Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Home / Archives / Vol. 12 No. 1 (2024) / Articles SPATIAL DISTRIBUTION OF MOLAR INCISOR HYPOMINERALIZATION (MIH) OPACITIES IN FIRST PERMANENT MOLARS

Aim: To evaluate the spatial distribution of MIH opacities in first permanent molars (FPM). Materials and methods: an analysis of intraoral photographs of FPM with demarcated MIH opacities was conducted. The presence of opacity was computed in a digital matrix, discriminating the anatomical regions of the FPM surfaces. The frequencies of distribution of the opacities were descriptively analyzed through 227 FPM digital images of 89 children built in GIMP and Python and by Spearman correlation (= 0,05). Results: the occlusal surface was the most affected one (94% to 100%). In the upper FPM, the palatine surface was the second most affected one (84%-91%). In the lower FPM, the vestibular surface was the second most affected one (85%-80%). A similar pattern of opacity distribution was observed in the contralateral teeth. On smooth surfaces, opacities were more frequent in the regions closer to the occlusal surface than to the cervical one. Conclusion: MIH opacities were mostly present on occlusal, vestibular, and lingual/palatine surfaces, respectively. There is a possibility that the occurrences are in accordance with the chronology of dental formation.

Quality analysis of four filling techniques in ovoid root canals prepared with M® instruments

Aims: This study aimed to assess the quality of various filling techniques in ovoid root canals prepared using M® instruments. Materials and Methods: Sixty ovoid root canals underwent endodontic treatment with M® instruments and were subsequently divided randomly into four experimental groups, each employing a different obturation technique: TU - single cone; TL - active lateral condensation; TH - Tagger hybrid; TS - Schilder technique. Digital radiographs were taken in both mesiodistal and buccolingual directions to examine the filled teeth. The percentage of filling material and empty spaces was quantified using Photoshop® software. Data were subjected to statistical analysis using the one-way ANOVA test and T test (? = 0.05). Results: In the TL and TS groups, there was a significantly lower average percentage of unfilled spaces compared to the TU and TH groups (P<0.0001). When analyzing the radiographic directions, the mesiodistal view exhibited the highest mean percentage of unfilled spaces, with differences in filling quality observed only in the TU and TL groups. Conclusions: Active lateral condensation and Schilder techniques demonstrated superior performance in achieving effective filling of ovoid root canals.

Are dental charts (odontograms) obsolete records for comparative dental analysis? / Os odontogramas são registros obsoletos para uma análise dental comparativa?

This communication aims to briefly present the importance of dental charts (odontograms) in the comparative dental analysis for human identification considering the time elapsed between its introduction and the current use in times of rapid technological changes in Dentistry. Future discussions about the rank of importance amongst the different types of dental records are necessary

Esta comunicação tem como objetivo apresentar brevemente a importância dos odontogramas na análise odontológica comparativa para a identificação humana, considerando o tempo decorrido entre sua introdução e o uso atual em tempos de rápidas mudanças tecnológicas na Odontologia. Discussões futuras sobre o grau de importância entre os diferentes tipos de registros odontológicos são necessárias

Uso de aplicativo de inteligência artificial como fonte de informação para resolução de provas de Odontologia / Use of an artificial intelligence application as a source of information for solving Dentistry exams

Introdução: O ChatGPT® é uma ferramenta pública desenvolvida pela OpenAI que utiliza a tecnologia do modelo de linguagem GPT. Este chatbot é capaz de atender a variadas solicitações de texto. Objetivo: avaliar se o ChatGPT® é capaz de ser a única fonte de informação para resolução de provas de Odontologia. Material e métodos: consiste em um estudo transversal quantitativo analítico. Para a coleta de dados, foi elaborada uma prova fictícia constituída por questões do ENADE e de outros concursos públicos. Os participantes responderam a prova em dois momentos: T1, sem o ChatGPT® e, após 15 dias (T2), utilizando-o. A amostra foi de 30 discentes de graduação em Odontologia, divididos igualmente entre 3 grupos: 1º ao 4º semestre, 5º ao 6º semestre e 7º ao 10º semestre. Para análise de dados foram aplicadas análises estatísticas descritiva e inferencial, por meio do software SPSS, com os testes de Wilcoxon e de McNemar. Resultados: revelaram uma eficácia notável do ChatGPT® na resolução de questões discursivas, com 83,3% de taxa de acerto, enquanto os discentes deram mais respostas incorretas ou incompletas. Porém, foram observadas limitações da base de dados do ChatGPT® quanto às questões objetivas. É crucial ressaltar que, apesar de resultados promissores, a aplicação do Chat levanta questões éticas e pedagógicas. Assim, a introdução do ChatGPT® na educação preocupa quanto à validade e equidade nas avaliações, destacando a importância de encontrar equilíbrio entre a inovação tecnológica e a preservação da integridade acadêmica

