Impact of an Educational Intervention on Oral Health Knowledge and Bacterial Plaque Control in Male Secondary School Students in a Peruvian Province: A Quasi-Experimental Study.

Background: The purpose of this study was to evaluate the effect of an educational intervention on oral health knowledge and bacterial plaque control in male secondary school students in a Peruvian province. Methods: This quasi-experimental study evaluated 294 male secondary school students in southern Peru. Oral health knowledge was measured with a validated 20-item questionnaire. Bacterial plaque was measured with the Simplified Oral Hygiene Index (OHI-S). This was rated as Excellent: 0, Good: 0.1-1.2, Fair: 1.3-3.0 and Poor: 3.1-6.0, before receiving the educational intervention and after four weeks of receiving it. Variables such as age, area of residence, having health professionals as family members, educational level of mother and father, and living with parents were considered. A significance level of p<0.05 was considered. Results: The comparison between the level of oral health knowledge and the OHI-S, before and after 4 weeks of receiving the educational intervention, showed a significant improvement (p<0.05) in all the categories of the variables studied. Likewise, before the educational intervention, there were significant differences in global knowledge about oral health among the categories of the following variables: age group (p=0.040), area of residence (p<0.001), educational level (father) (p=0.011) and living with parents (p<0.001). However, after four weeks of receiving the educational intervention, no significant differences were observed in all the variables studied (p>0.05). Regarding the OHI-S, no significant differences were observed in any of the variables studied, both before (p>0.05) and after four weeks (p>0.05) of receiving the educational intervention. Conclusion: After four weeks, the educational intervention significantly improved oral health knowledge and significantly reduced plaque bacterial plaque in male secondary school students in a Peruvian province, regardless of age, area of residence, having health professional family members, educational level of mother and father, and living with parents.

Effect of Polywave and Monowave Light Curing Units on the Microtensile Bond Strength and Failure Types of Different Bulk-Fill Resin Composites: An in vitro Study.

Aim: This study aimed to evaluate the effects of polywave and monowave light-emitting diode curing units on the microtensile bond strength and failure types of three bulk-fill resin composites. Materials and Methods: This in vitro experimental study was performed on 180 microbars obtained from human third molars and were distributed into 12 groups according to the type of bulk-fill resin composite and the light-curing unit. Third molars were restored using Filtek One Bulk Fill Restorative, Tetric® N-Ceram Bulk Fill, and Opus Bulk Fill resin composites was light-cured with Elipar Deep Cure L and Valo in three modes: standard, high power, and extra power. Subsequently, microtensile analysis was carried out with a universal testing machine and the type of failure with an optical stereomicroscope. For statistical analysis, the Kruskal-Wallis H-test was used, with the Bonferroni post hoc test and Fisher's exact test, considering a significance of p<0.05. Results: There were significant differences in the microtensile bond strength between the Filtek One Bulk Fill restorative and Opus Bulk-Fill (p = 0.042) when light was cured with the polywave unit at standard power. On the other hand, the Filtek One Bulk Fill Restorative and Opus Bulk Fill resins showed significant differences in microtensile bond strength when light was cured with the monowave unit compared with the polywave unit (p<0.05). Conclusion: The presence of alternative photoinitiator systems that are more reactive than camphorquinone produced higher microtensile bond strength in Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins when light-cured with a high and standard polywave unit, respectively, compared to Filtek One Bulk Fill resins. Finally, Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins had the highest percentage of mixed failures, while Filtek One Bulk Fill resin had adhesive failures, which was related to its lower microtensile bond strength.

Effect of fibrin-rich plasma and collagen sponge on healing of the palatal mucosa.

