Comparación entre edad cronológica y dental en niños de dos localidades peruanas de diferente altitud / Comparison between chronological and dental age in children from two peruvian locations at different altitude

RESUMEN Introducción: El nivel de maduración dental como indicador del nivel de maduración general de acuerdo con el método de Demirjian, puede ser afectado por la altitud geográfica. Objetivo: Determinar la relación de las edades cronológica y dental según el método Demirjian en niños de dos localidades peruanas con diferente altitud. Métodos: Se realizó un estudio observacional, analítico, retrospectivo de corte transversal, que tuvo como muestra a 179 radiografías panorámicas de niños peruanos entre 6 y 12 años: 109 radiografías de niños de la ciudad de Lima y 70 radiografías de niños de la ciudad de Huancayo. Se determinó la edad dental según el método de Demirjian, luego se relacionó con la edad cronológica en cada paciente de las dos localidades; posteriormente se comparó las diferencias de las edades en las dos ciudades. Resultados: Se encontró correlación estadísticamente significativa entre la edad dental y la cronológica en ambos sexos de pacientes de la ciudad de Lima (p< 0,001); mientras que solo se encontró correlación estadísticamente significativa entre la edad dental y la edad cronológica en el sexo masculino en la ciudad de Huancayo (p< 0,001 para el sexo masculino y p= 0,740 para el femenino). La comparación de las diferencias entre edad cronológica y edad dental de los pacientes de las dos ciudades es no estadísticamente significativa (U de Mann-Whitney, p= 0,057). Conclusiones: No se encontró correlación significativa entre las edades dentales y cronológicas en el sexo femenino de los pacientes habitantes a mayor altitud y al comparar las diferencias, entre la edad cronológica y la edad dental según el método Demirjian, en los habitantes de las localidades peruanas no se encontró diferencia estadísticamente significativa(AU)

ABSTRACT Introduction: The degree of dental maturation as an indicator of the degree of general maturation, according to Demirjian's method, may be affected by geographic altitude. Aim: To determine the relationship between chronological age and dental age according to Demirjian's method in children from two Peruvian locations at different altitudes. Methods: An observational, analytical, retrospective, cross-sectional study was performed on a sample of 179 panoramic radiographs of Peruvian children aged 6 to 12 years. Group A: 109 radiographs of children from Lima City; Group B: 70 radiographs of children from Huancayo City. Dental age was determined according to Demirjian's method and related to chronological age for each patient from each location, and the differences were compared for ages in both cities. Results: A statistically significant correlation was found between dental and chronological age for both sexes in patients from Lima City (p< 0.001), but only for male patients from Huancayo City (p< 0.001 for males and p= 0.740 for females). The differences between chronological age and dental age were not statistically significant in patients from either city (Mann-Whitney U test, p= 0.057). Conclusions: No significant correlation was found between dental age and chronological age in female patients living at higher altitude, and no statistically significant difference was found between chronological age and dental age according to Demirjian's method for children living in either city(AU)

Use of virtual reality as a learning environment in dentistry.

Second Life (SL) is an online virtual world with a social environment that may serve as a valuable learning supplement to traditional preclinical teaching methods. The educational advantages of this virtual world include immersion and interactivity. The aim of this study was to compare the efficacy of using 3-dimensional interactive platforms (3DIPs) designed in SL to that of traditional teaching methods for developing students' understanding of dental clinical situations that are difficult to simulate in real life. For this study, 3DIPs were developed to compare the acquisition of 3 learning objectives: understanding concepts, procedural aspects of interaction with the patient, and spatial interpretation of anatomical structure interactions. A representative dental topic, the use of a semiadjustable articulator, was selected. A quasi-experimental design with 2 groups and pretest-posttest comparison was used. The students in the control group received the conventional teaching established for the subject, which does not include SL experiences. The students in the experimental group received conventional instruction and had access to all 3DIPs for 4 weeks without limitation. The pretest and posttest consisted of a multiple-choice test with 20 questions. A Student t test was used to compare the test results of the groups (significance level α = 0.05). The posttest scores for the understanding of concepts and spatial interpretation were significantly higher in the experimental group than in the control group (P < 0.05). However, there was no statistically significant difference between groups in posttest scores on the topic of procedural aspects. Students who used cooperative methods for acquisition of knowledge were observed to be highly motivated. The results suggest that the SL environment helps students to understand anatomical interactions that are difficult to observe in real life, is attractive to students, and contains tools with high didactic potential.

Association Between Self-Perceived Oral Health and Clinical Indicators.