Introduction: ChatGPT® is a public tool developed by OpenAI that employs the language model technology of GPT. This chatbot is capable of addressing various text-based requests. Objective: To assess whether ChatGPT® can be the sole source of information for resolving Dentistry exams. Materials and Methods: This is an analytical quantitative cross-sectional study. For data collection, a fictitious exam was created, consisting of questions from the National Student Performance Exam (ENADE) and other public competitions. Participants answered the exam at two different times: T1, without ChatGPT®, and, after 15 days (T2), using it. The sample included 30 undergraduate Dentistry students, equally divided into three groups: 1st to 4th semester, 5th to 6th semester, and 7th to 10th semester. Descriptive and inferential statistical analyses were applied using SPSS software, including the Wilcoxon and McNemar tests. Results: They revealed a notable effectiveness of ChatGPT® in resolving essay questions, with an 83.3% accuracy rate, while students provided more incorrect or incomplete answers. However, limitations of the ChatGPT® database were observed regarding objective questions. It is crucial to emphasize that, despite promising results, the application of Chat raises ethical and pedagogical questions. Therefore, the introduction of ChatGPT® in education raises concerns about the validity and fairness of assessments, underscoring the importance of finding a balance between technological innovation and the preservation of academic integrity

Ètica na divulgação dos serviços odontológicos através da publicidade e propaganda externas em uma cidade do interior da Bahia / Ethics on the disclosure of dental services through advertising in inner city of Bahia

O marketing é uma estratégia de destaque comercial muito utilizada na odontologia, com suas mais variadas modalidades, é uma potente ferramenta, que ao contrário do que é diversas vezes retratado, não se trata apenas de vender, comprar ou comercializar. O objetivo deste trabalho é investigar as violações éticas apresentadas nas publicidades e propagandas de serviços odontológicos na cidade de Santo Antônio de Jesus - Bahia de acordo com o código de ética odontológico (CFO- 118/2012). Os dados foram coletados a partir de uma atenciosa análise de placas, panfletos e outdoors de consultórios odontológicos (pessoa física e/ou jurídica). Estas publicidades e propagandas foram documentadas através de fotografias coletadas por uma única examinadora. Os itens considerados obrigatórios foram registro profissional, nome do profissional e o nome representativo Cirurgião-Dentista, já os itens considerados opcionais avaliados foram logotipo, telefone, E-mail/site, endereço, áreas de atuação, procedimentos e técnicas de tratamento e a expressão "clínico-geral", no quesito infrações foram avaliados itens como cartão de desconto, modalidade de pagamento e aliciamento de pacientes. Verificou-se que apenas 15% dos anúncios apresentavam todos os itens obrigatórios, o item mais encontrado referente aos opcionais foi o Logotipo (48,2%), apenas uma única clínica apresentava itens que continham algum tipo de publicidade com infração ética. O presente estudo constatou que a maior parte das publicidades e propagandas realizadas por clínicas e consultórios odontológicos da cidade de Santo Antônio de Jesus, não seguem todas as normas e diretrizes, desobedecendo as regras básicas propostas

Marketing is a prominent commercial strategy widely used in dentistry, within its diverse modalities; it is a powerful tool, contrary to which is often portrayed, isn't just about selling, buying or marketing. The aim of this paper is investigating the ethical violations viewed on dental services advertisements in the city of Santo Antônio de Jesus - Bahia in accordance with the dental ethics and code of conduct (CFO- 118/2012). The data has been collected as from a careful analysis of advertising boards, flyers and outdoors at dental offices (individuals and/or legal entities). These advertisements were documented through photographs collected by a single examiner. The mandatory items have been considered professional registration, name of the professional and the professional representative name (dentist), while the optional items have been considered logo, phone, E-mail/website, address, activity areas, procedures and treatment techniques and the expression "general practitioner", in relation to infractions, items such as discount card, payment method and patient enticement have been evaluated. It has been found only 15% of the advertisements showed all mandatory items, the most common item was the Logo (48.2%), just a single clinic had some type of item that contained ethical violations advertising. The present article determine that the majority of advertisements carried out by dental clinics in the city of Santo Antônio de Jesus haven´t been followed all regulations, disobeying the basic rules proposals

Harmonização orofacial: evolução normativa e conflitos legais no reconhecimento da especialidade / Orofacial harmonization: normative evolution and legal conflicts for the recognition of the specialty

A Harmonização Orofacial (HOF) é especialidade odontológica reconhecida pelo Conselho Federal de Odontologia (CFO) e, no reconhecimento dessa especialidade, discussões internas e externas à classe odontológica surgiram. O presente artigo tem como objetivo levantar reflexões acerca do processo judicial n° 1003948-83.2019.4.01.3400 julgado pelo Tribunal Regional Federal (Seção Judiciária do Distrito Federal - 8ª Vara Federal) referente a HOF enquanto especialidade odontológica. Inicialmente, são discutidos os documentos que norteiam o ensino dos cursos de graduação e pós-graduação em odontologia. Em seguida, faz-se uma reflexão sobre o processo de reconhecimento da HOF como especialidade odontológica. Por fim, discute-se acerca do citado processo judicial, os principais pontos elencados pelas partes envolvidas no processo e eventuais consequências do desfecho desse processo para a classe odontológica. O reconhecimento da HOF enquanto especialidade odontológica não seguiu os trâmites que outras especialidades odontológicas seguiram e gerou debates educacionais e formativos sob uma perspectiva ética e legal. Ademais, tal reconhecimento fomentou debates relacionados ao conflito dos procedimentos dessa especialidade odontológica com procedimentos de especialidades médicas. Tais conflitos chegaram ao Poder Judiciário, que interveio em favor da Odontologia, contudo, isso não impede que o cirurgião-dentista seja responsabilizado profissionalmente pela realização de procedimentos que fogem ao escopo da odontologia

