296

RESUMEN

Biofilm model systems are used to study biofilm growth and predict the effects of anti-biofilm interventions within the human oral cavity. Many in vitro biofilm model systems use a confocal laser scanning microscope (CLSM) in conjunction with image analysis tools to study biofilms. The aim of this study was to evaluate an in-house developed image analysis software program that we call BAIT (Biofilm Architecture Inference Tool) to quantify the architecture of oral multi-species biofilms following anti-biofilm interventions using a microfluidic biofilm system. Differences in architecture were compared between untreated biofilms and those treated with water (negative control), sodium gluconate ('placebo') or stannous fluoride (SnF2). The microfluidic system was inoculated with pooled human saliva and biofilms were developed over 22 h in filter-sterilized 25 % pooled human saliva. During this period, biofilms were treated with water, sodium gluconate, or SnF2 (1000, 3439 or 10 000 p.p.m. Sn2+) 8 and 18 h post-inoculation. After 22 h of growth, biofilms were stained with LIVE/DEAD stain, and imaged by CLSM. BAIT was used to calculate biofilm biovolume, total number of objects, surface area, fluffiness, connectivity, convex hull porosity and viability. Image analysis showed oral biofilm architecture was significantly altered by 3439 and 10 000 p.p.m. Sn2+ treatment regimens, resulting in decreased biovolume, surface area, number of objects and connectivity, while fluffiness increased (P<0.01). In conclusion, BAIT was shown to be able to measure the changes in biofilm architecture and detects possible antimicrobial and anti-biofilm effects of candidate agents.


Asunto(s)
Biopelículas , Procesamiento de Imagen Asistido por Computador/métodos , Boca/microbiología , Programas Informáticos , Algoritmos , Antibacterianos/farmacología , Bacterias/clasificación , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Fenómenos Fisiológicos Bacterianos , Técnicas Bacteriológicas/instrumentación , Técnicas Bacteriológicas/métodos , Biopelículas/efectos de los fármacos , Humanos , Procesamiento de Imagen Asistido por Computador/instrumentación , Viabilidad Microbiana/efectos de los fármacos , Saliva/microbiología , Fluoruros de Estaño/farmacología
8.
J Dent ; 81: 52-58, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30582963

RESUMEN

OBJECTIVES: Optical Coherence tomography (OCT) is a promising clinical imaging technology for quantitative and objective assessment of dental erosion. We aimed to determine the influence of enamel surface roughness and demineralization severity (by erosive challenge) on dental surface loss measurements by cross-polarization OCT (CP-OCT). MATERIALS AND METHODS: Human enamel specimens were prepared with three surface roughness levels (very rough, rough and polished; n = 10 each). They were evaluated using CP-OCT and optical profilometry (gold standard) at baseline, and after 1, 2, 4, 6, 8, 16 and 24 h of erosion demineralization. The effects of roughness and demineralization on enamel loss were analyzed using ANOVA (alpha = 0.05). Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate inter-method agreement and intra-examiner repeatability. RESULTS: CP-OCT surface loss measurements did not significantly differ with the changes in enamel surface roughness (p = 0.27). Among demineralization severities, CP-OCT surface loss measurements at 1, 2, 4 and 8 h did not differ among each other, but they showed significantly lower enamel loss than 16 and 24 h; 6 and 16 h were significantly lower than 24 h (p < 0.05). Overall, CP-OCT and optical profilometry measurements did not differ (p = 0.73); however, ICC was relatively low (ICC = 0.34). Enamel loss estimation by CP-OCT presented an error of approximately ± 150 µm compared to profilometry. Intra-examiner repeatability with CP-OCT was excellent (ICC = 0.98). CONCLUSIONS: Enamel roughness did not affect CP-OCT measurements. The estimated error of CP-OCT measurements limited the appropriate assessment of enamel erosion surface loss, in the magnitude simulated in this study. CLINICAL RELEVANCE: Enamel thickness measurement by CP-OCT presents potential as an objective method for monitoring dental erosion lesions; however, its use may be limited for the assessment of the initial stages of enamel surface loss by erosion.