Background: The purpose was to evaluate the variation in thickness and early healing of the donor area of the palate with the placement of a collagen sponge and the use of fibrin-rich plasma (L-PRF). Material and Methods: Thirty patients who required mucogingival surgery treatment were selected and distributed into 2 groups. After obtaining the free palate graft, L-PRF was placed in Group A, and a collagen sponge was placed in Group B. The healing process of the palate was evaluated at 24 hours and 7, 14, 21 and 28 days postsurgery. The thickness of the donor area (palate) was evaluated using an acrylic splint. These measurements were made before and 4 months after surgery. Results: In the collagen sponge group, less gain of the palatal mucosa was observed, with a mean difference of 0.1 ± 0.8 mm (CI: -0.341-0.518) (p=0.691), whereas in the fibrin-rich plasma group, a mean difference of 0.0 ± 0.5 mm (CI: -0.229-0.229) (p=0.934) was found; however, when comparing the gain of the palatal mucosa in both groups, no significant difference was observed (p=0.932). The healing index at 24 hours indicated the presence of clots, on Day 28 vascularisation and total epithelialisation (100.0%), and finally, the collagen sponge group on Day 14 presented 93.3% partial vascularisation of connective tissue and 33.3% L-PRF (p=0.001). Conclusions: There was no statistically significant difference in the thickness of the palatal mucosa after the use of L-PRF and the collagen sponge. Key words:Palate thickness, connective tissue graft, fibrin-rich plasma, collagen sponge, palate healing.

Factors Associated with the Level of Knowledge about Biosafety against COVID-19 in Peruvian Dental Students: A Cross-Sectional Study under a Multivariable Regression Model.

AIM: Biosafety is a set of preventive measures aimed at controlling risk factors arising from biological, physical, and/or chemical agents. This topic is particularly important in the dental field since saliva is the main biological agent of the transmission of coronavirus. The present study aimed to determine the factors associated with the level of knowledge about biosafety against COVID-19 in Peruvian dentistry students. MATERIALS AND METHODS: The present observational, cross-sectional, and analytical study evaluated 312 Peruvian dentistry students. A validated 20-question questionnaire was used to measure the level of knowledge. The nonparametric Mann-Whitney U and Kruskal-Wallis tests were used to compare levels of knowledge between categories of each variable. A logit model was used to evaluate associated factors such as sex, age, marital status, place of origin, academic year of study, being in the academic upper third, history of COVID-19, and living with vulnerable family members. A significance level of p < 0.05 was considered. RESULTS: 36.2%, 31.4%, and 32.4% presented poor, fair, and good knowledge levels, respectively. Students under 25 years of age were 64% less likely to pass the biosafety against COVID-19 questionnaire than students 25 years of age and older (OR = 0.36; CI: 0.20-0.66). Students in the academic upper third were nine times more likely to pass the test than other students (OR = 9.38; CI: 4.61-19.07). Finally, third-year students were 52% less likely to pass the exam than fifth-year students (OR = 0.48; CI: 0.28-0.83). CONCLUSION: Only a minority of dentistry students had a good level of knowledge about biosafety against COVID-19. Younger and less educated students were more likely to fail the questionnaire. On the other hand, those students with outstanding academic performance were more likely to pass the questionnaire.

Sociodemographic Factors Associated with Knowledge About Management of Cleft Lip and Palate Patients in Peruvian Dental Students: A Logistic Regression Analysis.

Background: Cleft lip and palate are relatively frequent craniofacial alterations caused by the lack of union of the frontonasal processes with the maxillary processes during the first weeks of intrauterine life. This study evaluated the sociodemographic factors associated with the level of knowledge about management of cleft lip and palate (CLP) patients in Peruvian dental students. Methods: This analytical, observational, cross-sectional and prospective study evaluated 191 dental students belonging to two branches of a private Peruvian university (one branch in the capital city and the other in a province), from September to November 2022. A validated questionnaire of 14 closed multiple-choice questions was used. A logit model was used to evaluate the influence of the variables: sex, age, academic year of study, marital status, relationship with CLP persons, place of origin and area of residence, on the level of knowledge of the students considering a significance level of p<0.05. Results: Of the total, 77%, 22.5% and 0.5% presented a poor, fair and good level of knowledge, respectively, on the dental management of the patient with cleft lip and palate. In addition, those who lived in urban areas were 2.8 times more likely to have poor knowledge about the dental management of patients with CLP, compared to those who lived in non-urban areas (OR = 2.83; 95% CI: 1.26-6.33). Finally, sex, age, marital status, place of origin, academic year of studies and relationship with CLP persons were not considered influential factors (p>0.05). Conclusion: Most of the students showed a poor level of knowledge about the dental management of patients with cleft lip and palate, a risk factor being that the students live in an urban area. It is recommended that educational authorities include selected topics on CLP in subjects related to infant, child and adolescent care.