Orofacial Harmonization (HOF) is dental specialty recognized by the Federal Council of Dentistry (CFO) and, in recognition of this specialty, internal and external discussions of the dental class have arisen. This article aims to raise reflections on judicial process number 1003948-83.2019.4.01.3400 judged by the Federal Regional Court (Judicial Section of the Federal District - 8th Federal Court) referring to HOF as a dental specialty. Initially, the documents that guide the teaching of undergraduate and graduate courses in dentistry are discussed. Then, a reflection is made on the recognition process of HOF as a dental specialty. Finally, it discusses the judicial process number 1003948-83.2019.4.01.3400, the main points listed by the parties involved in the process, and the possible consequences of the outcome of this process for the dental class. The recognition of HOF as a dental specialty did not follow the procedures that other dental specialties followed and generated educational and training debates from an ethical and legal perspective. Furthermore, such recognition has fostered debates related to the conflict between procedures in this dental specialty and procedures in medical specialties. Such conflicts reached the Judiciary, which intervened in favor of Dentistry, however, this does not prevent the dental surgeon from being held professionally responsible for carrying out procedures that fall outside the scope of dentistry

Comparación de la microfiltración apical de cuatro tipos de cementos endodónticos: Endofill, mtaFillapex, Adseal y Roeko Seal / Comparison of the Apical Microleakage of Four Types Of Endodontic Cements: Endofill, mta Fillapex, Adseal and Roeko Seal / Comparação da microinfiltração apical de quatro tipos de cimentos endodônticos: Endofill, mta Fillapex, Adseal e Roeko seal

Introducción: La microfiltración apical es uno de los principales causantes de fracasos endodónticos donde hay invasión de bacterias y líquidos periapicales a la parte interna del conducto radicular y material de relleno. Materiales y Métodos: La muestra estuvo conformada por 60 dientes premolares unirradiculares que fueron seccionados en la unión amelocementaria, la instrumentación biomecánica se realizó con técnica rotatoria e irrigación con hipoclorito de sodio al 5.25% y EDTA 17%, se dividió aleatoriamente en 4 grupos (n=15) para cada tipo de cemento, la obturación se realizó con la técnica de condensación lateral, a nivel coronal se obturó con Ionómero vidrio base y resina, se colocaron en una incubadora a 37° sumergidos en NaCL 0.9% por 5 días hasta el fraguado de los cementos, para observar la microfiltración se utilizó el método filtración de tinta china y la diafanización con la técnica de Robertson. Las medidas de microfiltración apical se observaron utilizando el Estereomicroscopio. Resultados: El valor promedio fue menor para el cemento Adseal 0,33mm, seguido por los cementos Fillapex 0,87mm, Roeko seal 1,00mm y Endofill 1,30mm respectivamente. Hubo diferencias estadísticamente significativas en la microfiltración apical de los cuatro cementos endodónticos (p=0.00) Conclusiones: El cemento Adseal presentó menor microfiltración en comparación a los cementos Fillapex, Roeko seal y Endofill.

Introduction: Apical microleakage is one of the main causes of endodontic failure, either due to invasion of microorganisms or periapical fluids into the canal, and only the composition of the type of obturator cement favors its reduction. The objective of this research was to compare the apical microleakage of four types of endodontic cements Endofill, MTA Fillapex, Adseal and Roeko Seal. Materials and methods: The sample consisted of 60 single root premolar teeth that were sectioned at the cement- enamel junction, the biomechanical instrumentation was performed with a rotary technique and irrigation with sodium hypochlorite and edta, randomly divided into 4 groups (n = 15) for each type of cement, the obturation was performed with the lateral condensation technique, at the coronal level it was obturated with base glass ionomer and resin, they were placed in an incubator at 37° submerged in NaCL 0.9% for 5 days until setting. of the cements, to observe the microleakage the India ink filtration method was used and diaph-anization with the Robertson technique. Apical microleakage measurements were observed using the Stereomicroscope. Results: The average value was lower for the Adseal 0.33 mm cement, followed by the Fillapex 0.87 mm, Roeko Seal 1.00 mm and Endofill 1.30 mm cements respectively. There were sta-tistically significant differences in the apical microleakage of the four endodontic cements (p = 0.00) Conclusions: Adseal cement presented less microfiltration compared to Fillapex, Roeko Seal and Endofill cements

