Comparative analysis of periodontal pain and quality of life in patients with fixed multibracket appliances and aligners (Invisalign®): longitudinal clinical study.

BACKGROUNDS: The aim of this longitudinal clinical study is to analyse and compare according to location, degree and type, the pain presented by patients during their first year of treatment, as well as the quality of oral life after the placement of two types of orthodontic appliances: conventional brackets and removable Invisalign ® aligners. METHODS: The sample consisted of 140 patients grouped into 2 study groups of 70 patients each. The first group (brackets group- BG), with fixed multibracket appliances, using the MBT technique and a 0.022" slot. The second group (invisaling group- IG), in treatment with removable aligners (IG), using the Invisalign ® system. They were providen with a questionnare where they had to record the degree (mild, moderate or intense), the type and location of the pain monthly during the first year of treatment. The second form was the Spanish version of the OHIP-14, oral quality of life questionnaire, which was provided the twelfth month after the start of treatment. RESULTS: In both groups, we found that the most frequent location of pain occurred during the first phase: mandibular for the IG group and maxillary in the BG group. Throughout the whole analysis, the intensity was mild-moderate with lower values in the conventional brackets' group. The BG group reported acute pain while the IG group reported sensitive pain during the first month; later both reported sensitive pain. CONCLUSIONS: There are differences in terms of periodontal pain in its degree, location, and type according to the different orthodontic techniques used. TRIAL REGISTRATION: The study was approved by the bioethics committee of the University of Salamanca (USAL_20/516).

Periodontal health status, oral microbiome, white-spot lesions and oral health related to quality of life-clear aligners versus fixed appliances: A systematic review, meta-analysis and meta-regression.

Objective: : Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods: : An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results: : Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an "important" effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions: : Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.

Location and Gender Differences in Osteonecrosis of the Jaws in Patients Treated with Antiresorptive and Antineoplastic Drugs Undergoing Dentoalveolar Surgical, Systematic Review with Meta-Analysis and Trial Sequential Analysis.

In the treatment and prevention of osteoporosis and more generally of neoplastic and metabolic pathologies affecting bone tissues, antiresorption drugs such as bisphosphonates and monoclonal antibody are used. Bisphosphonates have been linked to cases of osteonecrosis of the jaws since 2003 by Marx, with more and more evidence over the next two decades; together with bisphosphonate drugs, cases relating to the use of monoclonal drugs have been subsequently added. Among the main independent risk factors, we have extraction procedures in oral surgery that can affect both the mandible and the maxilla and the anterior or posterior sectors. The incidence of MRONJ treated with oral bisphosphonates ranges from 0.5% to 3% according to studies; this incidence would appear to be higher in patients treated with antiresorptive agents with neoplastic diseases. Many pathologies including those in which antiresorptive drugs are used show differences in prevalence in relation to sex; similarly, there could be differences in the incidence of cases of osteonecrosis based on gender in patients undergoing dentoalveolar surgery. Therefore, the objective of this systematic review and trial sequential analysis was to identify and quantify whether there is a proportionally greater risk of MRONJ in male or female subjects and whether there is evidence of greater involvement of osteonecrosis at several extraction sites, differentiating them into mandibular or maxilla and in the anterior or posterior sector. The revision protocol followed the indications of the Cochrane Handbook, and were recorded in Prospero, while the drafting of the manuscript was based on PRISMA. The results of the systematic review, after the study identification and selection process, included a total of 24 studies. The results of the meta-analysis reports: odds ratio (random effects model): 1.476 (0.684, 3.184) between male and female; odds ratio (random effects model): 1.390 (0.801, 2.412) between mandible and maxillary, and an odds ratio value of 0.730 (0.250, 2.137) between the anterior and posterior extraction sites. In conclusion, we can see that there was a trend in the onset of MRONJ as a complication of dentoalveolar surgical procedures, which proportionally mostly involved the male sex and the posterior mandibular sectors, however, this trend must be further confirmed by additional studies.

Conservative Therapy of External Invasive Cervical Resorption with Adhesive Systems: A 6-Year Follow-Up Case Report and Literature Review.