Impact of a virtual educational intervention on knowledge and awareness of biomedical waste management among Peruvian dental professionals.

Waste from healthcare is a significant global issue, with around 85% of it being common waste and the remaining 15% being hazardous waste that is infectious and toxic. Dentistry uses various materials that create a substantial amount of biomedical waste capable of impacting the environment. Therefore, the purpose of this study was to assess the effects of a virtual educational program on the knowledge and awareness of dental material recycling and reuse, as well as biomedical waste management, among dental professionals in Peru. The current study was a longitudinal and quasi-experimental evaluation of 165 dentists from Peru. A validated questionnaire consisting of 30 items was administered at three different intervals (pre-test, immediate post-test, and 14-day post-test). Statistical analysis was conducted using the Mann Whitney U and Kruskal Wallis H tests to compare scores between categories of each sociodemographic variable, and the Cochrane's Q and Friedman test was used for related measures comparison. A significance level of p < 0.05 was considered. When comparing the percentage of correct responses regarding recycling and reuse of dental materials and biomedical waste management between the pre-test and the immediate post-test, a significant improvement in knowledge was observed for most of the questionnaire items (p < 0.05). At 14 days after the test, those who studied at a private university, unmarried, bachelors, non-specialists, non-teachers and have less than 10 years of professional experience did not did not retain knowledge on biomedical waste management (p < 0.05) or recycling and reusing dental materials (p < 0.05) to a significant extent. There was a significant enhancement in dentists' knowledge and awareness of managing biomedical waste, recycling, and reusing dental materials following the educational intervention. This improvement was observed across all sociodemographic variables considered in the study. However, this knowledge was not retained beyond two weeks for those who studied at a private university, unmarried, bachelor, with no specialty, non-teachers and with less than 10 years of professional experience. Government authorities should encourage oral health professionals to conduct research with educational interventions focused on improving and evaluating the sustainability and environmental impact of dental practices. This will enable professionals to better understand, control and evaluate the consequences of their practical work.

Predictability and Accuracy of the Short-Form Fonseca Anamnestic Index in Relation to the Modified Helkimo Index for the Diagnosis of Temporomandibular Disorders: A Cross-Sectional Study.

Aim: The aim of this study was to evaluate the predictability and accuracy of the Short-Form Fonseca Anamnestic Index (SFAI) in relation to the modified Helkimo Index for the diagnosis of temporomandibular disorders (TMDs). Materials and Methods: A cross-sectional, prospective, and analytical predictive study was conducted in 240 students of a public institute of higher technological education in Ica, Peru during the months of February to May 2018. The SFAI of 10 closed questions and the Helkimo Index modified by Maglione (gold standard) were used as instruments to diagnose TMDs. For the analysis of concordance between both instruments, Cohen's Kappa Index was applied. To evaluate the association according to gender and age group, Pearson's chi-square test was used. For validity of the SFAI in relation to accuracy, sensitivity and specificity were calculated, and they were verified by receiver operating characteristics (ROC) to determine the best cutoff points (area under the curve [AUC]) considering a P value < 0.05. Regarding the predictability of the SFAI, the positive and negative predictive value was calculated by applying Bayes' theorem. Results: The SFAI was highly significantly associated with the modified Helkimo Index according to gender (P < 0.001), age group (P < 0.001), and overall (P < 0.001) moderate overall agreement (k = 0.416; 95% confidence interval [CI] = 0.287-0.545); better concordance was obtained in individuals older than 20 years (k = 0.490, CI = 0.302-0.679) and women (k = 0.565, CI = 0.371-0.759). The ROC curve analysis of the SFAI showed good accuracy (0.852, CI = 0.800-0.905) and was highly significant (P < 0.001), with an optimal cutoff point of 17.5 and good sensitivity (80.10%) and specificity (74.36%). In addition, a very good positive predictive value (PPV) (94.15%) and a fair negative predictive value (NPV) (42.02%) were obtained. Conclusions: Although there was moderate concordance between the SFAI and the modified Helkimo Index for the diagnosis of TMDs, the SFAI obtained good accuracy in the overall analysis of sensitivity and specificity. In addition, it demonstrated a high predictive efficacy for detecting positive TMD cases, whereas its ability to rule out positive cases was fair.