Introdução: a microinfiltração apical é uma das principais causas de falhas endodônticas onde há inva-são de microrganismos e líquidos periapicais ao interior do conducto e só a composição do tipo de cimento obturador favorece sua disminuição. O objetivo desta pesquisa foi comparar a microinfiltração apical de quatro tipos de cimentos endodônticos Endofill, MTA Fillapex, Adseal e Roeko Seal. Materiais e métodos: a amostra foi composta por 60 dentes pré-molares uniradiculares que foram seccionados na junção amelocementária. A instrumentação biomecânica foi realizada com técnica rotatória e irrigação com hipoclorito e edta, sendo dividida aleatoriamente em 4 grupos (n = 15) para cada tipo de cimento. A obturação foi realizada pela técnica de condensação lateral, no nível coronal foi obturado com base de ionômero de vidro e resina, foram colocados em incubadora a 37° submersos em NaCl 0,9% por 5 dias até a pega dos cimentos. Para observar a microfiltração utilizou-se o método de filtração em tinta nan-quim e diafanização pela técnica de Robertson. As medidas de microinfiltração apical foram observadas utilizando o estereomicroscópio. Resultados: o valor médio foi menor para o cimento Adseal (0,33 mm), seguido pelos cimentos Fillapex (0,87 mm), Roeko Seal (1,00 mm) e Endofill (1,30 mm), respectivamente. Houve diferenças estatisticamente significativas na microinfiltração apical dos quatro cimentos endo-dônticos (p = 0,00). Conclusões: o cimento Adseal apresentou menor microinfiltração comparado aos cimentos Fillapex, Roeko seal e Endofill.

Social stigma towards people with HIV/AIDS, in dentistry students from Concepción

Objective: Characterize HIV/AIDS Social stigma towards people with HIV/AIDS in a sample of dentistry students from Concepción. Materials and methods: Cultural adaptation and pre-test were developed for the Stigma and HIV/AIDS Scale in dental students. Researchers collected the data from the instrument, demographic (sex/age), and academic information (course/training in HIV/AIDS, knowing a person with HIV/AIDS, provision of dental services to people living with HIV/AIDS [PLHIV]). To characterize the sample, univariate and bivariate descriptive statistics were performed with absolute and relative frequencies; the reliability of the scale was assessed with Cronbach's alpha; the relationship between the quantitative and ordinal variables was analyzed with the Spearman correlation coefficient. Results: The final sample comprised 138 dental students, whereas most of them reported not having training in HIV/AIDS nor providing dental services to PLHIV. Stigma and HIV/AIDS Scale showed good reliability. Two items expressing that PLHIV must disclose their condition to health professionals so they can take precautions have the highest values. A weak inverse correlation was found between Stigma and the variables age and course. Conclusions: Dental school students from Universidad of Concepción have a low social stigma towards people with HIV/AIDS. Items regarding professional practice showed higher stigma levels.

Effect of lacteal products containing probiotic in the progression of tooth decay around orthodontic brackets

Objective: To evaluate the progression of caries around orthodontic brackets after the enamel has been exposed to lacteal products containing probiotics. Methods: Orthodontic brackets were bonded to the enamel surfaces. The test specimens were randomly divided into six groups: G1-negative control; G2-positive control, exposed to culture environment only (without microorganisms); G3-exposed to the cariogenic environment and the fermented cow's milk without probiotic; G4-exposed to the cariogenic environment and fermented cow's milk with probiotic; G5-exposed to the cariogenic environment and yogurt without probiotic; and G6-exposed to the cariogenic environment and yogurt with probiotic. The groups were placed in brain heart infusion medium, supplemented with 2% sucrose and with 1x106 cells/ml of Streptococcus mutans and Streptococcus salivarius (ATCC). The Shapiro-Wilk, Levene, Student t, Kruskal-Wallis, and Mann-Whitney tests were used. Results: all groups exposed to the ATCC strains showed lower final microhardness, compared to the negative control (p0.05). Conclusions: Lacteal products are not able to prevent the progression of caries around orthodontic brackets.

Bisphenol A released and ultrastructural changes in dental composite resins

Dental composite resins may release bisphenol-A or similar molecules affecting patient health and the environment. This study measured bisphenol-A release from three commonly used in patients composite resins (Filtek™ Z350 XT, Filtek™ P60, Filtek™ Bulk Fill) immersed in three liquid mediums (artificial saliva, 0.001 M lactic acid and 15% ethanol) and assessed the changes in the surface micromorphology.The released BPA was measured by HPLC at basal time (t=0), 1 h, 1 d, 7 d and 30 d. Topographic analysis of specimens was performed by scanning electron microscopy (SEM). The data were analyzed using one-way ANOVA and Tukey post-hoc test (P < 0.05). BPA in solution increased significantly in the three DCRs immersed in 0.001 M lactic acid at all times. SEM micrographs of the specimen in 0.001 M lactic acid disclosed more structural defects than others. The surface of the three composite resins was morphologically affected by their immersion in all solutions. SEM evidenced that the dental materials underwent erosion and cracks with filler particles protruding from the surface. The morphological changes in tested dental materials produced by exposure to these solutions are potentially dangerous to patients by causing caries, infections, and partial loss of dental material.

