Is scanning under rubber dam isolation a feasible approach for the execution of indirect restorations? / O escaneamento sob isolamento absoluto é uma técnica viável para execução de restaurações indiretas?

Objective: The aim of the study was to report the aplicability of intraoral scanning while rubber dam isolation is in place. Material and Methods: Female patient, 50 years old, required restorative procedures on teeth 35 and 37. An intraoral scan was initially performed on both arches. Isolation was carried out from 33 to 37, tooth preparation and immediate dentin sealing were carried out. A new scan with the rubber dam in place was performed and a CAD/CAM lithium disilicate hybrid block was digitally designed, milled, crystallized and cemented under the tooth surface with the rubber dam still in position. After completing this stage, the rubber dam was removed, the occlusion was verified, presenting excellent aesthetic and functional results. Results: The absolute isolation process used in the present study works as an excellent device for gingival retraction. Conclusion: The absolute isolation can be recommended in clinical activities of intraoral scanning favoring the quality of the final result of treatments (AU)

Objetivo: O objetivo do estudo foi relatar a aplicabilidade do escaneamento intraoral sob isolamento absoluto. Material e Métodos: Paciente do sexo feminino, 50 anos, necessitou de procedimentos restauradores nos dentes 35 e 37. Uma varredura intraoral foi inicialmente realizada em ambos os arcos. O isolamento absoluto foi feito de 33 a 37, permitindo a realização do preparo dentário e selamento imediato da dentina. Um novo escaneamento com o dique de borracha colocado foi realizado e um bloco híbrido de dissilicato de lítio CAD/CAM foi projetado digitalmente, fresado, cristalizado e cimentado sob a superfície dentária ainda com o dique de borracha em posição. Após a finalização dessa etapa, o dique de borracha foi removido, a oclusão foi verificada apresentando ótimos resultados estéticos e funcionais. Resultados: O isolamento absoluto utilizado no presente estudo funciona como um excelente dispositivo para retração gengival. Conclusão: O isolamento absoluto pode ser recomendado em atividades clínicas de escaneamento intraoral favorecendo a qualidade do resultado final dos tratamentos (AU)

Clinical study of polyetheretherketone resin-bonded bridge for restoring anterior missing teeth in patients with periodontitis / 口腔疾病防治

Objective@#To study the clinical effect of a polyetheretherketone (PEEK) bonding bridge on the loss of 3 internal incisors in patients with periodontitis.@*Methods@#This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. Thirty-eight patients with periodontitis and 3 missing central or lateral teeth were selected to undergo restoration with a PEEK bonding bridge and then returned to the hospital 3, 6, 12, and 24 months after the restoration was completed. The survival rate of the restorations was assessed by the modified USPHS/Ryge criteria. The plaque index, gingival index, periodontal probing depth and attachment loss of the abutments were recorded, and the changes in periodontal tissues after restoration were observed and compared.@*Results@#Over 24 months of clinical follow-up observation of 38 patients, only 1 patient underwent secondary bonding after partial debonding (evaluated as grade B), while bonding was successful in the other 37 cases (evaluated as grade A). The plaque index, gingival index and periodontal probing depth were significantly lower after restoration than before (P<0.05). There was no significant change in attachment loss between before and after restoration (P>0.05).@*Conclusion@#For periodontitis patients missing 3 internal incisors, short-term PEEK bonding bridge repair has good clinical efficacy.

Divorcio parental, apego a los padres y satisfacción con la vida en adolescentes chilenos: un estudio comparativo

Si bien existen una serie de avances en la comprensión de los efectos del divorcio sobre el bienestar y desarrollo de los adolescentes, un aspecto que requiere mayor exploración es si existen variaciones en la satisfacción con la vida y la calidad de los vínculos de apego entre adolescentes que han experimentado o no el divorcio de sus padres. El presente estudio tuvo por objetivo evaluar diferencias en la satisfacción con la vida y en la calidad del apego a la madre y al padre entre adolescentes provenientes de familias intactas y quienes han experimentado el divorcio de sus padres. Mediante un estudio de corte transversal, se evaluó una muestra de 421 adolescentes chilenos entre 12 y 17 años, siendo un 54,6% hijos de padres casados y un 45,4% hijos de padres divorciados. Los análisis de diferencias de medias mediante pruebas t permitieron identificar que la satisfacción con la vida es mayor en los hijos de familias intactas. Asimismo, se detectaron diferencias en la calidad del apego hacia el padre, pero no hacia la madre. En específico, los hijos de padres divorciados reportaron menor calidad de la comunicación, menor confianza mutua y mayor alienación con sus padres que los hijos de familias intactas. Estos resultados, discutidos desde una perspectiva clínica, avanzan en la comprensión de los efectos del divorcio en adolescentes chilenos.

While there have been several advances in understanding the effects of divorce on the well-being and development of adolescents, one aspect that requires further exploration is whether there are variations in life satisfaction and the quality of attachment relationships among adolescents who have experienced their parents' divorce and those who have not. The present study aimed to assess differences in life satisfaction and the quality of attachment to both mothers and fathers among adolescents from intact families and those who have experienced their parents' divorce. Through a cross-sectional study, a sample of 421 Chilean adolescents aged 12 to 17 was evaluated, with 54.6% being children of married parents and 45.4% being children of divorced parents. Mean difference analyses using t-tests revealed that life satisfaction is higher among children from intact families. Additionally, differences in the quality of attachment to the father, but not to the mother, were detected. Specifically, children of divorced parents reported lower quality of communication, less mutual trust, and greater alienation from their parents than children from intact families. These results, discussed from a clinical perspective, contribute to the understanding of the effects of divorce on Chilean adolescents.