Asunto(s)
Desmineralización Dental , Erosión de los Dientes , Esmalte Dental , Humanos , Tomografía de Coherencia Óptica
9.
Clin Oral Investig ; 23(4): 1785-1792, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30182319

RESUMEN

OBJECTIVE: Non-invasive esthetic treatment options for stained arrested caries lesions have not been explored. This study aimed to develop laboratory models to create stained-remineralized caries-like lesions (s-RCLs) and to test the efficacy of bleaching on their esthetic treatment. MATERIALS AND METHODS: One hundred twelve enamel/dentin specimens were prepared from human molars, embedded, and had their color measured spectrophotometrically at baseline and after demineralization. They were randomly divided into four groups (n = 14) based on the staining/remineralization protocols for a total of 5 days: G1, no staining/no remineralization; G2, no staining/remineralization in artificial saliva (AS); G3, non-metallic staining/remineralization with sodium fluoride/AS; and G4, metallic staining/remineralization with silver diamine fluoride/AS. The lesion mineral loss (ΔZ) and depth (L) were measured using transverse microradiography along with color change (ΔE). Specimens were bleached and color was re-evaluated. Data were analyzed using ANOVA models followed by Fisher's PLSD tests (α = 0.05). RESULTS: s-RCLs in G4 were significantly (p < 0.001) darker than G3, G2, and G1 regardless of substrate type and condition. s-RCLs in G2, G3, and G4 showed significantly lower ΔZ and L than G1 (all p < 0.001), confirming occurrence of remineralization. G4 exhibited significantly lower ΔZ and L compared to G2 (p < 0.001). Bleaching was more effective in non-metallic than in metallic stained lesions regardless of substrate type (p < 0.001). CONCLUSION: The proposed models created distinct s-RCLs. Non-metallic s-RCLs were lighter and more responsive to bleaching compared to metallic s-RCLs. CLINICAL RELEVANCE: The developed experimental models allow the further investigation of the efficacy and safety of different clinical strategies for the esthetic management of s-RCLs.


Asunto(s)
Caries Dental , Blanqueamiento de Dientes , Remineralización Dental , Color , Esmalte Dental , Dentina , Estética Dental , Humanos , Técnicas In Vitro , Microrradiografía , Distribución Aleatoria
10.
Dent Clin North Am ; 63(1): 119-128, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30447787

RESUMEN

The objective of this article was to provide a summary of evidence-based recommendations for the assessment of caries risk and management of dental caries. The goal is to help clinicians manage the caries disease process using personalized interventions supported by the best available evidence, taking into account the clinician's expertise and the patient's needs and preferences, to maintain health and preserve tooth structure.


Asunto(s)
Caries Dental/diagnóstico , Caries Dental/terapia , Manejo de la Enfermedad , Odontología Basada en la Evidencia , Antiinfecciosos/uso terapéutico , Biopelículas/efectos de los fármacos , Disbiosis/tratamiento farmacológico , Fluoruros/uso terapéutico , Fluoruros Tópicos/uso terapéutico , Humanos , Selladores de Fosas y Fisuras/uso terapéutico , Medición de Riesgo , Desmineralización Dental
11.
J Dent ; 81: 59-63, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30579860

RESUMEN

OBJECTIVES: To evaluate the efficacy of different bleaching systems on artificially created stained-remineralized caries lesions; and to assess the susceptibility of the bleached lesions to further demineralization. METHODS: Human enamel specimens were sectioned, polished, demineralized, and randomly divided into six groups (n = 21) to create stained-remineralized lesions, either non-metallic (non-Met: G1, G2 and G3) or metallic (Met: G4, G5 and G6). G1 and G4 received no bleaching treatment, while G2 and G5 were treated with 15% carbamide peroxide (at-home bleaching protocol; 4 h/d×7), and G3 and G6 with 40% hydrogen peroxide (in-office bleaching protocol; 20min × 3). Susceptibility to further demineralization was tested after bleaching treatment. Lesion mineral loss and depth were measured by transversal microradiography, and color change by spectrophotometry. Outcomes were analyzed using ANOVA models followed by Fisher's PLSD tests (α = 0.05). RESULTS: Metallic-stained lesions were significantly darker (all p < 0.001) and more resistant to bleaching (p < 0.005) than non-Met ones. For both stain types, the at-home bleaching protocol was more effective than the in-office (p < 0.005); however, it also increased the lesion susceptibility to demineralization (p < 0.05) [ΔΔZ mean ± SD ranging from 205 ± 73 to 313 ± 188 (at home) vs. 132 ± 45 to 206 ± 98 (in office); p < 0.05]. After bleaching, non-Met lesions were significantly more susceptible to demineralization (p < 0.05), with the ΔΔZ ranging from 206 ± 98 to 313 ± 188 compared to Met lesions ranging from 132 ± 45 to 205 ± 73. CONCLUSIONS: At-home bleaching protocol presented greater bleaching efficacy compared to in-office bleaching protocol. After bleaching, metallic-stained lesions were more resistant to subsequent demineralization compared to non-metallic stained lesions. CLINICAL SIGNIFICANCE: Bleaching stained-arrested caries lesions may improve aesthetics but also increase susceptibility to demineralization, depending on the type of stain involved and bleaching system used.


