Latin American Forensic Odontology: A Scoping Review of its Current Research and the Objective/Subjective Nature of its Studies

SUMMARY: The new paradigm in Forensic Sciences initiated by the entry of genetics (the current standard of legal evidence) and accentuated by recognized wrongful convictions derived from experts today in the eye of criticism, has highlighted the potential for bias and error in forensic disciplines when they depend on human interpretation and subjectivity, which has not been avoided by Forensic Odontology (FO). However, a subjective judgment is not necessarily wrong, so the refinement of processes, the development of standards, and robust research can contribute to the validity of interpretation to increase objectivity. Latin America (LATAM) has its own realities and needs, which have conditioned the priorities and objectives of FO research. A scoping review is presented to systematically map the investigation of LATAM researchers and identify the objective or subjective nature of their assessments. LATAM shows interesting productivity and intentions to adhere to international standards, with Brazil leading this research significantly, followed by Chile and Colombia, among others. However, there is a disproportionate approach in certain lines of research (dental age estimation), and needs to address other quantitative studies, and to improve the visibility of the LATAM FO research.

El nuevo paradigma en ciencias forenses iniciado por la entrada de la genética (el actual estándar de la evidencia jurídica), y acentuado por reconocidas condenas injustas derivadas de pericias hoy en el ojo de la crítica, ha destacado el potencial de sesgo y error que poseen algunas disciplinas forenses cuando dependen de la interpretación humana y la subjetividad, lo cual no ha sido ajeno a la odontología forense (OF). Sin embargo, un juicio subjetivo no necesariamente es erróneo, con lo que el refinamiento de procesos, el desarrollo de estándares y la investigación robusta pueden contribuir a validar esa interpretación para aumentar su objetividad. Latinoamérica (LATAM) posee realidades y necesidades propias que han condicionado las prioridades y objetivos de la investigación en OF. Se presenta una revisión con búsqueda sistemática para mapear sistemáticamente la investigación en OF realizada por investigadores latinoamericanos, así como identificar la naturaleza objetiva o subjetiva de sus evaluaciones. LATAM demuestra una productividad interesante e intenciones de adherirse a estándares internacionales, con Brasil liderando significativamente esta investigación, seguido por Chile y Colombia entre otros. Sin embargo, se observa un enfoque desproporcionado en ciertas líneas de investigación (estimación de edad dental particularmente), y necesidad tanto de abordar otros estudios cuantitativos como de mejorar la visibilidad de la investigación latinoamericana en OF.

Desarrollo de la Psicomotricidad en Estudiantes de Odontología Durante el Confinamiento por COVID-19

Las habilidades psicomotrices son un pilar fundamental del aprendizaje en odontología y clásicamente han sido trabajadas a través de la simulación o atención de pacientes. Durante el confinamiento debido a COVID-19, los estudiantes no tuvieron factibilidad de realizar procedimientos preclínicos. Debido a esto, se implementaron sesiones de entrenamiento de habilidades psicomotrices, en formato online, que permitieran preparar a los estudiantes durante el confinamiento para el retor no a la clínica. Se implementaron sesiones de entrenamiento psicomotriz a través de la utilización de materiales de artes plástica s e instrumental odontológico en formato online y guiados por una Terapeuta ocupacional. Para su medición, se realizó un estudio de casos y controles, donde los grupos se seleccionaron por conveniencia entre estudiantes que participaron de las sesiones y aquellos que tuvieron la formación virtual tradicional. La experiencia se evaluó a través cuestionario de autopercepción contestado por los estudiantes con respuestas en una escala de Likert y se comparó a través de pruebas estadísticas no paramétricas. Se recolectó una muestra total de 27 estudiantes, con una edad promedio de 23,7 años. Al comparar las respuestas de ambos grupos, los estudiantes del grupo casos percibieron significativamente una mejor sujeción de objetos pequeños utilizando pinzas, manipulación de instrumentales manuales y rotatorios de manera más precisa y mejor coordinación entre ambas manos durante un procedimiento simple en boca en comparación al grupo que no participó de las mismas. El entrenamiento de habilidades psicomotrices realizadas durante el periodo de confinamiento mostró resultados positivos en la percepción de las habilidades psicomotrices de los estudiantes, siendo una estrategia de bajo costo para ser implementada durante la formación de destrezas de los estudiantes de odontología en diferentes contextos. Sin embargo, para una mejor implementación debe estar en conjunto a estrategias de simulación para ser totalmente efectiva.

Psychomotor skills are a fundamental pillar of learning in dentistry and traditionally have been worked on through simulation or patient care. During the confinement due to COVID-19, students were not able to perform preclinical procedures. Due this, psychomotor skills training sessions were implemented, in online format to prepare students during confinement for the return to the patient care. Psychomotor training sessions were implemented using plastic arts materials and dental instruments in online format and guided by an occupational therapist. For its measurement, a case-control study was carried out, where the groups were selected by convenience between students who participated in the sessions and those who had traditional virtual training. The experience was evaluated through a self- perception questionnaire answered by the students with answers on a Likert scale and compared through non- parametric statistical tests. A total sample of 27 students was collected, with an average age of 23.7 years. When comparing the responses between groups, the students in the case group perceived significantly better grasping of small objects using forceps, more precise manipulation of hand and rotary instruments and better coordination between both hands during a simple mouth procedure compared to the group that did not participate in the same. The psychomotor skills training performed during the confinement period showed positive results in the perception of psychomotor skills of the students, being a low-cost strategy to be implemented during the skills training of dental students in different contexts. However, for a better implementation it should be in conjunction with simulation strategies to be fully effective.