Unvaccinated periodontal patients with a history of COVID-19: clinical findings in a Dental School setting

Abstract This study analyzed the periodontal clinical data of individuals with a history of COVID-19 treated in a dental school during the pandemic in 2021 before vaccination. Methods: This analysis included individuals older than 18 years with no history of systemic disorders other than systemic arterial hypertension. Individuals who had COVID-19 were classified according to the World Health Organization as asymptomatic, with mild, moderate, severe, or critical symptoms. Results: A total of 95 individuals were evaluated, which included 24 with a history of COVID-19. Seventeen percent had been asymptomatic, 21% had mild, 25% moderate, 21% severe, and 17% critical symptoms, including intubation. Individuals with no history of COVID-19 presented significantly lower measurements of probing depth (p=0.003; Mann-Whitney test) and clinical attachment level (p=0.002) compared to individuals with a history of COVID-19. A significant negative association was found between bleeding on probing and the severity of characteristics of COVID-19 (rho= -0.233; p=0.023). Conversely, positive associations between the values of probing depth (rho= 0.292; p=0.004) and mean clinical attachment level (rho= 0.300; p=0.003) and the characteristics of COVID-19 were found. Conclusions: The periodontal data shows that patients who had COVID-19 before vaccination may present a worse periodontal status when compared to patients in the same clinical setting with no history of COVID-19. However, a more extensive study should confirm it with more participants.

Resumo Este estudo analisou os dados clínicos periodontais de indivíduos com histórico de COVID-19 tratados em uma escola de odontologia durante a pandemia em 2021, antes da vacinação. Métodos: Essa análise incluiu indivíduos maiores de 18 anos sem histórico de distúrbios sistêmicos, exceto hipertensão arterial sistêmica. Os indivíduos que tiveram COVID-19 foram classificados de acordo com a Organização Mundial da Saúde como assintomáticos, com sintomas leves, moderados, graves ou críticos. Resultados: 95 indivíduos foram avaliados, incluindo 24 com histórico de COVID-19. 17% eram assintomáticos, 21% tinham sintomas leves, 25% moderados, 21% graves e 17% críticos, incluindo intubação. Os indivíduos sem histórico de COVID-19 apresentaram medidas significativamente mais baixas de profundidade de sondagem (p=0,003; teste de Mann-Whitney) e nível de fixação clínica (p=0,002) em comparação com indivíduos com histórico de COVID-19. Foi encontrada uma associação negativa significativa entre o sangramento à sondagem e a gravidade das características da COVID-19 (rho= -0,233; p=0,023). Por outro lado, foram encontradas associações positivas entre os valores de profundidade de sondagem (rho = 0,292; p = 0,004) e o nível médio de apego clínico (rho = 0,300; p = 0,003) e as características da COVID-19. Conclusão: Os dados periodontais mostraram que os pacientes que tiveram COVID-19 antes da vacinação podem apresentar um pior estado periodontal quando comparados a pacientes no mesmo ambiente clínico sem histórico de COVID-19. No entanto, um estudo mais extenso deve ser realizado para confirmar tal achado com maior número de participantes.

Apego Adulto y Soltería: Validación de una Escala / Adult Attachment and Singleness: Validation of a Scale

Resumen El apego es un vínculo afectivo que caracteriza y moldea las relaciones interpersonales cercanas. Los estilos de apego son el conjunto de conocimientos, expectativas e inseguridades que se sostienen sobre el sí mismo y los demás. El objetivo de la presente investigación fue elaborar una escala que evalúe el apego adulto no solo en el contexto romántico, sino con otros significativos, lo que permitirá el estudio de las personas sin pareja. Se realizaron tres estudios: en el estudio uno se realizó un análisis factorial exploratorio (n=400); en el estudio dos un análisis factorial confirmatorio (n=700). Se obtuvo una escala compuesta por 16 reactivos distribuidos en cuatro factores: preocupado, temeroso, evitante y seguro. La varianza explicada fue del 38.09%, con un índice de fiabilidad con un rango de 0.46 a 0.82 en los distintos factores. En el estudio tres se analizó la validez concurrente (n=201). En los tres estudios se encontraron diferencias entre las personas con pareja y sin pareja, puntuando más alto en seguridad las primeras y más alto en apego ansioso aquellas sin pareja. Se obtuvo una escala válida, confiable, culturalmente relevante que evalúa el apego adulto no solo en el ámbito romántico, sino con otros significativos.

Abstract The attachment is an affective bond that characterizes and shapes close interpersonal relationships. Attachment styles are the set of knowledge, expectations and insecurities about oneself and others. The aim of this research was to develop a scale with adequate psychometric properties, that allows to assess adult attachment not only in a romantic context, but with significant others in general. It will allow the study of groups such as single people. To address that aim, three studies were conducted in which men and women form Mexico City participated voluntarily. In study one an exploratory factor analysis was performed (n=400), in study two a confirmatory factor analysis was performed (n=700). As a result of these studies, it was obtained a scale compounded by 16 items distributed in four factors: preoccupied, fearful, dismissing, and secure. The explained variance was 38.09%, with a reliability index of 0.46 to 0.82 in the different factors. In study three concurrent validity was analyzed (n=201). Differences between people with a partner and single were found in the three studies, scoring higher in security the first and single people scoring higher in preoccupied attachment. It was obtained a valid, reliable, and culturally relevant scale to assess adult attachment not only in the romantic ambit, but also in relation to significant others like family and friends.