Asunto(s)
Caries Dental , Blanqueadores Dentales , Blanqueamiento de Dientes , Desmineralización Dental , Peróxido de Carbamida , Esmalte Dental , Humanos , Peróxido de Hidrógeno
12.
Caries Res ; 53(2): 119-136, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30041245

RESUMEN

Toothpastes are the most universally accepted form of fluoride delivery for caries prevention. To provide anti-caries benefits, they must be able to release fluoride during the time of tooth brushing or post brushing into the oral cavity. However, there is no standard accepted procedure to measure how much fluoride in a toothpaste may be (bio) available for release. The European Organization for Caries Research proposed and supported a workshop with experts in fluoride analysis in toothpastes and representatives from industry. The objective of the workshop was to discuss issues surrounding fluoride analysis in toothpaste and reach consensus on terminology and best practices, wherever the available evidence allowed it. Participants received a background paper and heard presentations followed by structured discussion to define the problem. The group also reviewed evidence on the validity, reliability and feasibility of each technique (namely chromatography and fluoride electroanalysis) and discussed their strengths and limitations. Participants were able to reach a consensus on terminology and were also able to identify and summarize the advantages and disadvantages of each technique. However, they agreed that most currently available methods were developed for regulatory agencies several decades ago, utilizing the best available data from clinical trials then, but require to be updated. They also agreed that although significant advances to our understanding of the mechanism of action of fluoride in toothpaste have been achieved over the past 4 decades, this clearly is an extraordinarily complex subject and more work remains to be done.


Asunto(s)
Caries Dental , Pastas de Dientes , Cariostáticos , Fluoruros , Humanos , Reproducibilidad de los Resultados
13.
Sci Rep ; 8(1): 13013, 2018 08 29.
Artículo en Inglés | MEDLINE | ID: mdl-30158655

RESUMEN

Biofilms are surface-attached microbial communities whose architecture can be captured with confocal microscopy. Manual or automatic thresholding of acquired images is often needed to help distinguish biofilm biomass from background noise. However, manual thresholding is subjective and current automatic thresholding methods can lead to loss of meaningful data. Here, we describe an automatic thresholding method designed for confocal fluorescent signal, termed the biovolume elasticity method (BEM). We evaluated BEM using confocal image stacks of oral biofilms grown in pooled human saliva. Image stacks were thresholded manually and automatically with three different methods; Otsu, iterative selection (IS), and BEM. Effects on biovolume, surface area, and number of objects detected indicated that the BEM was the least aggressive at removing signal, and provided the greatest visual and quantitative acuity of single cells. Thus, thresholding with BEM offers a sensitive, automatic, and tunable method to maintain biofilm architectural properties for subsequent analysis.


Asunto(s)
Biopelículas/crecimiento & desarrollo , Procesamiento de Imagen Asistido por Computador/métodos , Microscopía Confocal/métodos , Automatización/métodos , Humanos , Saliva/microbiología
14.
J Dent ; 74: 107-112, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29800639