Conhecimento e experiências vividas por cirurgiões-dentistas quanto à importunação sexual e perseguição em Pernambuco, Brasil / Knowledge and experiences lived by dentists regarding sexual harassment and persecution in Pernambuco, Brazil

Importunação Sexual e Perseguição são práticas configuradas como crime pelo Código Penal Brasileiro - CPB. Sendo o tema pouco explorado na área da saúde, este trabalho teve como objetivo verificar o nível de conhecimento do cirurgião-dentista atuante no estado de Pernambuco (Brasil), sobre estes dois tipos penais, suas experiências no exercício profissional e atitudes tomadas para resolutividade da questão. Para isto foi realizado estudo descritivo de corte transversal, com aplicação de um questionário online semiestruturado, através da plataforma Google Forms®, utilizando a metodologia "bola de neve", sendo coletados dados sociodemográficos, questões relacionadas ao conhecimento de Importunação Sexual e Perseguição, e por fim, questões relacionadas a experiências sofridas no exercício de sua profissão. Foram incluídos neste estudo 69 questionários, 22% respondidos por homens e 78% por mulheres. A maioria dos participantes respondeu que já ouviu falar sobre Importunação Sexual e sobre Perseguição, no entanto, grande parte demonstrou dificuldade em reconhecer a definição de Importunação, estabelecida pelo CPB. Os que informaram ter tido vivência com algum destes tipos penais, relataram que contaram o fato a um amigo, a algum familiar ou não fizeram nada a respeito. Conclui-se sobre existência de situações dentro da prática profissional odontológica que podem configurar, sobretudo, o crime de Importunação sexual. E, contar a um amigo, a um familiar ou mesmo não fazer nada a respeito foram as atitudes mais comumente realizadas por estes profissionais

Sexual Harassment and persecution are acts configured as a crime by the Brazilian Penal Code - CPB. As the subject is little explored in the health area, this work aimed to verify the level of knowledge of the dentists working in the state of Pernambuco (Brazil), about these two criminal types, their experiences in professional practice and attitudes taken to resolve the issue. For this, a descriptive cross-sectional study was carried out, with the application of a semi-structured online questionnaire, through the google forms platform, using the "snowball" methodology, collecting sociodemographic data, questions related to the knowledge of sexual harassment and persecution, and by finally, questions related to the experiences suffered in the exercise of their profession. 69 questionnaires were included in this study, 22% answered by men and 78% by women. Most participants answered that they had already heard about sexual harassment and persecution, however, most of them showed difficulty in recognizing the definition of harassment, established by the CPB. Those who reported having had experience with one of these criminal types, reported that they told the fact to a friend, to a family member or did nothing about it. It concludes on the existence of situations within professional dental practice that can configure, above all, the crime of sexual harassment. And telling a friend, a family member or even doing nothing about it were the attitudes most commonly performed by these professionals

Persistência da sutura metópica em crânios secos adultos do Nordeste brasileiro: análise antropológica forense / Persistence of metopic suture in adult dry skulls from Northeast Brazil: a forensic anthropological analysis / Persistencia de la sutura metópica en cráneos secos adultos del Nordeste de Brasil: análisis antropológico forense

A sutura metópica forma-se aproximadamente no primeiro trimestre da vida intrauterina entre os dois centros de ossificação que irão formar o osso frontal. Há controvérsias na literatura em relação ao momento em que essa sutura oblitera, mas se sabe que ocorre antes dos dez anos de idade; entretanto, essa sutura pode não obliterar e persistir ao longo da vida do indivíduo. Este trabalho objetivou relatar a persistência da sutura metópica em crânios secos de esqueletos humanos adultos pertencentes ao Centro de Estudos em Antropologia Forense da Faculdade de Odontologia da Universidade de Pernambuco (CEAF/FOP/UPE), com a finalidade de demonstrar a importância para a perícia antropológica forense. Dentre os 426 examinados, foram identificados dez crânios (2,4%) com a presença de sutura metópica completa, sendo 5 do sexo masculino e 5 do feminino, compreendendo uma faixa etária de 29 a 86 anos. A persistência da metópica possui relevância forense, afinal as variações anatômicas são vistas como estruturas que não são consequência de uma patologia e que diferem do encontrado na população geral, tornando o indivíduo que as possui ainda mais único. Dessa forma, essa variação anatômica pode atuar como auxiliar no processo de identificação humana na perícia antropológica forense... (AU)