Los servicios de odontología en los tiempos del COVID- 19 en Colombia: análisis de país

Se desconoce el impacto que produjo la pandemia por el COVID-19 en la prestación y en la consulta de los servicios odontológicos y analizados según el sistema integrado de protección social o SISPRO en Colombia. El objetivo fue Determinar los cambios en la cobertura y los patrones de atención odontológica, entre los años pre pandemia (2017-2019) y los años de pandemia (2020-2021). Se analizaron los registros de las atenciones odontológicas reportadas en el sistema SISPRO del Ministerio de Salud de Colombia en periodos prepandemia y postpandemia por el COVID-19. En el año 2019 la tasa de cobertura por cada 100 habitantes en el estudio era de 31,14; sin embargo, la cobertura de atención odontológica se redujo al 17% en el 2020 y al 9% en el 2021 y las atenciones de urgencias disminuyeron drásticamente en los años 2020 y en el 2021. Se requiere que los tomadores de decisión promuevan los servicios de odontología para recuperar los niveles de cobertura previos a la pandemia. Se identificó una disminución en la cobertura odontológica asociada a la pandemia de la COVID-19 en los años 2020 y 2021 y desconocen cuales son los posibles efectos en la morbilidad bucal de los Colombianos.

Introduction. The COVID-19 pandemic affected Colombian dental services from March 2019 to now, but its magnitude is unknown. Objective. To determine dental care coverage in Colombia during the pandemic period and compare these data with the pre-pandemic period 2017-2019. Methods. Dental coverage and consultation services registered in the "Sistema Integrado de Protección Social" or SISPRO from 2017 to 2021 were analyzed. Results. The whole dental service coverage rate was nearly 20% before Covid-19 pandemic and even registered a slight increase from 2017 to 2018 at national and at department levels. This dental national coverage was 31,14% for every 100 habitants in 2019. However, there was a sharp reduction to 17% in 2020 and to 9% in 2021, revealing a clear and negative impact of the pandemic in dental coverage services and in dental emergency services. Conclusion. A decrease in dental coverage during to the COVID-19 pandemic is revealed, with a concomitant reduction in dental emergency consultations during 2020 and 2021 at country level. The consequences of this disruption on the oral and dental epidemiological profile of Colombians is still unknown and might require urgent preventive, promotional and curative care actions to recover the pre-pandemic dental coverage levels.

Uso del Diseño Universal para el Aprendizaje para Mejorar la Práctica Docente y la Motivación de los Estudiantes en Anatomía: Una Propuesta de Intervención

En la asignatura de anatomía aún existen estudiantes que no se encuentran motivados con su propio proceso de aprendizaje. El rol del docente es un factor extrínseco clave que contribuye a dicha vinculación afectiva. El Diseño Universal para el Aprendizaje (DUA) es un modelo educativo que propone una serie de pautas de aplicación docente para poder activar en los alumnos sus redes neuronales afectivas, asociadas con la formación de estudiantes decididos y motivados. El objetivo de este estudio es crear una propuesta de intervención, basada en el uso selectivo de las pautas de compromiso afectivo del DUA, para mejorar la práctica docente y la motivación de los estudiantes en anatomía. Es una investigación acción que utiliza el modelo de Whitehead, implicando el cruce conceptual y metodológico entre las pautas de compromiso afectivo del DUA y las fases y factores que determinan la motivación. Corresponde a la programación de seis sesiones de laboratorio de anatomía, los instrumentos para la recopilación de la información y las técnicas de análisis de la misma. La propuesta de intervención presenta un valor teórico ya que fue diseñada a partir de un análisis exhaustivo del DUA y de las publicaciones existentes sobre la motivación, y un valor práctico que se sustenta en su aplicabilidad directa y recursiva en los laboratorios de anatomía y en la incorporación del DUA en el currículum de una asignatura de educación superior. La motivación es el motor de la educación, ya que impulsa y mantiene el quehacer académico tanto a nivel estudiantil como docente. El DUA permite que los docentes aborden la desmotivación de los estudiantes de una forma accesible, precisa y confiable, lo que llevó a considerarlo como uno de los pilares de la propuesta de intervención.

SUMMARY: In anatomy courses there are still students who are not motivated by their own learning process. The teacher´s role is a key extrinsic factor that contributes to this bonding process. Universal Design for Learning (UDL) is an educational model that proposes a series of teaching application guidelines to activate students' affective neural networks, associated with the formation of motivated students. The objective of this study is to create an intervention proposal, based on the selective use of the UDL affective commitment guidelines, to improve teaching practice and student motivation in anatomy. It is an action research that uses Whitehead's model, involving the conceptual and methodological intersection between the UDL's affective commitment guidelines and the phases and factors that determine motivation. It corresponds to the programming of six anatomy laboratory sessions, the instruments for collecting information and the techniques for analyzing it. The intervention proposal has a theoretical value since it was designed based on an exhaustive analysis of the UDL and existing publications on motivation, and a practical value that is based on its direct and recursive applicability in anatomy laboratories and in the incorporation of the UDL in the curriculum of a higher education subject. Motivation is the driving force of education, since it drives and maintains academic work at both the student and teacher level. The UDL allows teachers to address student lack of motivation in an accessible, precise and reliable way, considering this one of the pillars of the intervention proposal.