Outcome measurements following palatal soft tissue graft harvesting: A review.

BACKGROUND: Free gingival graft (FGG) and connective tissue graft (CTG) are two of the most commonly techniques performed in periodontal and peri-implant plastic surgery. Although several outcome measurements have been proposed for evaluation of palatal wound healing and patient morbidity, a comprehensive review about these variables is lacking. The objective of this review is to present comprehensive information about outcome measurements related to postoperative palatal wound healing and postoperative patient-reported morbidity after FGG or CTG procedures. MATERIAL AND METHODS: An electronic search of English language dental literature in the Medline database via PubMed access was conducted from May 1994 to May 2020 following the PRISMA guidelines. Electronic search strategy complemented by hand search of impacting related dental journals, and the reference list of all included studies were used to complete data collection considering only clinical trials. Finally, inclusion criteria were applied to identify articles after full-text evaluation. RESULTS: A total of 111 articles were identified. After the exclusion of 34 articles based on title and abstract evaluation, 77 articles were full text screened. Following, 46 articles were excluded since they evaluated other surgical areas. Finally, 31 studies were selected and included for final evaluation. Outcome measurements were classified in variables collected by indexes and systems assessed professionally and patient-centered measurements. Visually-assessed measurements include indexes, photographs, bleeding and use of laboratory-aided measurements. Patients-centered outcomes comprise pain, discomfort and quality-of life, among others. CONCLUSIONS: The most commonly used outcome measurements related to postoperative palatal wound healing are hydrogen peroxide test, tissue color match, visual inspection, and bleeding evaluation. Pain perception, analgesic consumption, discomfort sensation, burning sensation, and changes in feeling habits are the most commonly used outcome measurements related to postoperative patient-reported morbidity. Key words:Morbidity, patient comfort, periodontics, tissue harvesting, wound healing.

[Prevention of complications and risk reduction in oral implantology considering human factors and situation awareness]. / Prevención de complicaciones y reducción de riesgos en implantología oral considerando los factores humanos y la conciencia de la situación.

In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures.

Prevención de complicaciones y reducción de riesgos en implantología oral considerando los factores humanos y la conciencia de la situación / Prevention of complications and risk reduction in oral implantology considering human factors and situation awareness

En los últimos años, se ha incrementado el porcentaje de colocación de implantes dentales y, con ello, también la mayor presencia de eventos adversos, por lo que las complicaciones no son infrecuentes. La gran mayoría de recomendaciones para la reducción de complicaciones asociadas con la colocación de implantes dentales están analizadas desde el punto de vista de sus causas directas, juzgando la técnica o al individuo, pero no al sistema en conjunto, cuando este constituye la etiología real de las complicaciones. Recientemente, se ha empezado a considerar más importante la inclusión de los factores humanos y la conciencia de la situación en la comprensión de las complicaciones en implantología oral. Esto ha permitido analizar de manera global tanto al individuo como a su entorno, y aportar soluciones basadas en la prevención. Sin embargo, el conocimiento y la utilización de estos aspectos en implantología oral están aún en vías de popularización, por lo que el objetivo del presente artículo es difundir el enfoque de los factores humanos y la conciencia de la situación en la prevención de complicaciones y en la reducción de riesgos en los procedimientos de colocación de implantes dentales. (AU)