The metopic suture forms approximately in the first trimester of intrauterine life between the two ossification centers that will form the frontal bone. There are controversies in the literature as to when this suture obliterates, but it is known to occur before the age of ten; however, this suture may not obliterate and persist throughout the individual's life. This work aimed to report the persistence of the metopic suture in dried skulls of adult human skeletons belonging to the Center for Studies in Forensic Anthropology of the School of Dentistry of the University of Pernambuco (CEAF/FOP/UPE) in order to demonstrate its importance for forensic anthropology. Among the 426 skeletons examined, ten skulls (2.4%) with complete metopic sutures were identified, five male and five female, ranging in age from 29 to 86 years. The persistence of metopic sutures has forensic relevance, after all, anatomical variations are seen as structures that are not a consequence of pathology and that differs from what is found in the general population, making the individual who has them even more unique. Thus, this anatomical variation can act as an aid in the process of human identification in forensic anthropology... (AU)

La sutura metópica se forma aproximadamente en el primer trimestre de vida intrauterina entre los dos centros de osificación que formarán el hueso frontal. Existen controversias en la literatura sobre el momento en que se oblitera esta sutura, pero se sabe que ocurre antes de los diez años; sin embargo, esta sutura puede no obliterarse y persistir durante toda la vida del individuo. Este estudio tuvo como objetivo informar sobre la persistencia de la sutura metópica en cráneos desecados de esqueletos humanos adultos pertenecientes al Centro de Estudos em Antropologia Forense de la Faculdade de Odontologia da Universidade de Pernambuco (CEAF/FOP/UPE), con el fin de demostrar su importancia para la antropología forense. Entre los 426 esqueletos examinados, se identificaron diez cráneos (2,4%) con presencia de sutura metópica completa, 5 masculinos y 5 femeninos, con edades entre 29 y 86 años. La persistencia de la sutura metópica tiene relevancia forense, después de todo las variaciones anatómicas son vistas como estructuras que no son consecuencia de una patología y que difieren de lo que se encuentra en la población general, haciendo aún más único al individuo que las presenta. Así pues, esta variación anatómica puede servir de ayuda en el proceso de identificación humana en antropología forense... (AU)

Limitaciones Técnicas del Método de Conteo de Anulaciones del Cemento para Estimación de Edad. Hallazgos a Partir de Una Revisión con Búsqueda Sistemática / Technical Limitations of Cementum Annulation Count Method for age Estimation. Findings From A Scoping Review

En la última década, la odontología forense se ha enfocado en el desarrollo de metodologías para la estimación de edad (EE) debido a la gran demanda en procesos identificatorios. Entre esas técnicas, el conteo de anulaciones del cemento dental (TCA) ha ofrecido resultados promisorios, pero también contradictorios que han generado dudas sobre su precisión y confiabilidad. El objetivo de este trabajo fue caracterizar, establecer alcances, e identificar las limitaciones del conteo de TCA según los actuales estándares normativos y metodológicos. Se realizó una revisión con búsqueda sistemática del método de conteo de TCA para EE incluyendo estudios experimentales y notas técnicas en las bases PubMed/Medline, Scopus, Web of Science (WoS) y Embase. Se emplearon los términos "estimation", "age" y "cementum", con búsqueda manual complementaria en Google Scholar. Se excluyeron revisiones, estudios en colecciones arqueológicas, estudios radiológicos y cartas al editor. La búsqueda arrojó un total de 273 artículos, seleccionándose 27 que cumplieron con los criterios de inclusión. La mayoría de los estudios fueron publicados en Asia, particularmente en India (n=21). Sólo 6 artículos declararon el número total de individuos, tipos de diente y de cortes histológicos, siendo el premolar el más estudiado. Apenas dos artículos evaluaron la calidad de la muestra a analizar mediante legibilidad de los cortes obtenidos. El test más empleado para evaluar la precisión del método fue el coeficiente de correlación de Pearson (n=21). Estos hallazgos exponen la alta heterogeneidad reportada en las metodologías de EE mediante conteo por TCA, por lo que aún no existe un proceso estandarizado que abarque todas sus etapas y entregue resultados confiables siguiendo los estándares jurídicos actuales para la evidencia científica. Un mayor control de las limitaciones técnicas detectadas aumentará el valor como prueba en un contexto identificatorio legal o forense.

SUMMARY: In the last decade, forensic odontology has focused on the development of age estimation (AE) methodologies due to the great request in identification processes. Among these techniques, the tooth cementum annulation (TCA) count method has offered promising but also contradictory results, raising questions about its accuracy and reliability. The aim of this work was to characterize, establish the scope, and identify the limitations of the TCA count method according to the current normative and methodological standards. A scoping review was carried out for TCA count methods for AE, including experimental studies and technical notes in the PubMed/Medline, Scopus, Web of Science (WoS) and Embase databases. The terms "estimation", "age" and "cementum" were used, with a complementary manual search in Google Scholar. Reviews, studies in archaeological collections, radiological studies and letters to the editor were excluded. The search yielded a total of 273 articles, selecting 27 of them that met the inclusion criteria. Most of the studies were published in Asia, particularly India (n=21). Only 6 articles declared the total number of individuals, types of teeth, and histological sections, with the premolar being the most studied. Only two articles evaluated the quality of the sample to be analyzed through the legibility of the cuts obtained. The most widely used test to assess the precision of the method was the Pearson correlation coefficient (n=21). These findings expose the high heterogeneity reported in EE methodologies by counting TCA, so there is still no standardized process that covers in all its stages and delivers reliable results following current legal standards for scientific evidence. More control of the detected technical limitations will increase the value as evidence in a legal or forensic identification context.