Neural and Neural Crest-Derived Stem Cell Distribution in the Adult Human Dental Pulp

SUMMARY: Despite comprehensive studies and reports about the properties of dental pulp stem cells (DPSCs) in vitro, we still need to confirm whether these in vitro characteristics coincide with the nature of DPSCs in situ. The anatomical location of DPSCs populations in the dental pulp has yet to be investigated. Moreover, the mesenchymal DPSCs have been much more studied than the neural crest-derived DPSCs. In this study, well-recognized neural/neural crest stem cell markers NCAM1, Nestin, SNAIL/SLUG, SOX9, and S100 are being investigated by immunohistochemistry to localize the precise location of these populations of DPSCs within the human adult dental pulp.All previously mentioned markers were expressed in the dental pulp, and their intensity and location of expression were reported.

A pesar de estudios e informes exhaustivos sobre las propiedades de las células madre de la pulpa dental (DPSC) in vitro, todavía necesitamos confirmar si estas características in vitro coinciden con la naturaleza de las DPSC in situ. La ubicación anatómica de las poblaciones de DPSC en la pulpa dental aún no se ha investigado. Además, las DPSC mesenquimales han sido mucho más estudiadas que las DPSC derivadas de la cresta neural. En este estudio, se están investigando mediante inmunohisto química marcadores de células madre de la cresta neural/ neural NCAM1, Nestin, SNAIL/SLUG, SOX9 y S100 para localizar la ubicación precisa de estas poblaciones de DPSC dentro de la pulpa dental humana adulta. Todos los marcadores mencionados anteriormente se expresaron en la pulpa dental y se informó su intensidad y ubicación de expresión.

Dental Loss in the Lower Socioeconomic Stratum of a Sample of the Chilean Population Born in the 19TH and 20TH Centuries

SUMMARY: Partial or total dental loss (edentulism) is associated with decreased quality of life. Chile has large socioeconomic gaps, which are also recognized in oral health, but it is not known how Edentulism has evolved throughout the country. The aim of this study was to determine the edentulism in people born during the 19th and 20th centuries in Chile, who died in the 20th century, and to compare it with current data from the Chilean Ministry of Health (MINSAL) to observe its evolution in the country. For this purpose, 60 3D models of skulls from the Subactual Osteological Collection of Santiago were analyzed (30 individuals per sex), in which the presence and absence of teeth in antemortem in the maxilla were analyzed. A high percentage of tooth loss was observed, with 65 % partial edentulism, a 30 % total edentulism, and only 5 % had complete dentition in this osteological collection. In addition, a significant decrease over time was found; in 2017, the percentage of complete dentition at the national level was 32.8 %. A higher frequency of edentulism was also found in females from the osteological collection, with a significant probability of twice as much edentulism as in males. However, this sex difference was smaller than those found in the current study. Our study is the first to compare edentulism in Chile in two different time periods, since, in addition to studying it in the 19th and 20th century, it is carried out with data from the present day and in line with previous research, reveals the importance of socioeconomic and sex variables for dental loss.

La pérdida parcial o total de dientes (edentulismo) se asocia a una disminución de la calidad de vida. Chile tiene grandes brechas socioeconómicas, que también se reconocen en la salud oral, pero se desconoce cómo ha evolucionado el edentulismo en el país. El objetivo de este estudio fue determinar el edentulismo en personas nacidas durante los siglos XIX y XX en Chile y fallecidas en el siglo XX, y compararlo con datos actuales del Ministerio de Salud de Chile (MINSAL) para observar su evolución en el país. Para ello, se analizaron 60 modelos 3D de cráneos de la Colección Osteológica Subactual de Santiago (30 individuos por sexo), en los que se analizó la presencia y ausencia de dientes en dentición antemortem en el maxilar. Se observó un alto porcentaje de pérdida dentaria, con un 65 % de edentulismo parcial y un 30 % de edentulismo total, y sólo un 5 % presentaba dentición completa en esta colección osteológica. Además, se encontró una disminución significativa a lo largo del tiempo; en 2017, la dentición completa a nivel país fue del 32,8 %. También se encontró una mayor frecuencia de edentulismo en las mujeres de la colección osteológica, con una probabilidad significativa del doble de edentulismo que en los hombres. Sin embargo, esta diferencia de sexo fue menor que la hallada en datos actuales. Este estudio es el primero que compara el edentulismo en Chile en dos épocas diferentes, ya que además de estudiarlo en los siglos XIX y XX, se realizó con datos de la actualidad y, en línea con investigaciones previas, revela la importancia de las variables socioeconómicas y de sexo en la pérdida dental.

Gingivitis crónica y otros campos de interferencia en pacientes con artritis del hombro

Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.

Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.

Aspectos clinicoepidemiológicos de adultos con guía anterior de la oclusión dentaria disfuncional