Validación Chilena del Cuestionario de Evaluación de Apego en el adulto CaMir versión abreviada

El Cuestionario de Evaluación de Apego en el adulto CaMir, es un instrumento de auto-reporte basado en la Teoría del Apego que evalúa los modelos de relación en adultos y permite describir las estrategias de apego. El objetivo de la presente investigación fue desarrollar una versión breve para el contexto chileno, para lo cual se llevaron a cabo dos estudios. En el Estudio 1 se obtuvo una versión reducida del CaMir bajo una estrategia de validación cruzada. En el Estudio 2, se aplicó la versión reducida obtenida en el estudio 1 a una amplia muestra de adultos/as chilenos/as (n=1246). Los resultados muestran evidencias que apoyan la estructura interna propuesta, y los análisis de invarianza apoyan la existencia de equivalencia/invarianza de medida entre hombres y mujeres. Adicionalmente, esta versión obtuvo correlaciones significativas con la Escala de Dificultades de Regulación Emocional, el cuestionario de Experiencias en Relaciones Cercanas y la Escala de Depresión del Centro de Estudios Epidemiológicos. En síntesis, los resultados muestran que esta nueva versión abreviada del CaMir, es un instrumento apropiado para el estudio de los modelos de relación y las estrategias de apego en adultos/as chilenos/as.

The CaMir Adult Attachment Assessment Questionnaire is a self-report instrument based on Attachment Theory that assesses relationship models in adults and allows describing attachment strategies. The objective of this research was to develop a short version for the Chilean context. The results of two studies are presented. In Study 1, a reduced version of CaMir was obtained under a cross-validation strategy. In Study 2, the reduced version obtained in Study 1 was applied to a large sample of Chilean adults (n=1246). The results show evidence that supports the proposed internal structure, and the invariance analysis support the existence of equivalence/invariance of measurement between men and women. Additionally, this version obtained significant correlations with the Difficulties in Emotion Regulation Scale, the Experiences in Close Relationships questionnaire and the Center for Epidemiologic Studies Depression Scale. In summary, the results show that this new abbreviated version of the CaMir is an appropriate instrument for the study of relationship models and attachment strategies in Chilean adults.

Mentalización, estilo de apego y afrontamiento al estrés en una muestra poblacional de la Costa Atlántica colombiana durante la cuarentena por el COvID-19 / Mentalizing, Attachment Style, and Coping During the COvID-19 Quarantine in Colombia / Mentalização, estilo de apego e enfrentamento do estresse em uma amostra populacional da Costa Atlântica colombiana durante a quarentena causada pelo COvID-19

El objetivo de este artículo es describir la relación de la mentalización y el estilo de apego sobre el afrontamiento del estrés durante la cuarentena por COVID-19 en Colombia. En el estudio participaron 253 personas, de las cuales 68 fueron hombres, 184 mujeres y 1 se identificó como otro. Los participantes se eligieron mediante un muestreo no probabilístico de tipo bola de nieve y el cuestionario de datos se distribuyó por redes sociales. Como instrumentos de investigación se utilizó el Cuestionario de Afrontamiento frente al Estrés (CAE) ­la forma revisada de la EEC-R­, medida de autoinforme diseñada para evaluar siete estilos básicos de afrontamiento; el Cuestionario de Experiencias en Relaciones Cercanas-revisado (ECR) y el Cuestionario de Función Reflexiva (RfQ-8). En los resultados se encontraron correlaciones entre el estilo de apego y la mentalización con el estilo de afrontamiento frente al estrés durante el aislamiento por la pandemia de COVID-19. Se evidenció que un estilo de apego seguro facilita estilos de afrontamiento más adaptativos, a diferencia de los estilos de apego ansioso y evitativo que están más relacionados con estilos de afrontamiento como la auto focalización negativa y la evitación.

This study aimed to describe the relationship between mentalization and attachment style in coping with stress during the COVID-19 quarantine in Colombia. In this study 253 people participated of which 68 were men, 184 were women and 1 was defined as other; the partici- pants were chosen through a non-probabilistic snowball sampling where the questionnaire was distributed in social networks. As instruments, the CAE is the revised form of the EEC-R; a self-report measure designed to assess seven basic coping styles, the Experiences in Close Relationships-Revised (ECR) questionnaire and the Reflective Function Questionnaire (RfQ-8) were used. The results found correlations between attachment style and mentalization with coping style in the face of stress during the COVID-19 pandemic isolation. Finding that a secure attachment style facilitates more adaptive coping styles, as opposed to anxious and avoidant attachment styles that are more related to coping styles such as negative self-focus and avoidance.

O objetivo do estudo foi descrever a relação entre mentalização e estilo de apego no enfrentamento do estresse durante a quarentena da COVID-19 na Colôm- bia. Neste estudo, participaram 253 pessoas, das quais 68 eram homens, 184 eram mulheres e 1 definido como outro; os participantes foram escolhidos por meio de uma amostragem não probabilística em bola de neve onde o questionário foi distribuído nas redes sociais. Como instrumentos foram usados, o CAE, que é a forma revisada do EEC-R; medida de autorrelato projetada para avaliar sete estilos básicos de enfren- tamento, o questionário Experiencias em Relaciona- mentos Próximos-revisado (ECR) e o Questionário de Funcionamento Reflexivo (RfQ-8). Nos resultados, foram encontradas correlações entre o estilo de apego e a mentalização com o estilo de enfrentamento do estresse durante o isolamento devido à pandemia de COVID-19. Descobriu-se que um estilo de apego seguro facilita estilos de enfrentamento mais adaptativos, ao contrário dos estilos de apego ansioso e evitativo, que estão mais relacionados a estilos de enfrentamento, como autofoco negativo e evitação.