A career in Forensic Odontology: it is not only about teeth / Odontologia Legal como carreira: não se trata apenas de dentes

Throughout the world, forensic odontology academic programmes have been designed and permeate discussions about international or local standard operational protocols, principles or guidelines requiring current technical and scientific knowledge. The heterogeneous groups of students who aim to pursue this career might have high educational and occupational aspirations that will be confronted with the labour markets. In this report, the authors briefly present aspects of the education and training that comprise the choice of a career in forensic odontology nowadays. In conclusion, the individual who opts for forensic odontology as a career must be prepared to find the confidence and resilience to practice professional skills in a unique and challenging field to comply with the society's expectation

Em todo o mundo, vários programas acadêmicos de Odontologia Legal têm sido criados e permeiam discussões sobre protocolos, princípios ou diretrizes operacionais, padrão internacional ou local, que exigem conhecimento técnico e científico atualizado. Os grupos heterogêneos de estudantes que pretendem seguir esta carreira poderão ter elevadas aspirações educativas e profissionais que serão confrontadas com os mercados de trabalho. Neste contexto, os autores apresentam brevemente aspectos da educação e formação que compõem a escolha de uma carreira em Odontologia Legal nos dias de hoje. Em conclusão, o indivíduo que opta pela Odontologia Legal como carreira deve estar preparado para encontrar confiança e resiliência para exercer habilidades profissionais em um campo único e desafiador para atender às expectativas da sociedade

Displasia frontonasal / Frontonasal dysplasia

Los trastornos del desarrollo son aquellos padecimientos que se manifiestan por defectos en la embriogénesis de la región afectada. La cara del ser humano comienza su formación alrededor de la cuarta semana de vida intrauterina y se manifiesta gracias a la fusión de cinco prominencias: dos pares conocidas como maxilar y mandibular, y una impar conocida como frontonasal. Cuando esta fusión no se lleva a cabo de una forma óptima, aparecen numerosas alteraciones del desarrollo como el labio y paladar hendido, y la displasia frontonasal. La displasia frontonasal produce frecuentemente afecciones oculares, nasales y orales. Dentro de las manifestaciones orales destacan una forma atípica de hendidura labial o palatina, afecciones dentales y alteraciones en el crecimiento de la cara. Dada la gran relación que este padecimiento tiene con la cavidad oral resulta importante que el odontólogo conozca la etiología y las características clínicas de este trastorno (AU)

Developmental disorders are those conditions that are manifested by defects in the embryogenesis of the affected region. The human face begins its formation around the fourth week of intrauterine life and is manifested thanks to the fusion of five prominences: two pairs known as maxillary and mandibular and odd one known as frontonasal. When this fusion is not carried out in an optimal way, numerous developmental alterations appear, such as cleft lip and palate and frontonasal dysplasia. Frontonasal dysplasia frequently produces ocular, nasal and oral affections. Among the oral manifestations, and atypical form of clef lip and/or palate, dental affections and alterations in the growth of the face stand out. Given the great relationship that this condition has with the oral cavity, it is important for the dentist to know the etiology and clinical characteristics of this disorder (AU)

Dried Salivary Spot As A Diagnostic Aid- A Review

Saliva is a colourless, watery and complex fluid secreted by the salivary glands into the oral cavity. It plays an important role in maintaining the moisture and well being of the oral cavity. In recent years, Saliva has been used by the researches, as it is non invasive technique, limited training required, potentially valuable for children and elderly patients, cost effective, eliminates the risk of infection and screening in large population. Collecting dried salivary sample is still being a greater challenge in the forensic. The process of identifying a disease, condition, or injury from its signs and symptoms is referred as diagnosis and diagnostic tool helps in simplifying the clinical findings to obtain a reasonable and relevant differential diagnosis. Recently, Dried salivary spot has been most commonly used among Forensic Odontology which can be used as an efficient diagnostic aid. This article aims to review the updates and significance of dried saliva spot and sampling in forensic odontology.