The diagnosis and treatment of external invasive cervical resorption (EICR) could be a challenging clinical situation even for the most experienced dentists. It is a fairly rare lesion and a poorly understood phenomenon, and its insidious and aggressive nature can lead to tooth loss. Even in the era of dental implants, trying to save a compromised tooth is imperative for any clinician. This report presents a case of an upper central incisor with a class II Heithersay EICR in which treatment was performed using a multidisciplinary approach and the defect was restored with resin composite. The surgery in which the defect was exposed and repaired was followed by an endodontic treatment and the placement of a fiber-reinforced post. In this case, the use of modern materials, such as resin composites, allowed not only the avoidance of tooth extraction but also the achievement of satisfactory aesthetic results. The 6-year follow-up demonstrated the success of therapy and the resolution of clinical symptoms. This case report highlights the importance of early detection of EICR and how composite resins could provide an effective and aesthetic restauration of the defect, which favors the health of the surrounding gingival tissue.

Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the Application of Infiltrative Resins: Systematic Review and Meta-Analysis.

One of the risks that we find after orthodontic treatment is the secondary appearance of white spot lesions (WLS) after the removal of fixed multi-bracket appliances. Today, there are several treatment methods, resin infiltration being the most used in the most serious cases. The objective of this study is to carry out a systematic review and meta-analysis to determine the efficacy and stability in the variables of color and gloss, six months after resin infiltration. A comprehensive search was performed in the following databases: PubMed, Embase, Google Scholar, Scopus, Medline, and Web of Science. Articles published in the last 10 years were selected, including in vivo studies with a six-month follow-up. PRISMA guidelines were followed to carry out this systematic review. All studies where the application of resin was performed on carious lesions were discarded. Once the inclusion and exclusion criteria were applied, a final sample of four articles was obtained, on which the review and meta-analysis were carried out. Once examined, all authors considered that there was an immediate improvement in both variables. However, statistically significant differences were obtained in the color change outcome, but not in the brightness outcome in the subgroup analysis after six months of icon resin infiltration.

What Do Mothers (or Caregivers) Know about Their Children's Oral Hygiene? An Update of the Current Evidence.

Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents' incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children's oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman's care should increase parents' knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.

The Prognostic Role of miR-31 in Head and Neck Squamous Cell Carcinoma: Systematic Review and Meta-Analysis with Trial Sequential Analysis.

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with high recurrence, metastasis, and poor treatment outcome. Prognostic survival biomarkers can be a valid tool for assessing a patient's life expectancy and directing therapy toward specific targets. Recent studies have reported microRNA (miR) might play a critical role in regulating different types of cancer. The main miR used as a diagnostic and prognostic biomarker and reported in the scientific literature for HNSCC is miR-21. Other miRs have been investigated to a lesser extent (miR-99a, miR-99b, miR-100, miR-143, miR-155, miR-7, miR-424, miR-183), but among these, the one that has attracted major interest is the miR-31. METHODS: The systematic review was conducted following the PRISMA guidelines using electronic databases, such as PubMed, Scopus, and the Cochrane Central Register of Controlled Trials, with the use of combinations of keywords, such as miR-31 AND HNSCC, microRNA AND HNSCC, and miR-31. The meta-analysis was performed using the RevMan 5.41 software (Cochrane Collaboration, Copenhagen, Denmark). RESULTS: This search produced 721 records, which, after the elimination of duplicates and the application of the inclusion and exclusion criteria, led to 4 articles. The meta-analysis was conducted by applying fixed-effects models, given the low rate of heterogeneity (I2 = 40%). The results of the meta-analysis report an aggregate hazard ratio (HR) for the overall survival (OS), between the highest and lowest miR-31 expression, of 1.59, with the relative intervals of confidence (1.22 2.07). Heterogeneity was evaluated through Chi2 = 5.04 df = 3 (p = 0.17) and the Higgins index I2 = 40; testing for the overall effect was Z = 3.44 (p = 0.00006). The forest plot shows us a worsening HR value of OS, in relation to the elevated expression of miR-31. CONCLUSIONS: In conclusion, the data resulting from the current meta-analysis suggest that miR-31 is associated with the prognosis of patients with HNSCC and that elevated miR-31 expression could predict a poor prognosis in patients with this type of neoplasm.

Reliability of Tooth Width Measurements Delivered by the Clin-Check Pro 6.0 Software on Digital Casts: A Cross-Sectional Study.