In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures. (AU)

Supernumerarios múltiples no sindrómicos en dentición permanente. Reporte de caso / Multiple non syndromic supernumerary teeth in permanent dentition. A case report

RESUMEN El número de dientes puede incrementarse por piezas dentarias denominadas Dientes Supernumerarios (DS). En los casos en que los DS son cinco o más y no relacionados con ningún síndrome, son considerados DS múltiples o hiperdoncia múltiple no sindrómica; anomalía dentaria con una escasa prevalencia menor al 1% de los reportes de esta alteración. El objetivo de esta investigación es documentar un caso poco frecuente de DS múltiples no sindrómicos en una paciente con dentición permanente. Paciente de sexo femenino, 22 años de edad, presenta siete DS en total; clínicamente: dos DS en la zona central superior, un DS por palatino de la pieza 1.2, un DS por distal de la pieza 3.5. Radiográficamente: un DS entre las piezas 1.5 y 1.4, la pieza 1.1 retenida en posición horizontal, la agenesia de la pieza 2.2 y dos DS suplementarios entre los premolares inferiores derechos. El diagnóstico precoz de los DS es fundamental para evitar las alteraciones futuras originadas por esta anomalía dentaria; así como un examen adecuado que permita descartar la asociación con hiperdoncia relacionada a algún síndrome.

SUMMARY The number of teeth can be increased by extra teeth named Supernumerary Teeth (ST). Multiple ST or hyperdontia is consider when there are five or ST with non syndromic association, which is a dental anomaly with a prevalence less than 1% of the reports of this alteration. The aim of this report was to keep record an unusual case of non- syndromic supernumerary teeth in a permanent dentition patient. Intraoral examination of a 22 years old woman revealed permanent dentition with presence of two supernumerary teeth in the upper central region, one of them palatally to 1.2, and another distal to 3.5. Radiographic findings: A panoramic radiograph showed us impacted supernumerary teeth between 1.5 and 1.4, another in similar condition, 1.1 in horizontal position, agenesy of 2.2 tooth, and two supernumeraries more between right lower bicuspids. The early diagnosis of ST is essential to avoid future alterations caused by this dental anomaly; as well as an adequate examination that allows to rule out the association with hyperdoncia related to some syndrome.

Rehabilitación oral en paciente con alteración de la dimensión vertical oclusal aplicando un enfoque multidisciplinario / Oral rehabilitation in patient with alteration of vertical dimension occlusal applying a multidisciplinary approach

El objetivo de éste caso clínico fue restaurar las funciones del sistema estomatognático mediante confección de prótesis convencional combinada, restableciendo de esta manera la dimensión vertical alterada. Caso clínico: Paciente de sexo masculino, 64 años de edad, edéntulo parcial superior clase II de Kennedy modificación 1 e inferior clase II de Kennedy, el motivo de consulta fue la atrición de las piezas dentarias antero superiores e inferiores evidenciando disminución de la dimensión vertical, se realizó tratamiento de conductos con fines protésicos; confección de espigos muñones y se restableció una dimensión vertical terapéutica a través de prótesis superior e inferior; para posteriormente lograr una rehabilitación definitiva mediante prótesis fija y prótesis parcial removible convencional. Las prótesis combinadas definitivas son los dispositivos protéticos que mantienen la dimensión vertical en el tiempo.

The aim in the present case report was re-establish stomatology system functions by conventional mixed dental prosthesis for recovering altered vertical dimension. Clinical case: A 64 years old male patient with upper partial edentulism, Kennedy class II-1 and also lower partial edentulism but Kennedy class II. Patient's chief complaint was dental wearing and an evident oclusal vertical dimension loss. Endodontic treatment was done focusing it in dental prosthetic rehabilitation. Thus therapeutic vertical dimension was reestablished with fixed and removal dental prosthesis. Later, definitive dental therapeutic rehabilitation was attained with fixed and conventional removable dental prosthesis. That mixed dental rehabilitation is an alternative which recovers and maintains oclusal vertical dimension through the time.