Tiempo empleado para estimar edad dental en niños peruanos comparando el método de Demirjian y el cuadro integral del enfoque de Demirjian: un estudio piloto / Time spent to estimate dental age in peruvian children comparing the demirjian method and the comprehensive chart based on demirjian method: a pilot study

El objetivo de este estudio fue comparar el tiempo empleado al estimar la edad dental (ED) entre el método propuesto por Demirjian et al. y el cuadro integral del enfoque de Demirjian (DAEcc) utilizando radiografías panorámicas digitales de individuos peruanos de 5 a 13 años residentes en Lima. Se realizó un estudio no experimental, comparativo, transversal y retrospectivo. Se utilizaron 100 radiografías panorámicas digitales que presentaban siete dientes permanentes mandibulares izquierdos. Una odontóloga forense capacitada y calibrada determinó el tiempo utilizado en evaluar la maduración dental y la estimación de ED con dos métodos (Demirjian y DAEcc). La unidad de medida utilizada fue los minutos (min.). No hubo diferencias en el tiempo de evaluación del estadio de maduración dental entre ambos métodos (p<0,05). El tiempo para estimar ED fue estadísticamente inferior con DAEcc (2,09 min) que con Demirjian (4,19 min). La diferencia del tiempo total de evaluación resultó estadísticamente significativa entre ambos métodos (Δ2,1 min.; 2,05-2,11; p=0,000). La aplicación del DAEcc redujo en 50 % el tiempo empleado en estimar ED en comparación con los cuadros propuestos por Demirjian. Aunque la odontología forense se centra en el estudio de la eficacia de estimación de la edad, es necesario abordar también su uso práctico.

SUMMARY: The objective of this study was to compare the time used to estimate dental age (DA) between the method proposed by Demirjian et al., and the comprehensive chart for dental age estimation (DAEcc) using digital panoramic radiographs of Peruvian individuals aged 5 to 13 years residing in Lima. A non- experimental, comparative, cross-sectional and retrospective study was carried out. 100 digital panoramic radiographs showing seven mandibular left permanent teeth were used. A trained and calibrated forensic odontologist determined the time used to assess tooth maturation and DA estimation with two methods (Demirjian and DAEcc). The unit of measurement used was minutes (min.). There were no differences in the evaluation time of the dental maturation stage between both methods (p<0.05). The time spent to estimate DA was statistically less with DAEcc (2.09 min) than with Demirjian (4.19 min). The difference in total evaluation time was statistically significant between both methods (Δ2.1 min; 2.05-2.11; p=0.000).The application of DAEcc reduced by 50 % the time spent estimating DA compared to the method proposed by Demirjian. Although forensic odontology focuses on the study of the effectiveness of age estimation, its practical use needs to be addressed as well.

Pulpectomia o pulpotomía en el tratamiento de dientes temporales: Revisión

Objetivo: Comparar las terapias pulpares de dientes temporales en pacientes según la evidencia en la literatura. Metodología: Revisión bibliográfica en la literatura científica, en las siguientes bases de datos: PUBMED, MEDLINE, BVS, BBO Odontología, IBECS y Web of Science. Los descriptores seleccionados fueron: pulpotomía y pulpectomia, combinados en la siguiente estrategia de búsqueda: (pulpotomía) AND (pulpectomía). Resultados: Se encontraron 65 artículos, seleccionados por título y resumen. Después de una lectura minuciosa, solamente 23 artículos cumplieron con el criterio de inclusión que fuera un ensayo clínico, estudio longitudinal (cuasiexperimental o cohorte), no se excluyeron artículos duplicados y 13 que no tenían relación directa con el tema. La muestra final totalizó 7 artículos para la revisión integradora. La evidencia es limitada por el número de estudios que cumplieron con los criterios. Conclusiones: La contribución de este estudio sobre el tema es aumentar el conocimiento con respecto a las terapias pulpares; contribución que requiere ser mejorada o detallada en estudios posteriores; por tal motivo no se puede hacer una conclusión definitiva respecto a cuál de los tratamientos pulpares es mejor, pero nos indica una tendencia para desde el punto de vista clínico poder considerar los tratamientos pulpares como una alternativa adecuada para mantener el diente temporal en la cavidad bucal con evidencia científica.

Objective: To compare pulp therapy of primary teeth in patients according to the evidence in the literature. Methodology: Literature review in the scientific literature, in the following databases: PUBMED, MEDLINE, BVS, BBO Dentistry, IBECS and Web of Science. The descriptors selected were: pulpotomy and pulpectomy, combined in the following search strategy: (pulpotomy) AND (pulpectomy). Results: 65 articles were found by selecting by title and abstract. After a thorough reading only 23 articles met the inclusion criteria of being a clinical trial, longitudinal study (quasi-experimental or cohort), duplicate articles and 13 that were not directly related to the topic were not excluded. The final sample totaled 7 articles for the integrative review. The evidence is limited by the number of studies that met the criteria. Conclusions: The contribution made on the subject is to increase knowledge regarding pulp therapies, which needs to be improved or detailed in further studies, for that reason we cannot make a definitive conclusion on which of both pulp treatments is better, but it gives us a tendency and from a clinical point view to be able to consider pulp treatments as an adequate alternative to maintain the primary tooth in the oral cavity with scientific evidence.