The purpose of this study was to assess the accuracy and reliability of tooth width measurements and Bolton Indices delivered by the Clin-Check Pro 6.0 software (Align Technology, San José, CA, USA). Fifty-four plaster casts were selected and measured with a manual calliper by a trained and calibrated observer. The data gathered were compared with those delivered by the software on the corresponding fifty-four virtual casts. The method reliability of the software was assessed by comparing the measurements performed by the software on 201 pairs of clin-checks corresponding to two consecutive treatment phases. Accuracy and reliability were statistically assessed using a mixed model. The software tends to provide larger widths compared with the manual method. Statistically significant differences were found in 23 teeth. At a global level, the mean difference between the methods was -0.19 mm, with a Dahlberg error of 0.24 mm and an intraclass correlation coefficient of 0.98. The Bolton Indices delivered by the two methods had a moderate correlation (ICC = 0.59; 0.69). The within method reliability of the software was extremely high. Tooth width measurements delivered by the software, despite the positive bias, can be considered accurate and clinically acceptable for all teeth except molars. The Bolton Indices made available by the software are not accurate and clinically acceptable, especially in the case of mandibular excess.

MicroRNA-21 Expression as a Prognostic Biomarker in Oral Cancer: Systematic Review and Meta-Analysis.

Oral carcinoma represents one of the main carcinomas of the head and neck region, with a 5-year survival rate of less than 50%. Smoking and tobacco use are recognized risk factors. Prognostic survival biomarkers can be a valid tool for assessing a patient's life expectancy and directing therapy towards specific targets. Among the biomarkers, the alteration of miR-21 expression in tumor tissues is increasingly reported as a valid prognostic biomarker of survival for oral cancer. The purpose of this meta-analysis was, therefore, to investigate and summarize the results in the literature concerning the potential prognostic expression of tissue miR-21 in patients with OSCC. METHODS: The systematic review was conducted following the PRISMA guidelines using electronic databases, such as PubMed, Scopus, and the Cochrane Central Register of Controlled Trials, with the use of combinations of keywords, such as miR-21 AND oral cancer, microRNA AND oral cancer, and miR-21. The meta-analysis was performed using the RevMan 5.41 software. RESULTS: At the end of the article-selection process, 10 studies were included in the meta-analysis, and the result for the main outcome was a pooled HR per overall survival (OS) of 1.29 (1.16-1.44) between high and low expression of miR-21. CONCLUSIONS: The data in the literature and the results emerging from the systematic review indicate that miR-21 can provide a prognostic indication in oral cancer.

From Bench to Bedside in Precision Medicine: Diabetes Mellitus and Peri-Implantitis Clinical Indices with a Short-Term Follow-Up: A Systematic Review and Meta-Analysis.

Background and objective: Diabetes mellitus (DM) refers to a group of metabolic disorders characterized by hyperglycemia resulting from impaired secretion or action of insulin. The high levels of glucose in the blood can negatively affect the healing processes through alterations in vascularization, bone remodeling, and with increased susceptibility to infections. Diabetes mellitus is therefore a risk factor not only for many systemic diseases, but also for localized problems such as peri-implantitis. The objective of this systematic review was to identify a clear relationship between peri-implant inflammation indices and glycemic levels, through the investigation of prospective studies that report data on a short-term follow-up period. Our hypothesis was that peri-implant inflammatory indices may already present themselves in a statistically significant way as altered in patients with DM compared to patients without DM. Materials and methods: This review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Results: More than 992 records were identified in the PubMed, Scopus, and Cochrane Central Register of Controlled Trial electronic databases and only seven studies were included in the meta-analysis. The results of the meta-analysis report worse outcomes in patients with DM, even in the short period of six months, for peri-implatitis inflammation indices, such as Marginal bone loss (standardized (Std). mean difference (MD) 12\6 months 0.81 [0.45, 1.17]\1.82 [0.53, 3.10]), Bleeding on probing (Std. MD 12\6 months 2.84 [1.34, 4.34]\3.44 [1.41, 5.50]), Probing depth (Std. MD 12\6 months 1.14 [0.60, 1.68]\2.24 [0.66, 3.83]), and the plaque index (Std. MD 12 months 2.83 [0.09, 5.57]). Conclusion: The literature linking glycaemic control to peri-implant disease is highly heterogeneous due to lack of consistency of the definition of peri-implantitis and its clinical indicators among studies. Therefore, interpretation of finding and relevance to clinical practice should be considered on individual bases. In the era of personalized medicine, the clinician should utilize individualized information from translational researches and analyze all risk factors to provide the patient with evidence-based treatment options.