Propuesta de Valores de Referencia para el Cuestionario de Evaluación del Apego Adulto: Experiences in Close Relationships (ECR-12), en población adulta chilena / Reference values for the Adult Attachment Assessment Questionnaire: Experiences in Close Relationships (ECR-12) in the Chilean Adult Population

El cuestionario de Experiencias en Relaciones Cercanas (ECR) es un instrumento de auto-reporte ampliamente utilizado para evaluar el apego en la adultez, a partir de dos dimensiones: la ansiedad y la evitación asociadas al apego. Este instrumento ha sido adaptado en múltiples contextos, incluyendo el chileno, del cual existe una versión abreviada (ECR-12), objeto de análisis del presente estudio. Si bien existe consenso en que la seguridad en el apego es mejor descrita en términos dimensionales, hay ámbitos, como en la práctica clínica donde contar con valores de referencia podría ser de utilidad. El objetivo de este estudio es proveer valores de referencia para la interpretación de los valores del ECR-12 en el contexto chileno. Para ello, una muestra de 6779 participantes respondió el ECR-12. Se utilizó el método de puntuación z con normalización para obtener los valores de referencia. Los análisis realizados evidenciaron la necesidad de construir baremos diferenciados por edad. Así, para el grupo de 29 años o menos, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.4 puntos, y para la evitación, el punto de corte es de un promedio igual o superior a 2.5. En cambio, para el grupo de 30 años o más, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.2, y para la evitación, es de un promedio igual o superior a 2.9. Estos hallazgos pueden ser relevantes no sólo para identificar a personas que puedan presentar niveles sustancialmente altos de ansiedad y/o evitación en el apego, sino, también puede constituirse como una herramienta clínica complementaria en contextos terapéuticos.

The Experiences in Close Relationships (ECR) questionnaire is a widely used self-report measure to assess adult attachment, based on two dimensions: attachment anxiety and attachment avoidance. This instrument has been adapted in multiple contexts, including the Chilean, for which there is an abbreviated version (ECR-12), that is the object of analysis in the present study. Although there is consensus that attachment security is best described in dimensional terms, there are areas, such as clinical practice, where having reference values could be useful. The aim of this study is to provide reference values for the interpretation of ECR-12 scores in the Chilean context. To do this, a sample of 6779 participants was evaluated using the ECR-12. The z-score normalization method was used to obtain the reference values. The analyzes carried out showed the need to build scales differentiated by age. Thus, for the group of 29 years or less, the cut-off point in the anxiety dimension is an average equal to or greater than 4.4 points, and for avoidance, the cut-off point is an average equal to or greater than 2.5. On the other hand, for the group aged 30 or older, the cut-off point in the anxiety dimension is an average equal to or greater than 4.2, and for avoidance, it is an average equal to or greater than 2.9. These findings can be relevant not only for identifying people who may present substantially high levels of anxiety and/or avoidance in attachment, but also as a complementary clinical tool in therapeutic contexts.

Evaluation of Salivary IL?8 and Calcium Levels in Postmenopausal Females with and without Periodontitis—A Comparative Study

Background and Objective: Menopause is a normal developmental stage in a woman’s life marking the permanent cessation of menstruation. Calcium is predominant in intracellular signalling and its intracellular increase can affect the cell’s proliferation, phagocytosis and cytokine secretion. IL?8 expression in various cells such as neutrophils and osteoblasts was reported to involve a calcium signalling pathway. Well?known functions of IL?8 includes help in angiogenesis, role in tumour progression, tissue remodelling, etc., Hence, the aim of this study was to establish the relationship between calcium?dependent IL?8 and periodontal disease in postmenopausal females. Method: The study population included 52 postmenopausal women aged 45–57 years. The patients were divided into two groups in which group I included postmenopausal women without periodontitis and group II with periodontitis. Unstimulated salivary samples were collected from all the participants to evaluate IL?8 and calcium levels. Results: There was a statistically significant difference in salivary IL?8 levels between the two groups (P < 0.001), but there was no statistical difference in salivary calcium levels between the two groups (P = 0.730). A weak negative correlation between salivary IL?8 and calcium was found in group I, while a weak positive correlation was found between the same in group II. Conclusion: Analysis of salivary IL?8 from the present study was in accordance with several previous studies. It can be concluded that saliva can also be used as a reliable oral diagnostic fluid for IL?8 and calcium detection in periodontitis.

The Effect of the Interproximal Creeping Attachment in Aesthetic Site After Root Coverage Surgery with VISTA Technique ? A Case Report

Gingival recession is a common manifestation in most populations. The mechanism by which gingival recession occurs is not well understood, but it seems to be complex and multifactorial. The main etiological factors are the accumulation of dental plaque biofilm with the resulting inflammatory periodontal diseases and mechanical trauma due to faulty oral hygiene techniques, especially in thin biotypes. This case report describes the treatment of a vestibular recession associated with interdental bone loss, with the VISTA technique associated with a connective tissue graft. The case was evaluated at 3, 9 months and 48 months after the surgery clinically complete root coverage and increased thickness of keratinized tissue were achieved, and the interdental papilla was augmented improving the soft tissue quality for future orthodontic treatment. VISTA technique associated with a connective tissue graft to reconstruct vertically papilla is a promising alternative for minimally invasive treatment and stable after 4 years.

Narrativas de mulheres mães: vivências e ressignificações diante da prematuridade extrema / Narratives of women mothers: experiences and resignifications in the face of extreme prematurity / Narrativas de mujeres madres: vivencias y resignificaciones frente a la prematuridad extrema

OBJETIVO: A partir do nascimento pré-termo, a maternidade é convocada prematuramente, pois o tempo final da gestação não pode ser vivido e o que foi idealizado não se concretiza. Dessa forma, a mulher mãe precisa ressignificar seu papel e a própria maternidade, reestruturando seu sistema cuidador para dar conta da situação real que se apresenta. O nascimento prematuro insere muitas dificuldades para a mulher, influenciando em momentos estressantes e deflagrando sentimentos de frustação, culpa, ansiedade, tristeza, medo, entre outros. OBJETIVO: Compreender as dificuldades, emoções e sentimentos presentes durante o nascimento e hospitalização dos recém-nascidos pré-termos extremos e como a(s) maternidade(s) puderam ir se construindo nesse contexto. MÉTODO: Estudo qualitativo, com coleta de narrativas de mulheres que compartilharam suas experiências em um site especializado na internet. A análise foi realizada a partir da Análise de Conteúdo, utilizando como embasamento teórico a teoria do apego. RESULTADOS: As narrativas retratam uma alta expectativa em relação ao nascimento dos bebês, bem como a frustração e angústia geradas a partir da necessidade de uma separação brusca e literal. Ainda, os momentos foram marcados por uma rotina exaustiva e pelo medo do bebê vir a óbito, além da necessidade de aprenderem a reconhecer os sinais sutis dos bebês e construir modos de cuidados possíveis. As narrativas trabalhadas foram/são uma maneira que elas encontraram para relatar suas histórias e de ressignificar o vivido. CONSIDERAÇÕES FINAIS: Destaca-se a importância de haver o reconhecimento das vivências maternas nesse contexto para que melhorias no acolhimento prestado e construção de políticas públicas sejam possíveis de serem realizadas.