RESUMEN

OBJECTIVE: This retrospective in-vitro study investigated tooth age effect on dental hard-tissue conditions. METHODS: Unidentified extracted premolars (n = 1500) were collected and their individual age was estimated (10-100 (±10) years old (yo)) using established dental forensic methods Dental caries, fluorosis and tooth wear (TW) were assessed using the International Caries Detection and Assessment System (ICDAS; 0-5 for crown and 0-2 for root), Thylstrup-Fejerskov (TFI; 0-9) and Basic Erosive Wear Examination (BEWE; 0-3) indices, respectively. Staining and color were assessed using the modified-Lobene (MLI) (0-3) and VITA shade (B1-C4) indices, respectively. Relationships between indices and age were tested using regression models. RESULTS: Starting at age ∼10yo, presence of caries increased from 35% to 90% at ∼50yo (coronal), and from 0% to 35% at ∼80yo (root). Caries severity increased from ICDAS 0.5 to 2 at ∼40yo and from ICDAS 0 to 0.5 at ∼60yo for coronal and root caries, respectively. Presence of TW increased from 25% (occlusal) and 15% (smooth-surfaces) to 100% at ∼80yo. TW severity increased from BEWE 0.5 to 2 at ∼50yo (occlusal) and ∼0.3 to 1.5 at ∼50yo (smooth-surfaces). Percentage and severity of fluorosis decreased from 70% to 10% at ∼80yo, and from TFI 1 to 0 at ∼90yo, respectively. Percentage of extrinsic staining increased from 0% to 85% at ∼80yo and its severity increased from MLI 0 to 2 at ∼70yo. Color changed from A3 to B3 at ∼50yo (crown), and from C2 to A4 at ∼85yo (root). CONCLUSIONS: Aging is proportionally related to the severity of caries, TW, staining, and inversely to dental fluorosis. Teeth become darker with age.


Asunto(s)
Caries Dental/patología , Esmalte Dental/patología , Dentina/patología , Fluorosis Dental/patología , Desgaste de los Dientes/patología , Adolescente , Adulto , Determinación de la Edad por los Dientes/métodos , Anciano , Anciano de 80 o más Años , Envejecimiento , Diente Premolar , Niño , Color , Femenino , Odontología Forense , Dureza , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Corona del Diente , Enfermedades Dentales , Adulto Joven
15.
Caries Res ; 52(6): 431-438, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29614502

RESUMEN

The aim of this study was to evaluate the fluoride release from differently formulated 5% NaF varnishes into unstimulated whole saliva in vivo. The fluoride concentration in unstimulated whole saliva was determined after the application of 3 different 5% NaF varnishes (5% NaF, 5% NaF + tricalcium phosphate [TCP], and 5% NaF + amorphous calcium phosphate [ACP]) or a placebo. Fifteen subjects were recruited and enrolled following Institutional Review Board approval based upon the inclusion/exclusion criteria of this study. A cross-over study design was used for the application of either one of the 5% NaF varnishes or a placebo. Unstimulated whole saliva was collected at baseline and at 1, 4, 6, 26, and 50 h following application and analyzed for supernatant ionic fluoride and whole fluoride by microdiffusion. Linear mixed-effects models (5% significance level) were used to determine the effects of varnish and time on the salivary fluoride concentration. The highest amount of fluoride in saliva was found 1 h after application of the fluoride varnishes, with no significant differences among the treatment varnishes with respect to whole fluoride but with lower levels for 5% NaF + ACP in the saliva supernatant. Salivary fluoride levels at 4, 6, and 26 h decreased at each time point and were generally significantly higher for 5% NaF and 5% NaF + TCP. After 50 h, fluoride levels in saliva for all groups were at or below baseline levels. In conclusion, the formulation of other ingredients in fluoride varnishes can affect the fluoride concentration in saliva. The reasons for this phenomenon warrant further investigation since it might affect efficacy of the treatment. This trial is registered at ClinicalTrials.gov (NCT01629290).


Asunto(s)
Fluoruros Tópicos/farmacocinética , Fluoruros/análisis , Saliva/química , Adulto , Anciano , Estudios Cruzados , Femenino , Fluoruros Tópicos/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad
16.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-900322