Sex estimation through geometric morphometric analysis of the frontal bone: an assessment in pre-pubertal and post-pubertal modern Spanish population.

Sex estimates is a key step of biological profile assessment in a forensic or anthropologic context. In this study, the sexual dimorphism of the frontal bone was analyzed to assess the accuracy of sex estimates using a geometric morphometric approach in a pre-pubertal and post-pubertal sample. The shape of the frontal bone was digitized on the lateral cephalograms of 87 pre-pubertal subjects (42 males, mean age 10.14, SD ± 1.48 years; 45 females mean age 10.02, SD ± 1.11 years) and 103 post-pubertal ones (53 males, mean age 29.33 SD ± 11.88 years; 50 females, mean age 26.77 SD ± 11.07 years). A generalized Procrustes analysis (GPA) was performed for shape analyses, filtering the effects of position, rotation, translation, and size. A principal component analysis (PCA) was performed on the GPA transformed variables, and a multiple logistic regression model was used to assess the accuracy of sex estimates. In both age groups, the average size of the centroid was significantly larger in males. The females presented shapes with a shorter distance between P2 (glabella) and P1 (supratoral) and a general narrowing of the structure on the sagittal plane. In the pre-pubertal group, the shape difference was not statistically significant. In the post-pubertal group, the mean shape was significantly different between the sexes. The method displayed a high accuracy for sex estimates (88.7% males, 90.3% females) also when applied in a validation sample (82.6% males and 94.1% females). The described morphometric analysis of the frontal bone is based on a limited number of landmarks, which allows sex estimates with high accuracy in post-pubertal subjects, while it is not applicable in pre-pubertal ones.

Novel Digital Measurement Technique to Analyze the Palatine Suture Expansion after Palatine Rapid Maxillary Expansion Technique.

The aim of the study was to validate a novel digital measurement method to quantify the volume of the midpalatal suture after rapid maxillary expansion (RME). MATERIAL AND METHODS: Eight patients with maxillary skeletal transverse deficiency were submitted to palatine suture expansion using the McNamara orthodontic appliance during a period of nine months. After 30 days of treatment, all patients were exposed postoperatively to a cone-beam computed tomography (CBCT) scan. Afterwards, the scans were uploaded into the three-dimensional orthodontic-planning software to allow the volumetric assessment of the palatine suture expansion through palatine rapid maxillary expansion using a McNamara appliance. The repeatability was analyzed by repeating twice the measures by a single operator and reproducibility was analyzed by repeating three times the measures by two operators, and Gage R&R statistical analysis was performed. RESULTS: The expansion of the midpalatal suture by means of the rapid maxillary expansion technique, in terms of digital volume measurement, showed a repeatability value of 0.09% and between the two operators a reproducibility value of 0.00% was shown. CONCLUSIONS: The novel measurement technique demonstrated a high repeatability and reproducibility rate for volume assessment of the palatine suture expansion through palatine rapid maxillary expansion technique.

Compliance with the ISO 27020:2019 norm of a sample of currently available preadjusted Orthodontic bracket systems. Are the actual dimensions as expected?

BACKGROUND: Determine the exact slot dimension of a sample of a MBT prescription stainless steel conventional brackets from different manufacturers to compare the actual values with the nominal ones declared by the manufacturers and to verify the compliance with tolerance limits given by the ISO 27020:2019. Different batches from each manufacturer were evaluated to determine whether or not they are different in size. In addition, the geometry of the slot walls was assessed. METHODS: 360 stainless steel preadjusted orthodontic brackets of 12 different manufacturers were assessed. All brackets had a nominal slot size of 0.022 by 0.028 inches, belonged to the right upper central incisor, and were fabricated with the metal injection molding technique (MIM). For each manufacturer, three different manufacturing batches were evaluated. Brackets were coded using a single-blind design. RESULTS: All bracket systems in the study group except one displayed a statistically significant difference with the nominal declared value, although only four of the systems did not comply with the tolerance limits established by the ISO 27020:2019. In most of the systems, the slot height was oversized when compared to the nominal one. A significant interbatch variability was found in most of the evaluated systems. Most of the brackets walls were divergent. CONCLUSIONS: The dimensional accuracy of commercially available metal brackets is not guaranteed. The respect for the norm should be enforced as well as the quality controls along the manufacturing process since orthodontic brackets are a precision medical device.