Análisis forense de dientes, materiales de obturación y restauraciones protésicas en restos humanos expuestos a elevadas temperaturas. Revisión de la literatura / Forensic analysis of teeth, filling materials and prosthetic restorations in human remains exposed to high temperatures. Literature review

Resumen El proceso para establecer una identificación odontológica inequívoca se sustenta en la recuperación de la mayor cantidad posible de información post mortem, y su posterior cotejo con aquellos registros ante mortem de la víctima. Los dientes son tejidos del cuerpo humano con una elevada resistencia en su estructura, lo que les permite tolerar el embate de los efectos ambientales como el fuego, la desecación, la descomposición o la inmersión prolongada. En la mayoría de los desastres naturales, y también en los provocados por el hombre, los registros odontológicos pueden contribuir para identificar cuerpos que sería irreconocibles aplicando metodologías tradicionales. En cadáveres quemados o carbonizados, resulta imperativo conservar la evidencia odontológica recuperada, para evitar que su manipulación pueda desvirtuarla e incluso destruirla; por eso se suele fijar y estabilizar antes de ser transportada. Los recursos imagenológicos constituyen una sólida estrategia de perennización de evidencia, los cuales pueden ser complementados por fotografías y toma de impresiones. El presente artículo revisa varios estudios sobre restos dentales, materiales de obturación y aparatos protésicos quemados o carbonizados, haciendo énfasis sobre su importancia en el proceso de identificación humana.

Abstract The process to establish an unequivocal dental identification is based on the recovery of the greatest possible amount of post mortem information, and its subsequent comparison with the ante mortem records of the victim. Teeth are tissues of the human body with high resistance in their structure, which allows them to tolerate the onslaught of environmental effects such as fire, desiccation, decomposition, or prolonged immersion. In most natural disasters, an also in those caused by men, dental records can help identify a body that would be unrecognizable using traditional methodologies. In burned or charred corpses, it is imperative to preserve the recovered dental evidence, to avoid its manipulation from distorting and even destroying it; this is why it is usually fixed and stabilized before being transported. Imaging resources constitute a solid strategy for the perpetuation of evidence, which can also be complemented by photographs and impression taking. This article reviews several studies on dental remains, materials and burned or charred prosthetic devices, emphasizing their importance in the human identification process.

Comprensión del consentimiento informado por parte de los pacientes de la Facultad de Odontología de la Universidad de Costa Rica / Understanding of informed consent by patients at the Faculty of Dentistry of the University of Costa Rica

Introducción: El consentimiento informado es el resultado de la evolución de la relación entre las personas profesionales de la salud y sus pacientes o usuarios donde el principio de autonomía está por encima de cualquier otra cosa. Existen muchos artículos sobre el consentimiento informado pero ninguno de los estudios encontrados evaluó si los pacientes realmente lo comprenden. El objetivo de esta investigación fue determinar el nivel de comprensión del consentimiento informado por parte de los pacientes de la Clínica de Exodoncia y Cirugía de la Facultad de Odontología de la Universidad de Costa Rica, en el período agosto a septiembre del 2022, mediante un cuestionario que permitiera correlacionar la comprensión con el nivel de escolaridad. Materiales y métodos: Se realizó un cuestionario a 100 personas dividido en dos partes, una sobre datos sociodemográficos y la otra para establecer la comprensión del consentimiento informado y determinar si el grado de escolaridad tenía relación con la comprensión de este. Resultados: El grupo entre 20 y 30 años fue el mayor, de estos el 51% tuvo estudios universitarios, y aunque la mayoría (98%) refirió conocer el concepto de consentimiento informado, únicamente el 33 % obtuvo las respuestas correctas a las preguntas clínicas realizadas. Conclusiones: A pesar de que los pacientes refieren conocer qué es el consentimiento informado los resultados sugieren una comprensión poco clara de conceptos importantes como complicaciones o reacciones adversas inmediatas o tardías producidas por el efecto de los tratamientos odontológicos o procedimientos quirúrgicos.

Introduction: Informed consent is the result of the evolution of the relationship between health professionals and their patients or users where the principle of autonomy is above anything else. There are many articles on informed consent but none of the studies found assessed whether patients really understand it. The objective of this research was to determine the level of understanding of informed consent by the patients of the Clinic of Oral Surgery of the Faculty of Dentistry of the University of Costa Rica, in the period August to September 2022, by means of a questionnaire that would allow correlating the understanding with the level of schooling. Materials and methods: A questionnaire was administered to 100 people divided into two parts, one on sociodemographic data and the other to establish the understanding of informed consent and to determine whether the level of schooling was related to the understanding of the same. Results: The group between 20 and 30 years of age was the largest, of these 51% had university studies, and although the majority (98%) referred to knowing the concept of informed consent, only 33% obtained the correct answers to the clinical questions asked. Conclusions: Even though patients refer to knowing what informed consent is the results suggest an unclear understanding of important concepts such as complications or immediate or late adverse reactions produced by the effect of dental treatments or surgical procedures.