OBJECTIVE: From preterm birth, motherhood is called prematurely, as the final period of pregnancy cannot be lived and what was idealized does not come true. Thus, the mother-woman needs to reformulate her role and her own motherhood, restructuring her care system to account for the real situation that is presented. Premature birth entails many difficulties for women, influencing stressful moments and triggering feelings of frustration, guilt, anxiety, sadness, and fear, among others. OBJECTIVE: Understand the difficulties, emotions, and feelings present during the birth and hospitalization of extreme preterm newborns and how motherhood could be built in this context. METHODS: Qualitative study, collecting narratives from women who shared their experiences on a specialized website on the internet. The analysis was carried out from the Content Analysis, using the attachment theory as the theoretical basis. RESULTS: The results point to a high expectation in relation to the birth of babies, as well as the frustration and anguish generated by the need for a sudden and literal separation. The moments were marked by an exhaustive routine and by the fear of the baby dying, in addition to the need to learn to recognize the subtle signs of the babies and build possible care modes. The narratives worked on were a way they found to report their stories and redefine what they had lived. CLOSING REMARKS: The importance of recognizing maternal experiences in this context is highlighted so that improvements in the reception provided and the construction of public policies are possible to be carried out.

OBJETIVO: Desde el parto prematuro, la maternidad es convocada prematuramente, ya que el período final del embarazo no se puede vivir y lo idealizado no se hace realidad. Por lo tanto, la madre necesita replantear su rol y maternidad, reestructurar su sistema de cuidado para dar cuenta de la situación real que se presenta. El parto prematuro conlleva muchas dificultades para la mujer, influyendo en momentos estresantes y desencadenando sentimientos de frustración, culpa, ansiedad, tristeza, miedo, entre otros. OBJETIVO: Comprender las dificultades, emociones y sentimientos presentes durante el parto y la hospitalización de recién nacidos prematuros extremos y cómo la(s) maternidad(es) podría(n) ser construida(s) en ese contexto. MÉTODO: Estudio cualitativo, con la recopilación de relatos de mujeres que compartieron sus experiencias en un sitio web especializado en internet. El análisis se realizó con base en el Análisis de Contenido, utilizando como base teórica la teoría del apego. RESULTADOS: Apuntaron a una alta expectativa en relación al nacimiento de bebés, así como a la frustración y angustia que genera la necesidad de una separación repentina y literal. Aún así, los momentos estuvieron marcados por una rutina exhaustiva y por el miedo a la muerte del bebé, además de la necesidad de aprender a reconocer los signos sutiles de los bebés y construir posibles modos de cuidado. Las narrativas trabajadas fueron/son una forma que apoyan para relatar sus historias y para resignificar la experiencia. CONSIDERACIONES FINALES: Se resalta la importancia de reconocer las experiencias maternas en este contexto, para que se puedan llevar a cabo mejoras en la atención brindada y la construcción de políticas públicas.

Estilos parentais e vinculação aos pares fazem a diferença nos motivos do consumo de álcool em jovens universitários? / ¿Los estilos parentales y el apego a los compañeros marcan la diferencia en los motivos de consumo de alcohol en jóvenes universitarios? / Do Parenting Styles and Peer Attachment Make a Difference in the Reasons for Alcohol Consumption in University Students?

A literatura suporta a importância da relação entre os jovens e as figuras parentais para um desenvolvimen-to adaptativo, nomeadamente capacidades pró-sociais e menor envolvimento em comportamentos de risco. A qualidade das relações com os pares pode também desempenhar um papel protetor no que respeita ao consumo de álcool. O objetivo deste estudo foca-se na análise do efeito dos estilos parentais e da vinculação aos pares nos motivos de consumo de álcool. Participaram 1.044 estudantes universitários de ambos os sexos com idades compreendidas entre os 18 e 25 anos (m= 19.78; dp= 1.68). De forma a recolher os dados recorreu-se a um questionário sociodemográfico, ao Parenting Styles & Dimensions Questionnaire: Short Version (psdq), ao Inventory of Peer and Parental Attachment (ippa-peer), ao Drinking Motives Questionnaire ­ Revised (dmq-r) e ao Alcohol Use Disorders Identification Test (audit). Os resultados apontam para um efeito preditor positivo dos estilos parentais autoritários e permissivos e da alienação aos pares face aos motivos de consumo de álcool e um efeito preditor negativo do estilo parental democrático e de uma vinculação aos pares pautada por comunicação e confiança. As mulheres apresentam maior qualidade relacional com os pares comparativa-mente com os jovens do sexo masculino. Os rapazes apre-sentam uma maior diversidade de motivos de consumo de álcool. Os resultados são discutidos considerando a relevância dos estilos parentais e qualidade das relações com os pares no desenvolvimento pessoal e as motivações dos jovens adultos, em contexto universitário, para a assunção de comportamentos de risco.