Invisalign treatment from the patient perspective: A Twitter content analyses.

BACKGROUND: Understanding patient perspective is a key factor in improving treatment satisfaction. The aim of the present study is to qualitatively describe the content of Twitter posts related to the treatment with Invisalign in order to get a better understanding of patient experience. MATERIAL AND METHODS: Tweets were prospectively collected during a period of four weeks from public available posts on Twitter using Awario™ a bespoke social media monitoring tool. After applying the pertinent inclusion and exclusion criteria the selected posts were analysed by three investigators using thematic analysis. Specific themes and subthemes were developed. RESULTS: A total of 1564 tweets were analysed; three mayor themes were identified: Pre-treatment related, Treatment related and Patient/clinician relationship. Pre-treatment posts were mainly positive and underlined patients' expectations, while in the treatment phase an almost equal number of positive and negative posts were found. The positive post were about the satisfaction with treatment and the improvement of self-esteem. The negative ones were related to pain, compliance, the impact on diet and pronunciation. CONCLUSIONS: The present study provides a better understanding of patients' experience during clear aligners treatment. Increasing the awareness of the clinicians can improve their ability to face problems related to the orthodontic treatment and to provide to their patients better professional advices and counselling. Key words:Social media, twitter, clear aligners, Invisalign, orthodontics.

Comparative Analysis of Periodontal Pain According to the Type of Precision Orthodontic Appliances: Vestibular, Lingual and Aligners. A Prospective Clinical Study.

The objective of this prospective clinical study was to analyze the pain (intensity, location and type) that patients presented after the placement of different types of orthodontic appliances: conventional, low friction, lingual and aligners. The sample consisted of 120 patients divided into four groups: conventional (CON), low friction (LF), lingual (LO) and aligners (INV). The participants were given the Short-Form McGill Pain Questionnaire (Ortho-SF-MPQ), where they had to record the pain intensity (no pain, mild, moderate or intense) and the periodontal location at different time points, from the first 4 h to 7 days after the start of treatment. In all the study groups, the most frequent location was both anterior arches, with maximum values between 56.7% (CON group at 24 h) and 30% (LO group at 4 h). The "whole mouth" and "complete lower arch" locations were indicated only by the patients in the lingual group. Regarding pain intensity, the patients reported a higher percentage of mild-moderate pain during the first 3 days of treatment (96.7% in LO at 4 h, 86.7% in CON, 83.3% in LF and 90% in INV at 24 h); later, the reported pain decreased to no pain/mild pain, especially in the lingual group, until reaching values close to zero at 7 days post-treatment. The most frequent type of pain was acute in the low friction and lingual groups (with maxima of 60% and 46.7% at 24 h, respectively). On the contrary, in the conventional (36.7% at 4 h) and Invisalign (40% at 24 h) groups, the sensitive type was the most frequent. There are differences regarding periodontal pain in its intensity, location and type according to the use of different orthodontic techniques.

The Influence of Friction on Design of the Type of Bracket and Its Relation to OHRQoL in Patients Who Use Multi-Bracket Appliances: A Randomized Clinical Trial.

Background and objectives: The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients' perception of pain and the impact on their oral health-related quality of life. Materials and Methods: A randomized clinical trial was carried out with 90 patients (62.2% women and 37.8% men) with three kinds of fixed multi-bracket appliances: Conventional (GC), fixed multi-bracket low friction (GS) and self-ligating (GA). The VAS (Visual Analogue Scale) was used to determine pain during the first seven days of treatment at different points in time. The patients were also given the OHIP-14 (Oral Health Impact Profile) questionnaire to analyse their oral health-related quality of life (OHRQoL) after the first 30 days of treatment. The ANOVA test was used for the analysis of the variables and the post hoc Bonferroni test for the comparison between groups. Results: Maximum pain was observed between one and two days after the start of treatment. The GC group showed the greatest degree of pain, with maximum values (4.5 ± 2.0) at 24 h. The self-ligation brackets show lower impact on patients' oral health-related quality of life (0.8 ± 2.2, p < 0.01). Conclusions: Friction in the type of bracket influences pain and the Oral Health-Related Quality of Life of patients who use multi-bracket fixed orthodontics.