RESUMEN

RESUMEN: Objetivo: Creación de un currículo de competencias mínimas en Cariología, para la formación de los Cirujano-Dentistas egresados de las escuelas de Odontología de Chile. Metodologías: A partir de una reunión de académicos de las Universidades de Talca y de Chile (año 2011), se elaboró una propuesta de currículo inicial, basado en los dominios propuestos por la Unión Europea (Schulte AG y cols). Durante el año 2016, dicha propuesta fue analizada mediante diálogos digitales y grupos de trabajo, con la participación del 96% de las Escuelas de Odontología existentes en el país, que concluyeron en un documento intermedio. Este documento fue analizado, discutido y perfeccionado durante el Taller para el Desarrollo de un Currículo de Competencias Mínimas en Cariología para las Escuelas de Odontología Chilenas (22/Mayo/2017, Talca, organizado por la Universidad de Talca y la Universidad de Chile) con la asistencia de representantes del 96% de las escuelas dentales chilenas, Ministerio de Salud de Chile, Colegio de Cirujano-Dentistas de Chile y con la asesoría de los profesores de Cariología Dres. Margherita Fontana y Carlos González-Cabezas (Universidad de Michigan, Ann Arbor, EEUU). Cada grupo de trabajo revisó el documento y envió nuevos comentarios, los que fueron incorporados en el documento final por una comisión asesora. Resultados: El documento del Currículo en Cariología se organizó en 5 Dominios: 1. Conocimientos base; 2. Determinación de Riesgo, diagnóstico de caries y detección de lesiones de caries; 3. Toma de decisiones y manejo preventivo no operatorio; 4. Toma de decisiones y manejo operatorio y 5. Cariología basada en la evidencia, en la práctica clínica y de salud pública. Se consensuaron las definiciones operacionales, las competencias principales y las sub-competencias para cada uno de los dominios. Las sub-competencias fueron clasificadas en tres niveles: A: Ser competente en; B: Tener conocimientos sobre y C: Estar familiarizado con. El documento final fue enviado a todos los participantes del taller para su aprobación y difusión en cada una de las instituciones involucradas. Conclusiones: Se logró, por medio de consenso, la construcción del Currículo de Competencias mínimas en Cariología para estudiantes de pregrado de Odontología en las universidades chilenas.


ABSTRACT: Objective: Development of a minimum set of competencies in Cariology that every dentist graduated from a Dental School in Chile must have. Methodology: Starting from a meeting of scholars from the Universities of Talca and Chile (year 2011), an initial proposal for a curriculum was developed, based on the domains proposed by the European Cariology Curriculum (Schulte, et al, 2011). During 2016, this proposal was discussed through online dialogues and working groups, with the participation of 95.2% of the Chilean dental schools, which resulted in an intermediate document. This document was analyzed, discussed and refined during the Workshop for the Development of a Curriculum of Minimum Competencies in Cariology for Chilean Dental Schools (May 22, 2017, Talca, organized by the Universities of Talca and Chile) with the attendance of representatives from 95.2% of the Chilean dental schools, the Chilean Ministry of Health, Chilean College od Dentists and with the assistance of the professors of Cariology Margherita Fontana and Carlos González-Cabezas (University of Michigan, Ann Arbor, USA). Each working group revised the document and provided feedback, which was incorporated in the final document by an advisory committee, elected on the day of the workshop, including the authors of the present article. Results: The Cariology Curriculum was organized in 5 Domains: 1. Basic knowledge; 2. Risk assessment, caries diagnosis and caries lesion detection; 3. Decision-making and non-operative preventive treatment; 4. Decision making and operative treatment; and 5. Evidence-based, clinical and public health practice. Operational definitions, main competencies and sub-competencies for each domain were agreed. Sub-competencies were classified into three levels: A: Be competent in; B: Have knowledge about, and C: Be familiar with. The final document was sent to all the participants of the workshop for dissemination in each of the institutions involved. Conclusions: The development of the Competency-based Curriculum in Cariology for undergraduate dental students at Chilean universities was achieved through consensus.

