Mecanismos preventivos de la degradación de la capa híbrida / Preventive mechanisms of the degradation of the hybrid layer

Uno de los mayores retos de la odontología actual es lograr una adhesión duradera y estable entre los materiales de restauración y los tejidos dentales. Los protocolos adhesivos han ido cambiando a lo largo del tiempo para cumplir con dicho objetivo, tratando de mantener la integridad de la capa hibrida, por lo que se revisaron los factores que provocan la degradación de la capa hibrida y los mecanismos propuestos para prevenir esta degradación. Se realizó una investigación y recopilación de información bibliográfica especializadas en el tema, en buscadores científicos como PubMed, Scielo, Redalyc, Medigraphic y Scopus. Para los criterios de inclusión se consideraron años de publicación entre el año 2002 al 2022, enfocados en trabajos de investigación relacionados con la degradación de la interfaz de unión resina-dentina y mecanismos para prevenir esta degradación en la capa híbrida. El mecanismo mas estudiado a corto y largo plazo es la aplicación de clorhexidina, la cual se utiliza después del ácido fosfórico y antes del adhesivo, inhibe la actividad proteolítica de las metaloproteinasas de la matriz (MMPs) y retarda la degradación de las fibras colágenas, consiguiendo de esta manera una mayor vida de las restauraciones adhesivas.

One of the biggest challenges in dentistry is to achieve a long-lasting and stable bond between restorative materials and dental tissues. The adhesive protocols have been changing over time to meet this objective, trying to maintain the integrity of the hybrid layer, so the factors that cause the degradation of the hybrid layer and the mechanisms proposed to prevent this degradation were reviewed. An investigation and compilation of specialized bibliographic information on the subject was carried out, in scientific search engines such as PubMed, Scielo, Redalyc, Medigraphic, Scopus, among others, as well as books. For the inclusion criteria, years of publication between 2002 and 2022 were considered, focused on research works related to the degradation of the resin-dentin bonding interface and mechanisms to prevent this degradation in the hybrid layer. The placement of CHX is used after the application of phosphoric acid and before the adhesive, it inhibits the proteolytic activity of matrix metalloproteinases (MMPs) and the degradation of collagen fibers, thus achieving a longer life of resin dental restorations.

Depression, anxiety, and stress during the sanitary emergency of COVID-19 in southeastern México

Abstract: Aim: Evaluate the level of depression, anxiety, and stress; and identify the factors associated with these psychological responses during the third phase of the COVID-19 health emergency in a sample of Mexican population. Methods: An online cross-sectional survey was conducted. We performed bivariate and multivariate analyses to identify factors associated with depression, anxiety, and stress. Results: We included 997 individuals with a mean age of 35.3 ± 12.9 years; 18.9% of the participants presented symptoms of depression, 21.7% symptoms of anxiety and 14.1% symptoms of stress. Respondents were more likely to present depression if they were <40 years old (OR 1.73), not having a religion (OR 1.71), if they were currently unemployed (OR 1.54). Factors associated with anxiety were age<40 years old (OR 1.73) and having recent contact with suspected or diagnosed patients with COVID-19 (OR 1.54). Self-perception of insufficient knowledge about COVID-19 disease was associated with stress (OR 1.55). Declaring not feeling safe of COVID-19 infection was associated with depression (OR 2.03), anxiety (OR 1.90), and stress (OR 1.75). Conclusions: The damage to mental health caused by the COVID-19 pandemic is evident; health personnel must pay attention to their psychological state and well-being to take appropriate measures.

Resumen: Objetivo: Evaluar el nivel de depresión, ansiedad y estrés; e identificar los factores asociados a estas respuestas psicologicas durante la tercera fase de la emergencia sanitaria COVID-19 en una muestra de población mexicana. Métodos: Se realizó un estudio transversal en línea. Mediante análisis bivariado y multivariado identificamos factores asociados con depresión, ansiedad y estrés. Resultados: Participaron 997 individuos con una edad media de 35,3 ± 12,9 años; el 18,9% de los participantes presentó síntomas de depresión; 21,7%, ansiedad; y 14,1%, estrés. Los encuestados tenían más probabilidades de presentar depresión si tenían <40 años (OR 1,73), si no tenían religión (OR 1,71) y no tenían empleo (OR 1,54). Los factores asociados con la ansiedad fueron edad <40 años (OR 1,73) y contacto reciente con pacientes sospechosos o diagnosticados de COVID-19 (OR 1,54). La autopercepción de conocimiento insuficiente sobre la enfermedad se asoció a estrés (OR 1,55). Declarar no sentirse seguro ante el contagio se asoció con depresión (OR 2,03); ansiedad (OR 1,90); y estrés (OR 1,75). Conclusiones: El daño a la salud mental causado por la pandemia COVID-19 es evidente; el personal de salud debe prestar atención a su estado psicológico y bienestar para tomar las medidas adecuadas.