There is still room for improvement in the completeness of abstract reporting according to the PRISMA-A checklist: a cross-sectional study on systematic reviews in periodontology.

BACKGROUND: To evaluate the completeness of reporting abstracts of systematic reviews (SRs) before and after the publication of the PRISMA-A checklist in 2013 and to assess if an association exists between abstract characteristics and the completeness of reporting. METHODS: A systematic search of the literature was conducted in the PubMed and Scopus databases in March 2020. The search focused on the SRs of evaluations of interventions published since 2002 in the field of periodontology. The abstracts of the selected SRs were divided into two groups before and after publication of the PRISMA-A checklist in 2013, and compliance with the 12 items reported in the checklist was evaluated by three calibrated evaluators. RESULTS: A set of 265 abstracts was included in the study. The total score before (mean score, 53.78%; 95% CI, 51.56-55.90%) and after (mean score, 56.88%; 95% CI, 55.39-58.44%) the publication of the PRISMA-A statement exhibited a statistically significant improvement (P = 0.012*). Nevertheless, only the checklist items included studies and synthesis of the results displayed a statistically significant change after guideline publication. The total PRISMA-A score was higher in the meta-analysis group and in articles authored by more than four authors. CONCLUSIONS: The impact of the PRISMA-A was statistically significant, but the majority of the items did not improve after its introduction. The editors and referees of periodontal journals should promote adherence to the checklist to improve the quality of the reports and provide readers with better insight into the characteristics of published studies.

Conocimiento sobre consentimiento informado en Odontología. Una encuesta aplicada a los odontólogos de la Universidad Europea de Valencia / Knowledge about Informed Consent in Dentistry. A survey to dental practitioners of Universidad Europea de Valencia

Introducción: Conocer los aspectos fundamentales del consentimiento informado es imprescindible para una correcta práctica clínica odontológica. Objetivo: Valorar el conocimiento de los odontólogos sobre el Consentimiento Informado y relacionarlo con género, edad y especialidad del odontólogo. Analizar la relación entre apreciación sobre la formación ética del odontólogo y el manejo de situaciones éticas en la consulta con género, edad y especialidad del odontólogo. Material y método: se aplicó un cuestionario online a los odontólogos que prestan servicio en la Clínica odontológica de la Universidad Europea de Valencia. Resultados: se analizaron 62 cuestionarios. Se obtuvo una nota ponderada de 4,27 ± 0,55 en conocimiento objetivo. Conclusiones: los odontólogos suelen tener un nivel de conocimiento entre medio y bajo. No se ha encontrado ninguna diferencia estadísticamente significativa entre el nivel de conocimientos sobre consentimiento informado en Odontología y las variables edad, género y especialidad. La percepción que el odontólogo tiene sobre su formación ética no guarda ninguna diferencia estadísticamente significativa con edad, género y especialidad. El manejo de la situación clínica guarda una relación estadísticamente significativa con la especialidad de Ortodoncia con independencia de la edad y género del odontólogo. En relación a la segunda situación clínica no se ha encontrado ninguna diferencia estadísticamente significativa con respecto a edad, género y especialidad del odontólogo (AU)

Introduction: Knowing the fundamental aspects of informed consent is essential for a correct dental clinical practice. Objective: Assess the knowledge of the dentists on the Informed Consent and relate it to the gender, age and specialty of the dentist. Analyze the relationship between the appreciation about the ethic training of the dentist and the management of clinical ethical situations with gender, age and specialty of the dentist. Material and methods: An online survey about informed consent was sent to the dentists practising in the dental clinic of Universidad Europea of Valencia. Results: 62 questionnaires were analysed. A grade of 4.27 ± 0.55 was obtained in objective knowledge. Conclusions: Dentists usually have a medium to low level of knowledge. There was no statistically significant difference between the level of knowledge on informed consent in dentistry and the age, gender and specialty. There was no statistically significant difference between the dentist's perception of his ethical training and age, gender and specialty. A statistically significant difference was found between the management of the clinical situation and thee specialty of Orthodontics regardless of the age and gender of the dentist. Regarding the second clinical situation, no statistically significant difference was found regarding the age, gender and specialty of the dentist (AU)