Relación entre los niveles de autoeficacia y disposición para realizar una tesis en estudiantes peruanos de Odontología / Relationship between levels of self-efficacy and willingness to do a thesis in peruvian dental students

Introducción: Algunos estudiantes logran desarrollar la tesis con mayor facilidad que otros. De ese modo surgen motivos para el aumento de la predisposición y el rendimiento satisfactorio, así como el incremento de las competencias desarrolladas durante el pregrado. Este rendimiento se encuentra asociado a mayor motivación para las actividades de investigación y la sensación de autoeficacia para la realización de las tareas. Objetivo: Analizar la relación existente entre los niveles de autoeficacia y la disposición para realizar la tesis universitaria. Métodos: Estudio analítico transversal, que incluyó 113 estudiantes de los dos últimos años de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos (Lima, Perú). Se utilizó la técnica de la encuesta con dos escalas: "autoeficacia para realizar la tesis" (dos dimensiones y 14 preguntas) y "disposición para realizar la tesis" (cuatro dimensiones y 44 preguntas). Se empleó la prueba de correlación de Pearson para analizar las puntuaciones de cada variable. Resultados: La autoeficacia obtuvo una puntuación general de 1,61 ± 0,53. No se encontraron diferencias significativas entre estudiantes de quinto e internado. La disposición tuvo una puntuación general de 4,04 ± 0,34. Se encontró correlación significativa entre las variables para todos los encuestados (p 0,05). Las puntuaciones de las mujeres evidenciaron correlación, existiendo significancia entre la autoeficacia para realizar la tesis y la disposición hacerla (p < 0,01; r = 0,430). No existió tal correlación en el grupo de los varones. Conclusiones: Existe una relación entre las puntuaciones de la "autoeficacia para realizar la tesis" y la "disposición para realizar la tesis" en un grupo de estudiantes de Odontología. Esta correlación se mantiene en las mujeres y no se presenta en los varones. Los estudiantes de quinto año evidenciaron mayores puntuaciones promedio respecto a ambas variables(AU)

Introduction: Some students manage to advance their thesis projects much easily than others. Thus, reasons arise for the increase in predisposition and satisfactory performance, as well as the increase in the skills developed during the undergraduate course. This performance is associated with greater motivation for research activities and the feeling of self-efficacy to carry out tasks. Objective: To evaluate the relationship between the levels of self-efficacy and the disposition to carry out the degree thesis. Methods: A cross-sectional analytical study was carried including113 students from the last two years of the School of Dentistry of Universidad Nacional Mayor de San Marcos, Lima, Peru. The survey technique was used with two scales: self-efficacy to achieve the thesis (two dimensions and 14 questions) and willingness to achieve the thesis (four dimensions and 44 questions). Pearson's correlation test was used to analyze the scores for each variable. Results: Self-efficacy obtained a general score of 1.61 ± 0.53. No significant differences were found between fifth and boarding school students. The disposition had an overall score of 4.04 ± 0.34. A significant correlation was found between the variables for all the respondents (p 0.05) was analyzed. Scores in women showed a correlation, significante between self-efficacy to achieve the thesis and willingness to do so (p < 0.01; r = 0.430). There was no such correlation in the male group. Conclusions: There is relationship between the scores of "self-efficacy to do the thesis" and the "willingness to do the thesis" in a group of dentistry students. This correlation is maintained in women and is not present in men. Fifth-year students showed higher average scores regarding both variables(AU)

Marco jurídico de la prescripción médica en odontología / Legal framework of medical prescription in odontology

La receta médica es la materialización del acto médico a través de la cual el profesional de la salud prescribe a su paciente los fármacos necesarios para aliviar su enfermedad. Existen numerosas sustancias o fármacos que, por sus efectos, no pueden ser ofrecidas al público en general si no es mediante la expedición de una receta médica; por tanto, existen numerosas legislaciones y normas que regulan la prescripción médica con el objetivo de tener un control sobre los fármacos prescritos. A su vez, la receta médica debe tener una estructura específica, misma que está establecida por numerosas leyes y reglamentos sanitarios y que interesantemente es ignorada por múltiples médicos u odontólogos. El objetivo del presente artículo es definir el concepto de prescripción médica, así como indagar en todas las leyes y normas vigentes que regulan la prescripción médica en México (AU)

The medical prescription is the materialization of the medical act through which the health professional prescribes to his patient the necessary drugs to alleviate his illness There are numerous substances or drugs that, due to their effects, cannot be offered to the general public, except through the issuance of a medical prescription, and therefore, there are numerous laws that regulate the medical prescription with the aim of having control over prescribed drugs. In turn, the medical prescription must have a specific structure, which is established by numerous health laws and regulations, and which, interestingly enough, is ignored by many doctors and dentists. The aim of this article is to define the concept of medical prescription as well as to investigate all the current laws and regulations that regulate the medical prescription in Mexico (AU)

Odontologia do Trabalho: o estado da arte, indicando trilhas para a promoção da saúde em contextos contemporâneos de labor - revisão de escopo / Occupational Dentistry: the state of the art, indicating paths for health promotion in contemporary work contexts - scoping review