17.
Front Physiol ; 9: 103, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29503619

RESUMEN

Aim: Antimicrobial and bioactive restorative materials are needed to develop a bacteria free environment and tight bond with the surrounding tissue, preventing the spread of secondary caries and thus extending the lifetime of dental restorations. The characteristic properties of new dental bioactive and antibacterial composites are presented in this work. The new composites have been microstructurally characterized and both long and short term properties have been studied. Methods: The Ag-doped sol-gel derived bioactive glass (Ag-BG) was incorporated into resin composite in concentrations 5, 10, and 15 wt.%, to fabricate new Ag-doped bioactive and antibacterial dental composites (Ag-BGCOMP). The microstructural properties and elemental analysis of the developed Ag-BGCOMP was observed. The total bond strength (TBS) was measured immediately and after long term of immersion in medium using microtensile testing. The capability of Ag-BGCOMPs to form apatite layer on their surface after immersion in Simulated Body Fluid (SBF) as well as the bacteria growth inhibition in a biofilm formed by Streptococcus mutans (S. mutans) were evaluated. Results: Homogeneous distribution of Ag-BG particles into the resin composite was observed microstructurally for all Ag-BGCOMPs. The TBS measurements showed non-statistically significant difference between control samples (Ag-BG 0 wt.%) and Ag-BGCOMP specimens. Moreover, the total bond strength between the surrounding tooth tissue and the material of restoration does not present any statistically significant change for all the cases even after 3 months of immersion in the medium. The bioactivity of the Ag-BGCOMPs was also shown by the formation of a calcium-phosphate layer on the surface of the specimens after immersion in SBF. Antibacterial activity was observed for all Ag-BGCOMPs, statistically significant differences were observed between control samples and Ag-BGCOMPs. Accordingly, the number of dead bacteria in the biofilm found to increase significantly with the increase of Ag-BG concentration in the Ag-BGCOMPs. Conclusions: New resin composites with antibacterial and remineralizing properties have been manufactured. Characterization of these materials provides a rationale for future clinical trials to evaluate clinical benefits and outcomes in comparison with currently used dental materials. Significance: The new developed composites could ultimately prevent restoration failure and could advance patients' wellbeing.

18.
J Dent Educ ; 81(8): eS153-eS161, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28765467

RESUMEN

To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21st Century."


Asunto(s)
Educación en Odontología/tendencias , Competencia Clínica , Curriculum , Atención Odontológica/tendencias , Caries Dental/epidemiología , Humanos , Liderazgo , Enfermedades Periodontales/epidemiología , Administración de la Práctica Odontológica/tendencias , Pautas de la Práctica en Odontología/tendencias , Prevalencia , Facultades de Odontología , Estados Unidos/epidemiología
19.
J Evid Based Dent Pract ; 16(4): 239-242, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27938697

RESUMEN

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The Caries Management System: are preventive effects sustained postclinical trial? Evans RW, Clark P, Jia N. Community Dent Oral Epidemiol 2016;44(2):188-97. SOURCES OF FUNDING: Foundation: Oral Health Foundation, University of Sydney; and the Australian Dental Research Foundation; government: National Health and Medical Research Council; other: Dental Board of New South Wales TYPE OF STUDY/DESIGN: The original 3-year study was a multicenter cluster randomized controlled clinical trial.


Asunto(s)
Caries Dental , Tiempo , Australia , Humanos , Práctica Privada , Gestión de Riesgos
20.
Caries Res ; 50(2): 151-8, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27073873

RESUMEN

This study aimed to explore the effect of fluoridated toothpastes on biofilm architecture and enamel demineralization in an in vitro biofilm model. Streptococcus mutans was grown on enamel and treated with slurries of commercial toothpastes, containing SnF2 or NaF. Water and chlorhexidine were used as negative and positive controls, respectively. The developed biofilms were imaged and enamel demineralization was measured. SnF2 and NaF toothpaste treatments significantly reduced enamel demineralization, but SnF2 toothpaste was more effective. Only SnF2 toothpaste and chlorhexidine treatments caused reductions on biofilm mass and thickness. In conclusion, this biofilm model was able to differentiate the effects of the SnF2 and NaF toothpastes on biofilm architecture and enamel demineralization.


Asunto(s)
Biopelículas/efectos de los fármacos , Esmalte Dental/efectos de los fármacos , Fluoruro de Sodio/farmacología , Streptococcus mutans/efectos de los fármacos , Fluoruros de Estaño/farmacología , Desmineralización Dental/tratamiento farmacológico , Pastas de Dientes/farmacología , Animales , Biopelículas/crecimiento & desarrollo , Bovinos , Clorhexidina/farmacología , Esmalte Dental/microbiología , Esmalte Dental/patología , Relación Dosis-Respuesta a Droga , Concentración de Iones de Hidrógeno , Imagenología Tridimensional , Técnicas In Vitro , Microscopía Confocal , Saliva/metabolismo , Fluoruro de Sodio/administración & dosificación , Streptococcus mutans/crecimiento & desarrollo , Fluoruros de Estaño/administración & dosificación , Desmineralización Dental/microbiología , Desmineralización Dental/prevención & control , Pastas de Dientes/administración & dosificación
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...