PURPOSE: To determine whether self-perceived oral health impact and satisfaction measure oral health in the same way as do clinical indicators in adults and older adults. MATERIALS AND METHODS: The population consisted of adult patients aged 20 to 59 years receiving care at "Juan Pablo II" Health Care Centre and older adult patients aged 60 or more years from the home for the elderly "Virgen del Amor Hermoso", Lima, Peru. The indices Oral Impacts on Daily Performance (OIDP) and Oral Satisfaction Scale of 0-10 (OSS 0-10) were used to evaluate perceived impact of and satisfaction with oral health. In addition, the following internationally validated criteria established by the World Health Organization (WHO) were used as clinical indicators: Decayed-Missing-Filled Teeth (DMFT) Index, O'Leary's Hygiene Index, Community Periodontal Index, Motivation to Hygiene Index, Denture Situation Index, Need for Denture Index, Denture Hygiene Index and Oral Mucosal Lesion Index. RESULTS: Forty-four adults and 53 older adults participated. OIDP showed that the greatest perceived difficulty in daily performance was "eating and enjoying food" (adults: 77.3% and older adults: 79.2%). The OSS 0-10 showed that among adults, 43.1% were dissatisfied, 20.5% were neutral and 36.4% were satisfied, while among older adults, 45.3% were dissatisfied, 22.6% were neutral and 32.1% were satisfied. A statistically significant association was found between OSS 0-10 and 1. DMFT index in adults; 2. upper denture situation in older adults; and 3. denture hygiene in older adults. A highly significant inverse linear correlation was found between OIDP and OSS 0-10 in adults and older adults. CONCLUSION: The perceived impact of oral health does not have a demonstrable association with oral health problems when used as an instrument for measuring oral health status, whereas perceived satisfaction with oral health has a better association with the clinical indicators.

Malignant lymphoma of the oral cavity and the maxillofacial region: Overall survival prognostic factors

Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus (AU)

Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p ≤ 0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p = 0.042), clinical stage (p = 0.007) and performance status (p = 0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma.

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p≤0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p=0.042), clinical stage (p=0.007) and performance status (p=0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors.

OBJECTIVE: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. STUDY DESIGN: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. RESULTS: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). CONCLUSION: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus.

Extirpación de canino retenido y estabilización dental mediante implantes endodónticos / Canin retaineds extirpation and dental stabilization with endodontic implants

El artículo reporta la extirpación de un canino retenido que originaba la reabsorción radicular de piezas dentarias antero superiores. El tratamiento fue realizado en el Centro Quirúrgico de la Clínica Especializada en Odontología de la Universidad San Martín de Porres, y consistió en la preparación biomecánica de los conductos radiculares de los dientes afectados, la remoción del canino retenido y la colocación de implantes trans endodónticos,obteniéndose un resultado funcional satisfactorio.

This report presents canin retaineds extirpation because it has caused radicular reabsortion on antero superior teeth and dental stabilization with endodontic implants. This procedure was performed in the Clinically Quirrgico Center of Specialized Dentistry, University of San Martín de Porres. The treatment consists of the root canal treatment of affected pieces, the removal of retained canin, and the transendodontic fixation. The case was resolved with acceptable functional results.

Extirpación de Torus Palatino por pensamiento dismórfico / Removing Torus Palatinus by thought dysmorphic

El artículo presenta un caso de extirpación de Torus palatino por pensamiento dismórfico, con la respectiva solución para el tumor benigno de origen óseo y del problema de dismorfia selectiva. La paciente no requería la cirugía por no tener fundamento clínico desde el punto de vista protésico, ni presentar cuadro inflamatorio de tejidos blandos adyacentes, ni interferencia con el habla. La intervención quirúrgica se justificó por el sentimiento de la paciente al mencionar su incomodidad, preocupación y ansiedad de observarse en el espejo una protuberancia en su paladar, la cual la llevaba a un estado de dismorfofobia dando como resultado autoexclusión social y la no aceptación personal. El tratamiento fue realizado en el Centro Quirúrgico de la Clínica Especializada en Odontología de la Universidad de San Martín de Porres. La paciente presentó una evolución sin complicaciones y se observó una respuesta favorable de los tejidos blandos y duros, cuyo interés queda para el análisis y estadística de este tipo de patologías.

This article described a case of removal of Torus palatinus by thought dysmorphic, with the respective solution for benign tumor of origin bone and the problem of selective dysmorphia. The patient did not require surgery because they have no clinical basis from the point of prosthetic sight, without presenting inflammation of soft tissue adjacent or interference with speech. The surgery was justified by the sense of the patient to mention his discomfort, worry and anxiety seen in the mirror a lump in his palate, which led to a state of Body Dysmorphic Disorder opt resulting in social and non-acceptance. Treatment was conducted at the Centre for Surgical Clinic Specializing in Dentistry at the University of San Martín de Porres, with an evolutiont without complications and favourable response from the hard and soft tissues, whose interest is for analysis and statistics of this sort of pathologies.