La literatura apoya la importancia de la relación entre los jóvenes y las figuras parentales para un desarrollo adaptativo, es decir, habilidades prosociales y menor involucramiento en conductas de riesgo. La calidad de las relaciones con los compañeros también puede desempeñar un papel protector con respecto al consumo de alcohol. El objetivo de este estudio es analizar el efecto de los estilos de crianza y el apego entre pares, sobre las razones para el consumo de alcohol. Participaron 1.044 estudiantes universitarios de ambos sexos con edades comprendidas entre 18 y 25 años (m= 19.78; ds= 1.68). Para la recolección de datos se utilizó un cuestionario sociodemográfico, el Parenting Styles & Dimensions Questionnaire: Short Version (psdq), el Inventory of Peer and Parental Attachment (ippa-peer), el Drinking Motives Questionnaire ­ Revised (dmq-r) y el Alcohol Use Disorders Identification Test (audit). Los resultados indican un efecto predictivo positivo de los estilos parentales autoritarios, permisivos y de alienación de los pares ante los motivos del consumo de alcohol, y un efecto predictivo negativo del estilo paren-tal democrático y de apego a los pares basado en la comunicación y la confianza. Las mujeres tienen más calidad relacional con sus compañeros que los hombres jóvenes. Los hombres tienen una mayor diversidad de motivos para el consumo de alcohol. Los resultados se discuten considerando la relevancia de los estilos de crianza y la calidad de las relaciones con los pares en el desarrollo personal, y las motivaciones de los jóvenes en un contexto universitario para asumir con-ductas de riesgo.

The importance of the relationship between young people and their parental figures for adaptative de-velopment has been supported by literature, namely prosocial capacities and less involvement in risk beha-viors. The quality of peer relationships may also play a protective role regarding alcohol consumption. The aim of this study was to analyze the effect of parenting styles and peer attachment on the reasons for alcohol consumption. Participants were 1.044 university stu-dents of both sexes, between 18 and 25 years of age (m = 19.78; sd = 1.68). For data collection, a socio-demographic questionnaire, the Parenting Styles & Dimensions Questionnaire: Short Version (psdq), the Inventory of Peer and Parental Attachment (ippa-peer), the Drinking Motives Questionnaire ­ Revised (dmq-r), and the Alcohol Use Disorders Identification Test (audit) were used. The results reveal a positive predictive effect of negative parenting styles (authoritarian and permissive) and alienation with peers on the reasons for alcohol consumption and a negative predictive impact on democratic parenting style and peer attachment ba-sed on communication and trust. Women have a better relational quality with their peers compared to males. Men have a greater diversity of reasons for consuming alcohol. Results are discussed considering the relevance of parenting styles, the quality of peer relationships in personal development, and the motivations of young adults, in a university context, for risk-taking behavior.

Impact of Early Relational Trauma on Psychic Processes: Implications for Treatment of vulnerable Children and Families / Impacto do Trauma Relacional Precoce nos Processos Psíquicos em Famílias Vulneráveis: Implicações para o Tratamento de Crianças e Famílias

ABSTRACT Numerous works and clinical research conducted in various institutions have cast fresh light on the notion of trauma and have contributed to the emergence of the concept of early relational trauma. Early relational trauma is a form of trauma rendered complex by the multiplicity of its sources and its modes of expression. Its main features are often attachment and acting-out disturbances. In families where such trauma occurs, links could sometimes be perverted and form a narcissistic configuration. This mode of functioning, organized around negativity, impacts the plurality of psychic processes and interferes with the treatment approaches of multidisciplinary teams. In order to promote a multifocal approach to care tailored to differences in situations, educational and socio-judicial practitioners.

RESUMO Inúmeros trabalhos e pesquisas clínicas realizados em diversas instituições trouxeram à luz a noção de trauma e contribuíram para o surgimento do conceito de trauma relacional precoce. O trauma relacional precoce é uma forma de trauma complexo pela multiplicidade de suas fontes e seus modos de expressão. Suas principais características são frequentemente distúrbios de apego e atuação. Nas famílias onde ocorre tal trauma que às vezes pode ser pervertido em configurações narcísicas, esse modo de funcionamento organizado em torno da negatividade impacta a pluralidade do psíquico e interfere nas abordagens de tratamento das equipes multidisciplinares. Para promover uma abordagem multifocal de cuidados adaptados às diferenças de situações, profissionais de educação e sócio judiciais.

Attachment, Jealousy, and Conjugal Violence / Apego, Ciúme e Violência Conjugal

Abstract Psychological aggression is the most common manifestation of intimate partner violence. Literature demonstrates that attachment and jealousy can predict intimate partner violence. The aim of this study was to test a theoretical model in which jealousy is a mediator between attachment and psychological aggression. This is a quantitative study, with cross-sectional and explanatory design. A sample of 600 people, aged between 18 and 65 years old, residing in 13 Brazilian states, was investigated. A Sociodemographic data questionnaire, Psychological Aggression Sub-scales (CTS2), Questionnaire on the Affective Relationships (QAR), Interpersonal Jealousy Scale (IJC) and Adult Attachment Scale (AAS 2) were used. Structural equation modeling indicated that jealousy functioned as a mediator between attachment and psychological aggressions, alerting to the possibility of prevention in conjugality through early interventions.

Resumo A agressão psicológica é a manifestação mais comum da violência conjugal. A literatura demonstra que o apego e o ciúme podem predizer a violência conjugal. O objetivo deste estudo foi testar um modelo teórico em que o ciúme é um mediador entre o apego e a agressão psicológica. Trata-se de um estudo quantitativo, com delineamento transversal e explicativo. Foi investigada uma amostra de 600 pessoas, com idades entre 18 e 65 anos, residentes em 13 estados brasileiros. Foi utilizado um questionário de dados sociodemográficos, uma subescala de agressão psicológica (CTS2), questionário de relacionamentos afetivos (QAR), Escala interpessoal de ciúme (IJC) e Escala de apego adulto (AAS 2). Por meio de modelagem de equações estruturais, os resultados indicaram que o ciúme funcionou como mediador entre o apego e a agressão psicológica, alertando para a possibilidade de intervenções precoces na conjugalidade.