Introducción: Los dientes anteriores tienen una función predominante en el sistema estomatognático, esencial para la estética, la fonación y la masticación. Objetivo: Caracterizar a los adultos con guía anterior de la oclusión dentaria disfuncional según variables clínicas y epidemiológicas. Métodos: Se realizó un estudio descriptivo y transversal, desde octubre de 2021 hasta abril de 2022, en la Clínica Estomatológica Docente 3 de Octubre de Las Tunas. El universo estuvo conformado por 825 historias clínicas que contenían el diagnóstico de pacientes con bruxismo, oclusión traumática y trastornos temporomandibulares, quienes presentaban disfunción de la guía anterior de la oclusión dentaria. Mediante el muestreo no probabilístico intencional, fue seleccionada una muestra de 615 con fórmula dentaria íntegra o desdentamiento parcial de clase III de Kennedy y atención estomatológica concluida o inactivación de los procesos de caries e inflamatorios agudos. Resultados: Primaron el sexo femenino (54,8 %) y las edades de 40-49 años (33,5 %). El bruxismo prevaleció como diagnóstico clínico (41,9 %) con predominio del correspondiente al sueño (39,1 %), el secundario (51,2 %), el probable (59,7 %) y el moderado (69,4 %); entre sus clasificaciones más relevantes se destacó el sistema estomatognático disfuncional (84,4 %). Las manifestaciones clínicas dentarias predominantes fueron las facetas de desgaste (87,5 %). Conclusiones: La caracterización de los pacientes con guía anterior de la oclusión dentaria disfuncional permite establecer una panorámica actualizada de esta problemática de salud para un mejor seguimiento y tratamiento a dichos pacientes.

Introduction: Anterior teeth have a predominant function in the stomatognatic system, essential for the aesthetics, phonation and mastication. Objective: To characterize adults with anterior guide of dysfunctional dental occlusion according to clinical and epidemiological variables. Methods: A descriptive and cross-sectional study, was carried out from October, 2021 to April, 2022, in the 3 de Octubre Teaching Stomatological Clinic from Las Tunas. The universe was formed by 825 medical records that contained the diagnosis of patients with bruxism, traumatic occlusion and temporomandibular disorders who presented anterior guide of the dysfunctional dental occlusion. By means of the intentional non probabilistic sampling, a sample of 615 with entire dental formula or class III partial toothlessness of Kennedy and concluded stomatologic care or inactivation of the cavity and acute inflammatory processes was selected. Results: There was a prevalence of the female sex (54.8%) and the 40-49 age group (33.5%). Bruxism prevailed as clinical diagnosis (41.9%) with prevalence of the corresponding to sleep (39.1%), secondary (51.2%), probable (59.7%) and moderate (69.4%); among the most outstanding classifications was the dysfunctional stomatognatic system (84.4%). The predominant dental clinical manifestations were the wear facets (87.5%). Conclusions: The characterization of patients with anterior guide of the dysfunctional dental occlusion allows to establish an up-to-date panoramic of this health problem, for a better follow-up and treatment to these patients.

Dental implants in patients with ectodermal dysplasia: a computer guided quad zygomatic case report and literature review / Implantes dentales en pacientes con displasia ectodérmica: Reporte de caso y revisión de literatura

Abstract Ectodermal dysplasia (ED) is a genetic disorder affecting anatomical structures with an ectodermal origin. The consequent alveolar bone anomalies and lack of teeth require a multidisciplinary approach to rehabilitate patients function and esthetics. To avoid bone grafting procedures the application of zygomatic implants was suggested for the upper jaw treatment. The advancements in three-dimensional (3D) radiology and the introduction of digital implant planning software could enhance the approach to zygomatic implants in ED patients. The present case report describes the quad zygomatic implant treatment of the edentulous maxilla of an ED patient by means of computer guided implant surgery. The patient reported previous failure of bone grafting procedures in the upper jaw. The implants were immediately loaded with a screw-retained complete-arch resin prosthesis. The patient was followed up for 1 year with no biological nor mechanical complications reported, but a slight bone resorption in the anterior zone was observed. Zygomatic implants could be a potential alternative treatment to bone grafting in upper jaw and the digital implant planning could enhance the surgical procedure.

Resumen La displasia ectodérmica (DE) es una enfermedad genética que afecta las estructuras anatómicas de origen ectodérmico. Las consiguientes anomalías del hueso alveolar y la anodoncia requieren un planteamiento multidisciplinario para rehabilitar la función y la estética de los pacientes. Para evitar procedimientos de injerto óseo se sugirió la aplicación de implantes cigomáticos para el tratamiento del maxilar superior. Los avances en radiología tridimensional (3D) y la introducción de software de planificación de implantes digitales podrían mejorar el enfoque de los implantes cigomáticos en los pacientes con displasia ectodérmica. El presente reporte de caso describe el tratamiento con implantes cigomáticos en el maxilar superior edéntulo de un paciente con displasia ectodérmica mediante cirugía de implantes guiada por ordenador. El paciente refirió fracaso de procedimientos de injerto óseo en el maxilar superior. Los implantes se cargaron inmediatamente con una prótesis de resina de arcada completa. El paciente ha sido incluido en un programa de control postoperatorio por 1 año, sin reportarse complicaciones ni biológicas ni mecánicas, siendo el único problema encontrado una ligera reabsorción ósea en la zona anterior. Los implantes cigomáticos podrían ser un posible tratamiento alternativo al injerto óseo en el maxilar superior y la planificación de implantes digitales podría mejorar el procedimiento quirúrgico.