Extirpación de granuloma periapical, tratamiento de conductos y apicectomía en un solo acto quirúrgico / Periapical granulomas removal, treatment of conduits and apicoectomy in one surgical act

Se realizó la extirpación de un granuloma periapical, junto con el tratamiento de los conductos de las piezas afectadas y apicectomía de las mismas para su conservación en la Clínica Especializada en Odontología de la Universidad de San Martín de Porres. El paciente presentó una protuberancia en el paladar, por lo que se le solicitó pruebas radiográficas. Se optó por realizar los tres procedimientos quirúrgicos en una sola cita, Previamente se confeccionó una placa de contención acrílica para el paladar, la que contuvo los tejidos blandos en su correcta posición al finalizar la operación. Posteriormente, procedimos a rellenar la cavidad con hueso liofilizado y a la sutura y colocación de la placa acrílica en el paladar, unida a las piezas dentales no tratadas mediante ligaduras metálicas.

We performed the removal of a periapical granuloma with the treatment of ducts and apicoectomy of the affected pieces in the Dental Clinic at the University of Saint Martin de Porres. The patient had a protuberance on the palate and so radiographical evidence was necessary. We decided to do the three surgical procedures in one appointment. Previously, a acrylic retained the soft tissues on its correct position after the operation. Subsequently, we proceeded to fill the cavity with lyophilized bone and to the suture and placement of the acrylic plate on the palate, coupled to the non treated teeth with metal ligatures.

Osteotomía segmentaria / Segmentary osteotomy

El presente artículo desarrolla un caso clínico en el que se realiza una osteotomía segmentaria en el centro quirúrgico de la Clínica Especializada en Odontología de la Universidad de San Martín de Porres. La paciente ingresa a la clínica requiriendo tratamiento protésico, pero debido al insuficiente espacio por la extrusión de piezas sin antagonista, es derivada al centro quirúrgico de la clínica para evaluarla. La paciente es programada para una osteotomía segmentaria bilateral posterior. Se toman modelos de estudio donde se realizan los cortes y nueva posiciones de los segmentos de manera tentativa; posteriormente se confecciona la placa palatina que servirá para fijar la nueva posición. El acto quirúrgico propiamente dicho comienza con la incisión y levantamiento del colgajo para la visualización de las zonas donde se va a realizar la osteotomía. Con instrumentales especiales separamos el segmento y lo reposicionamos manualmente hasta lograr una ubicación adecuada. Siguiendo la misma secuencia, continúa el segundo cuadrante. Se prueba la placa previamente confeccionada, la que nos da referencia de la posición final. Se suturan los tejidos blandos, y la placa palatina es fijada mediante ligaduras de alambre a las piezas adyacentes. Se realiza el seguimiento postoperatorio del paciente, y pasado un tiempo prudencial de aproximadamente seis meses, se puede comenzar con el tratamiento protésico.

The present article develops a clinical case in which a segmental osteotomy is realized in the surgical center of the Specialized Clinic in Odontology of the University of San Martín de Porres. The patients enters to the clinic needing protestic treatment, but due to the insufficient space for the extrusion of pieces without antagonist, is derived to the surgical center of the clinic to be evaluated. The patient is programmed for a segmental bilateral posterior osteotomy. Models os study are taken where the cuts are done and new positions of the segments are fixed in a tentative way. Laterly the palatine plate is made, it will serve to fix the new position. The surgical act in strict sense begins with the incision and raising of the hanging tatter for the visualization of the zones where the osteotomy will be realized. With special sets of instruments we separate the segment and re-position it manually up to achieve a suitable location. Following the same sequence, continues the second quadrant. The plate, previously completed, is proved, which gives us a reference of the final position. The soft tissues are sutured, and the palatine plate is fixed by means of wire ligatures to the adjacent pieces. The patient's postoperative is monitored, and after a prudential time of approximately 6 months, it is possible to begin with the protesic treatment.

Granuloma central de células gigantes / Central giant cell granuloma

Este artículo presenta el caso de una paciente que acudió a la Clínica Especializada en Odontología de la Universidad de San Martín de Porres. La paciente requería la exodoncia de las terceras molares inferiores. Mediante el examen radiológico se observó una imagen radiolúcida con bordes definidos a nivel apical de las piezas 4.7 y 4.8. El diagnóstico presuntivo planteado fue granuloma central de células gigantes. La presentación de esta lesión es muy rara y puede ser de crecimiento progresivo y destructivo. Este reporte de caso describe el tratamiento de esta lesión mediante escisión quirúrgica con exodoncias de las piezas dentarias afectadas y colocación de injerto óseo. El diagnóstico fue confirmado con el examen histológico de la muestra extirpada.

This article presents a case of a patient treated in the Clinic Specializing in Dentistry at San Martín de Porres University. The patient needed the extraction of third low molars. By means of radiological examination, radiolucency area with edges defined to apical level of teeth 4.7 and 4.8 was observed. The presumptive diagnosis was central giant cell granuloma. The presentation of this lesion is very rare and can be of progressive and destructive growth. This report of case described the treatment of this lesion by means of surgical excision with affected teeth extractions and placement of bone grafts. The diagnosis was confirmed by the histological examination of the extirpated sample.