Which social, gestational and mental health aspects are associated to maternal-fetal attachment? / Quais aspectos sociais, gestacionais e de saúde mental materna estão associados ao apego materno-fetal?

Abstract Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women. Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors. Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]). Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p<0,20 foram levadas para análise multivariada, por meio de regressão linear, a fim de controlar possíveis fatores de confusão. Resultados: foram incluídas 840 gestantes. As gestantes que apresentaram menores médias de AMF foram aquelas que não moravam com um companheiro (B=-3,8 [IC95%=-6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC95%=-5,9; -2,6]), que não tiveram o apoio da mãe durante a gestação (B=-2,4 [IC95%=-4,6; -0,2]) e que apresentaram sintomas depressivos (B=-4,9 [IC95%=-7,4; -2,5]). Conclusões: os resultados mostraram que um maior AMF está associado a presença de uma rede de apoio adequada na gravidez, melhor saúde mental materna e a uma gestação avançada. A avaliação precoce do AMF e a promoção de um vínculo pré-natal adequado, com foco nos aspectos psicológicos e emocionais maternos são fortemente sugeridos.

Bone density and implant stability with advanced platelet-rich fibrin in immediately loaded- implant assisted mandibular overdentures / Densidade óssea e estabilidade dos implantes com fibrina rica em plaquetas avançada em overdentures mandibulares com carga imediata

ABSTRACT Objective: The aim of this study is to determine the effect of Advanced Platelet-Rich Fibrin on bone density and implant stability in immediately loaded- implant-assisted mandibular overdentures (Split-mouth study). Material and Methods: Ten completely edentulous patients received two implants in the mandibular canine region and locator attachments were used to retain immediately loaded- implant mandibular overdentures. Each patient served in two Groups, one Group for each side. One side of the mandible received an implant with topical application of Advanced Platelet-Rich Fibrin in the implant osteotomy site (Group I) and the other site received an implant without application of Advanced platelet-rich fibrin (Group II). Each patient was examined clinically for implant stability using Osstell Mentor device and radiographically by ultra-low dose CT scan to measure bone density around the implant at baseline, three, six months, and one year. Results: There were no statistically significant differences (P>.05) in bone density and implant stability among the studied Groups during one year follow-up period. Conclusion : Advanced Platelet-Rich Fibrin has no effect on bone density and implant stability in immediately loaded implant-assisted mandibular overdenture.(AU)

RESUMO Objetivo: O objetivo deste estudo é determinar o efeito da Fibrina Rica em Plaquetas Avançada na densidade óssea e estabilidade dos implantes em Overdentures mandibulares com carga imediata (estudo de boca dividida). Material e Métodos: Dez pacientes edêntulos foram submetidos à instalação de dois implantes mandibulares na região dos caninos e pilares locator foram utilizados como sistema de retenção para as overdentures mandibulares com carga imediata. Cada paciente participou nos dois grupos, sendo um grupo para cada lado. Um lado da mandíbula recebeu implante com aplicação tópica de Fibrina Rica em Plaquetas Avançada no local do sítio cirúrgico do implante (Grupo I) e o outro local recebeu implante sem aplicação de Fibrina Rica em Plaquetas Avançada (Grupo II). Cada paciente foi examinado clinicamente quanto à estabilidade do implante usando o dispositivo Osstell Mentor e radiograficamente por tomografia computadorizada de ultrabaixa dose para medir a densidade óssea ao redor do implante no início do estudo, três, seis meses e um ano. Resultados: Não houve diferenças estatisticamente significativas (P>0,05) na densidade óssea e na estabilidade do implante entre os grupos estudados durante o período de acompanhamento de um ano. Conclusão: A Fibrina Rica em Plaquetas Avançada não tem efeito na densidade óssea e na estabilidade de implantes em Overdentures mandibulares com carga imediata (AU)

Adverse childhood experiences and psychopathology in adolescents from northern Chile: the moderating role of the attachment style

Abstract Background Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life. Objective The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships-Relationship Structures (ECR-RS), and Youth Self Report (YSR-18). Results The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = −0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models. Conclusion In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.

Complex post-traumatic stress disorder (CPTSD), executive function and attachment / Transtorno de estresse pós-traumático complexo (TEPT_C), função executiva e apego / Le trouble de stress post-traumatique complexe (SCPD), la fonction exécutive et l'attachement / El trastorno de estrés postraumático complejo (TEPT_C), la función ejecutiva y el apego

Studies conducted with children and adolescents suggest that long-term exposure to adverse events and the lack of emotional and psychosocial support can lead to complex traumatizing conditions (C_PSPT), providing difficulties that affect emotional regulation, cognition, interpersonal relationships and the constitution of identity. The aim of this essay is to reflect on about the cognitive, more specifically executive function abilities, emotional, and attachment dimensions in children, who have been exposed to the experience of violence.

Estudos realizados com crianças e adolescentes sugerem que a exposição prolongada a eventos adversos e à falta de apoio emocional e psicossocial podem levar a quadros traumatizantes complexos (TEPT_C), proporcionando dificuldades que afetam a regulação emocional, a cognição, as relações interpessoais e a constituição da identidade. O objetivo deste ensaio é refletir sobre as dimensões cognitivas, mais especificamente das funções executivas, os aspectos emocionais e de apego em crianças, que foram expostos à cenários e experiências de violência.

Des études menées auprès d'enfants et d'adolescents révèlent que l'exposition à long terme à des événements indésirables et le manque de soutien émotionnel et psychosocial peuvent conduire à des conditions de traumatisme complexe (TSPT_C) fournissant des difficultés qui affectent la régulation émotionnelle, la cognition, plus spécifiquement la fonction exécutive, les relations interpersonnelles, les relations et la constitution de l'identité. Ainsi, le but de cet essai est de réfléchir sur les aspects du développement cognitif, émotionnel, et de l'attachement chez les enfants qui sont exposés à l'expérience de la violence.