Introducció: Conèixer els aspectes fonamentals del consentiment informat és imprescindible per a una correcta práctica clínica odontològica. Objectiu: Valorar el coneixement dels odontòlegs sobre el Consentiment Informat i relacionar-lo amb gènere, edat i especialitat de l'odontòleg. Analitzar la relació entre apreciació sobre la formació ètica de l'odontòleg i el maneig de situacions ètiques en la consulta amb gènere, edat i especialitat de l'odontòleg. Material i mètode: es va aplicar un qüestionari online als odontòlegs que presten servei en la Clínica odontològica de la Universitat Europea de València. Resultats: es van analitzar 62 qüestionaris. Es va obtenir una nota ponderada de 4,27 ± 0,55 en coneixement objectiu. Conclusions: Els odontòlegs solen tenir un nivell de coneixement entre mitjà i baix. No s'ha trobat cap diferència estadísticament significativa entre el nivell de coneixements sobre consentiment informat en Odontologia i les variables edat, gènere i especialitat. La percepció que l'odontòleg té sobre la seva formació ètica no guarda cap diferència estadísticament significativa amb edat, gènere i especialitat. El maneig de la situació clínica guarda una relació estadísticament significativa amb l'especialitat d'Ortodòncia amb independència de l'edat i gènere de l'odontòleg. En relació a la segona situació clínica no s'ha trobat cap diferència estadísticament significativa respecte a edat, gènere i especialitat de l'odontòleg (AU)

The online attention to orthodontic research: an Altmetric analysis of the orthodontic journals indexed in the journal citation reports from 2014 to 2018.

BACKGROUND: To describe the impact of research, beyond the limits of the academic environment, Altmetric, a new social and traditional media metric was proposed. The aims of this study were to analyze the online activity related to orthodontic research via Altmetric and to assess if a correlation exists among citations, Mendeley reader count, and the AAS (Altmetric Attention Score). METHOD: The Dimensions App was searched for articles published in the orthodontic journals listed in the Journal Citation Reports (JCR) throughout the years 2014 to 2018. The articles with a positive AAS were collected and screened for data related to publication and authorship. The articles with an AAS higher than 5 were screened for research topic and study design. Citation counts were harvested from Web of Science (WOS) and Scopus. RESULTS: The best performing journals were Progress in Orthodontics and the European Journal of Orthodontics with a mean AAS per published item of 1.455 and 1.351, respectively and the most prevalent sources were Tweets and Facebook mentions. The most prevalent topic was Oral Health-Related Quality of Life (OHRQOL) and the study design was systematic reviews. The correlation between the AAS and the citations in both WOS and Scopus was poor (r = 0.1463 and r = 0.1508, p < .05). The correlation between citations count and Mendeley reader (r = 0.6879 and r = 0.697, p < .05) was moderate. CONCLUSIONS: Few journals displayed a high level of web activity. Journals and editors should enhance online dissemination of the scientific outputs. The authors should report the impact of the findings to the general public in a convenient way to facilitate online dissemination but to avoid an opportunistic use of the research outputs. Despite the lack of correlation, a combination of the citation count and the AAS can give a more comprehensive assessment of research impact.

Rehabilitation of Edentulous Jaws with Full-Arch Fixed Implant-Supported Prostheses: An Approach with Short and Ultrashort Implants and Metal-Free Materials.

Introduction. Short implants represent a valid alternative to bone regeneration techniques. In addition, metal-free prosthetic materials have several advantages for predictable rehabilitation. This case report is aimed at illustrating the advantages of fixed implant-prosthetic rehabilitation on short and ultrashort implants and metal-free prosthetic materials. Case report. A 66-year-old male patient with bone atrophy was treated with temporary denture placement performed based on a rapid protocol. Once the tissues after extractions matured and aesthetic/function was studied, short implants were prosthetically placed, and a fiber-reinforced composite (FRC) bar was digitally designed for a double full-arch fixed rehabilitation. The 2-year follow-up showed the absence of peri-implantitis signs and a stable occlusal relationship of prostheses. Discussion and conclusions. The FRC material has excellent aesthetic properties and is low cost with a simplified and fast workflow owing to digital dentistry methods. Further studies are still needed to confirm the effectiveness of long-term therapy; however, the combination of new minimally invasive surgery and prosthetic advances seems to be very promising.