Resumo: Objetivo: Avaliar o nível de depressão, ansiedade e estresse; e identificar os fatores associados a essas respostas psicológicas durante a terceira fase da emergência sanitária da COVID-19 em uma amostra da população mexicana. Métodos: Foi realizado um estudo transversal on-line. Através da análise bivariada e multivariada identificamos fatores associados à depressão, ansiedade e estresse. Resultados: 997 indivíduos com idade média de 35,3 ± 12,9 anos participaram; 18,9% dos participantes apresentaram sintomas de depressão; 21,7%, ansiedade; e 14,1%, estresse. Os respondentes tinham maior probabilidade de depressão se tivessem <40 anos (OR 1,73), não tivessem religião (OR 1,71) e estivessem desempregados (OR 1,54). Os fatores associados à ansiedade foram idade <40 anos (OR 1,73) e contato recente com pacientes suspeitos ou diagnosticados com COVID-19 (OR 1,54). O conhecimento insuficiente autopercebido sobre a doença estava associado ao estresse (OR 1,55). O relato de não se sentir seguro contra infecção estava associado à depressão (OR 2,03); ansiedade (OR 1,90); e estresse (OR 1,75). Conclusões: Os danos à saúde mental causados pela pandemia da COVID-19 são evidentes; os profissionais da saúde devem prestar atenção ao seu estado psicológico e bem-estar a fim de tomar as medidas apropriadas.

Caries dental y microorganismos asociados a la caries en la saliva de los alumnos del primer año de la Facultad de Odontología, UNAM / Dental caries and caries-associated mechanisms found in the saliva of first year students at the School of Dentistry, UNAM (National Autonomous University of Mexico)

Se estudiaron 380 alumnos del primer año en la Facultad de Odontología (n = 380) (periodo 2012-2013) a fin de determinar el índice CPOD y relacionar si la caries está asociada con los microorganismos Streptococcus y Lactobacillus. El índice CPOD (cariado, perdido y obturado) se registró usando los parámetros de la Organización Mundial de la Salud. Se tomaron muestras de saliva de cada alumno y se determinaron las unidades formadoras de colonias de Streptococcus y Lactobacillus. La media de los índices CPOD fue de 7.25 ± 4.59. Las mujeres (n = 278) y hombres (n = 102) presentaron una media de índices CPOD de 7.11 ± 4.66 y 7.29 ± 4.57, respectivamente. Encontramos que los alumnos de 19 años presentaron menos caries que los estudiantes de otras edades. Tanto Streptococcus y Lactobacillus se correlacionaron significativamente entre sí, así como en la incidencia de caries. Un incremento en el número de estos microorganismos, especialmente de Streptococcus mutans, se asociaron con el incremento en CPOD.

Three hundred and eighty first year students of the National School of Dentistry (UNAM) (n = 380) (academic year 2012-2013), were assessed targeting determination of DMFT (decayed, missing, lost teeth) index as well as to establish a relationship of whether caries is associated to Lactobacillus and Streptococcus microorganisms. DMFT index was recorded using World Health Organization (WHO) parameters. Samples of all students were taken and colony-forming units of Streptococcus and Lactobacillus were determined. DMFT indexes mean was established at 7.25 ± 4.59. Females (n = 278) and males (n = 102) exhibited mean DMFT indexes of 7.11 ± 4.66 and 7.29 ± 4.57 respectively. Results revealed that 19 year old students exhibited lesser amounts of caries than students of other ages. Both Streptococcus and Lactobacillus were significantly correlated to each other as well as to caries incidence. Increase in the number of the aforementioned micro-organisms, especially Streptococcus mutans, were associated to DMFT increase.