Los estudios realizados con niños y adolescentes revelan que la exposición prolongada a eventos adversos y la falta de apoyo emocional y psicosocial puede conducir a condiciones de traumatización compleja (TEPT_C) proporcionando dificultades que afectan la regulación emocional, cognitiva, relaciones interpersonales y constitución de la identidad. El objetivo de este ensayo es reflexionar sobre aspectos del desarrollo cognitivo, más específicamente la función ejecutiva, emocional, y del apego en niños que están expuestos a la experiencia de violencia.

The effect of different framework's material on strain induced in distal abutment in mandibular Kennedy's class II: an in-vitro study / O efeito de diferentes materiais de estrutura na deformação induzida na distal do pilar da classe II de Kennedy mandibular: um estudo in vitro

Objective: This study aims to compare the strain induced in the supporting structures of unilateral mandibular removable partial denture frameworks retained by extra-coronal attachments fabricated with three different materials. Material and Methods: Three mandibular class II digitally designed and printed acrylic models with detachable abutments were used to fabricate three removable partial denture framework with extra coronal attachments from three different materials. A total of 33 models were prepared for strain testing (n=11). Models were divided into three groups according to framework's material: porcelain fused to cobalt chromium (PFM), polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) group. Unilateral load of 60 N was applied in the three groups and strains were measured around the main abutment and saddle area using strain gauge. Results: Statistical analysis was performed using Shapiro-Wilk's test and by checking data distribution. Data were found to be non-parametric and were analysed using Kruskal-Wallis test followed by Dunn's post hoc test with Bonferroni correction. PFM group showed significantly the highest strain values around abutment, slot 1 (1mm distal to the socket of the last abutment) and slot 2 (1 cm away from slot 1) respectively (843.00±23.08, 91.00±6.52 and 1274.00±65.71) than the other tested groups (p<0.05) at same tested sites respectively followed by PEKK group (384.00±37.48, 81.00±2.24 and 135.00±0.00) and PEEK group (29.00±4.18, 63.00±4.47 and 52.00±5.70). Conclusions: PEEK and PEKK for partial denture framework with extra coronal attachments are adequate alternative to PFM due to their good mechanical response applying less strain on supportive structures in free-end cases. PEEK induces lower strain magnitude on the supporting structures when compared to PEKK. (AU)

Objetivo: Este estudo tem como objetivo comparar a tensão induzida nas estruturas de suporte de estruturas de próteses parciais removíveis mandibulares unilateraisretidas por encaixes extracoronários fabricados com três materiais diferentes. Material e Métodos: Três modelos mandibulares de classe II digitalmente projetados e impressos em acrílico com pilares destacáveis foram usados para fabricar três estruturas de próteses parciais removíveis com encaixes extracoronários de três materiais diferentes. Um total de 33 modelos foram preparados para testes de deformação (n=11). Os modelos foram divididos em três grupos de acordo com o material da estrutura: porcelana fundida com cobalto-cromo (PFM), poliétercetonacetona (PEKK) e polieteretercetona (PEEK). Carga unilateral de 60 N foi aplicada nos três grupos e as deformações foram medidas em torno do pilar principal e área de sela usando medido de tensão. Resultados: A análise estatística foi realizada por meio do teste de Shapiro-Wilk e com a verificação da distribuição dos dados. Os dados mostraram-se não paramétricos e foram analisados pelo teste de Kruskal-Wallis seguido pelo de Dunn com correção de Bonferroni. O grupo PFM mostrou significativamente os maiores valores de tensão ao redor do pilar, slot 1 (1mm distal do último pilar) e slot 2 (1 cm de distância do slot 1) respectivamente (843,00±23,08, 91,00±6,52 e 1274,00±65,71) do que os outros grupos testados (p<0,05) nos mesmos locais testados, respectivamente, seguido pelo grupo PEKK (384,00±37,48, 81,00±2,24 e 135,00±0,00) e grupo PEEK (29,00±4,18, 63,00±4,47 e 52,00±5,70). Conclusão: PEEK e PEKK para estrutura de prótese parcial com encaixes extracoronários são alternativas adequadas ao PFM devido à sua boa resposta mecânica aplicando menos tensão nas estruturas de suporte em casos de extremidade livre. O PEEK induz menor magnitude de deformação nas estruturas de suporte quando comparado ao PEKK (AU)

Latent class growth model-based study of demoralization syndrome among maintenance hemodialysis patients in young and middle-aged adults / 中国实用护理杂志

Objective:To investigate distinct trahectories of demoralization of maintenance hemodialysis patients in young and middle-aged adults, and analyze the factors that affect the trajectory category, so as to provides reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From April 2020 to April 2021, young and middle-aged maintenance hemodialysis patients fromShangyu People′s Hospital were collected by convenience sampling method and conducted 4-time follow-up investigation. The survey tools included general information questionnaire, Demoralization Scale Mandarin Version (DS-MV) and Experiences in Close Relationship Scale-Short Form (ECR-S). Latent class growth model was used to identify trajectory patterns of demoralization, Logistic regression was used to identify predictors of demoralization trajectories.Results:Totally, 105 patients were enrolled in the present study. Three distinct trajectories were identified and named as "table high level group" 24 cases, "slow reduction group" 39 cases and "continuous reduction group" 42 cases. Univariate analysis showed that age, occupational status, average income per person in family, number of comorbidities, attachment anxiety scores were related to the category of demoralization trajectories ( F = 15.92, χ2 values were 9.16-15.95, all P<0.05). Multivariate Logistic regression analysis showed that age, occupational status, average income per person in family, number of comorbidities, and attachment anxiety scores were important predictors of patterns of demoralization trajectories in young and middle-aged maintenance hemodialysis patients. Conclusions:This study identified three distinct demoralization trajectories in young and middle-aged maintenance hemodialysis patients, clinical nursing should formulate individualized intervention strategies according to the types of patients′ delirium trajectories.