Mathematical-Physical description of the oxygen-inhibited layer (OIL) in nanofilled dental polymers / Descripción físico-matemática de la capa inhibida por oxígeno en polímeros dentales nano rellenados

Abstract This research evaluates the presence of the oxygen-inhibited layer (OIL) on the top surface of a photopolymerized dental composite resin protected with a glycerin layer. This evaluation was conducted using physical and mathematical methods. Polymerized discs were fabricated to evaluate Vickers microhardness (VHN), and pre-and post-polymerized samples were used for the calculation of C-O/C-H ratios through Fourier Transform Infrared Spectroscopy (FTIR) (n=10), using two types of glycerin, one for medical use (MG) and another for dental use (DG). Surface hardness decreased from MG to DG to CO, and the increase in C-O/C-H ratios decreased in the same order (p<0.05). Samples protected with medical and dental glycerin layers are harder and exhibit lower C-O/C-H bond ratios than the control group.

Resumen La presente investigación evalúa la presencia de la capa inhibida por oxígeno OIL en la última superficie fotocurada de una resina compuesta de uso odontológica que fue protegida con una capa de glicerina. Esta evaluación se hizo a partir de métodos físicos y matemáticos. Se fabricaron discos polimerizados para evaluar la microdureza Vickers (VHN) y pre y post polimerizados para el cálculo de tasas C-O/C-H por medio de Espectroscopía Infrarroja Transformada de Fourier (FTIR) (n=10) usando dos tipos de glicerina, una de uso médico (MG) y otra de uso dental (DG). La dureza superficial disminuyó de MG a DG a CO y el aumento de tasas C-O/C-H disminuyó en ese mismo orden (p<0,05). Las muestras protegidas con capas de glicerina médica y odontológica son más duras y presentan menos cantidad tasas de enlaces C-O/C-H que el grupo control.

Whitening toothpastes effect on enamel surface morphology, chemical profile and color: An In Vitro study / Efecto de las pastas dentales blanqueadoras sobre la morfología, el perfil químico y el color de la superficie del esmalte: un estudio In Vitro

Abstract To assess the effect of different whitening toothpastes on enamel surface morphology, chemical profile and their whitening efficiency. Sixty teeth were divided into 5 groups (12 teeth/group); Gp I: brushed with no toothpaste. Gp II: brushed with Pearl-based toothpaste. Gp III: brushed with Charcoal- based toothpaste. Gp IV: brushed with Alumina-based toothpaste. Gp V: brushed with salt and lemon- based toothpaste. Each tooth was brushed with a bean sized toothpaste wetted with distilled water twice daily by using standard electronic toothbrush for four weeks. Enamel surface morphology, chemical profile and color of each tooth were investigated. Chemical profile results and color measurements were analyzed statistically. Gp I revealed normal enamel surface morphology and chemical profile. Gp II and Gp III demonstrated surface morphology close to Gp I with insignificant reduction in mineral content. Gp IV showed obvious shallowing of perikymata ridges, exposure of fish-scale appearance, with pits and depressions, alongside to the significant reduction in mineral content. Gp V presented the most enamel surface alteration with widening of prism sheath and depressions all over the surface, besides the highest significant reduction in mineral content. Gp V, followed by Gp IV, demonstrated the highest color and whiteness changes, followed by Gp III, then Gp II, while the lowest value was in Gp I. Salt & lemon-based toothpaste, followed by Alumina-based, exerted the most considerable changes in the morphology and chemical profile of the enamel surface, beside to the higher whitening effects on teeth than the others.

Resumen El objetivo del presente estudio fue evaluar el efecto de diferentes pastas dentales blanqueadoras sobre la morfología y el perfil químico de la superficie del esmalte y su eficacia blanqueadora. Sesenta dientes se dividieron en 5 grupos (12 dientes/grupo); Grupo I: cepillado sin pasta de dientes. Grupo II: cepillado con pasta de dientes a base de perlas. Grupo III: cepillado con pasta de dientes a base de carbón. Grupo IV: cepillado con pasta de dientes a base de Alúmina. Grupo V: cepillado con sal y pasta de dientes a base de limón. Cada diente se cepilló con una pasta de dientes del tamaño de un frijol humedecida con agua destilada dos veces al día utilizando un cepillo de dientes electrónico estándar durante cuatro semanas. Se investigaron la morfología de la superficie del esmalte, el perfil químico y el color de cada diente. Los resultados del perfil químico y las mediciones de color se analizaron estadísticamente. El Grupo I reveló una morfología de la superficie del esmalte y un perfil químico normales. Los Grupos II y III demostraron una morfología de superficie cercana a la del Grupo I con una reducción insignificante en el contenido mineral. El grupo IV mostró una evidente reducción de las crestas perikymatas, exposición de apariencia de escamas de pez, con hoyos y depresiones, junto con una reducción significativa en el contenido mineral. El grupo V presentó la mayor alteración de la superficie del esmalte con ensanchamiento de la vaina del prisma y depresiones en toda la superficie, además de una significativa reducción en el contenido mineral. El grupo V, seguido del grupo IV, demostró los mayores cambios de color y blancura, seguido del grupo III, luego el grupo II, mientras que el valor más bajo se presentó en el grupo I. Las pastas dentales a base de sal y limón, seguidas de las de alúmina, ejercieron los cambios más considerables en la morfología y el perfil químico de la superficie del esmalte, además de tener mayores efectos blanqueadores sobre los dientes que las demás.