Resumo O campo da Odontologia do Trabalho tem considerado lastro teórico-científico. Esta revisão de escopo objetiva desvelar o estado da arte acerca do tema em sete bases de pesquisas indexadas, considerando quase 100 anos de publicações (1921-2020). Das 337 produções inicialmente identificadas, realizou-se recorte para os últimos seis anos (2015-2021/janeiro), aplicando-se metodologia proposta pela extensão do Prisma para revisões de escopo (Prisma-ScR). Contudo, plataformas de revisões rápidas usadas para tomada de decisões em formulações de políticas públicas ou em aperfeiçoamentos de sistemas de saúde responderam por apenas 20 publicações, enquanto a amostra de 34 produções revelou peculiaridades: pesquisas privilegiam regimes de trabalho; associam o campo de estudo e prática ao modelo stricto sensu da saúde ocupacional; desconsideram concepções amplas e humanizantes do campo da Saúde do Trabalhador; tendem a priorizar a própria saúde ocupacional odontológica e parecem reduzir o conceito do acidente de trabalho a doenças. Tais questões precisam ser superadas se a perspectiva for manter-se em vanguarda, promovendo saúd e e segurança em contextos contemporâneos de trabalho, pois, embora seja evidente a transversalidade desse campo de saberes e práticas, é necessário mais, é preciso ousar para retirá-la da invisibilidade, seja em organizações privadas ou públicas de trabalho.

Abstract The field of Occupational Dentistry has considered theoretical-scientific ballast. This scoping review aims to reveal the state of the art on the subject in seven indexed research bases, considering almost 100 years of publications (1921-2020). Of the 337 productions initially identified, a cut was made for the last six years (2015-2021/January), applying the methodology proposed by the PRISMA extension for scope reviews (PRISMA-ScR). However, rapid review platforms used for decision making in formulating public policies or in improving health systems accounted for only 20 publications, whereas the sample of 34 productions revealed peculiarities: research favors work regimes; associates the field of study and practice with the stricto sensu model of occupational health; disregards broad and humanizing concepts in the field of Worker's Health; tends to prioritize its own occupational dental health, and seems to reduce the concept of work accidents to illnesses. Such issues need to be overcome if the perspective is to remain at the forefront, promoting health and safety in contemporary work contexts, since, although the transversality of this field of knowledge and practices is evident, more is needed, daring to remove it from invisibility whether in private or public work organizations is necessary.

Características de las tesis de licenciatura de estudiantes de Odontología que se publican en revistas científicas / Characteristics of Dentistry degree theses published in scientific journals

La publicación de los resultados de una tesis permite difundir los hallazgos a través de canales formales como las revistas; sin embargo, la producción científica de los estudiantes es escasa. El objetivo de la investigación fue caracterizar los hallazgos de las tesis de licenciatura que publican los estudiantes del programa de Odontología en revistas científicas. Se realizó un estudio descriptivo, transversal que valoró 217 tesis elaboradas por estudiantes del pregrado de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos desde el año 2016 hasta el 2021. Las tesis fueron buscadas por el título y el nombre del tesista en las bases de datos Scopus, Web of Science, PubMed, SciELO, Google Académico y Lilacs. Se registró la temática de cada tesis, lugar de publicación, idioma y año de publicación. Ocho tesis (3,7 por ciento) presentaron publicaron los resultados en revistas científicas. El 50 por ciento de las tesis estuvo relacionado con la Ortodoncia y la Ortopedia Maxilar; Scopus fue la principal base de datos donde se publicaron los hallazgos (75 por ciento, n = 6). Todas las tesis fueron realizadas por mujeres y los resultados se divulgaron en revistas internacionales. La publicación de las tesis de licenciatura por parte de estudiantes de Odontología en una universidad peruana es baja; generalmente realizada por mujeres, en idioma español, publicadas en la base de datos de Scopus y con temáticas relacionadas con la Ortodoncia-Ortopedia maxilar y las Ciencias Básicas(AU)

The publication of the results of a thesis allows the dissemination of the findings through formal channels such as journals; however, the scientific production of the students is scarce. The objective of the research was to characterize the findings of the undergraduate theses published in scientific journals by the students of the Dentistry program. A descriptive, cross-sectional study was carried out, which evaluated 217 theses prepared by undergraduate students of the Faculty of Dentistry at Universidad Nacional Mayor de San Marcos from 2016 to 2021. The theses were searched by the title and the name of the thesis student in Scopus, Web of Science, PubMed, SciELO, Google Scholar, and Lilacs databases. The theme of each thesis, place of publication, language and year of publication were recorded. Eight theses (3.7percent) published the results in scientific journals. 50percent of the them were related to Orthodontics and Maxillary Orthopedics; Scopus was the main database where the findings were published (75percent, n = 6). All these were written by women and the results were published in international journals. The publication of undergraduate theses by Dentistry students at a Peruvian university is low; generally carried out by women, in Spanish, published in Scopus database and on themes related to Orthodontics-Maxillary Orthopedics and Basic Sciences(AU)

Analysis of the Development Trend in Forensic Odontology Based on CiteSpace / 法医学杂志

OBJECTIVES@#To realize the dynamic visualization of forensic odontology based on the bibliometrics methods, and capture the research hotspots and identify the future development trend.@*METHODS@#Literature articles published from January 1995 to December 2020 were searched according to specific subject words in the core data set of Web of Science. The visualization analysis of publishing country, institution, discipline, author, co-cited journal and keywords was performed by CiteSpace 5.7.R5W software.@*RESULTS@#The annual analysis of publications showed an upward trend of forensic odontology research literature year by year, with the number of annual publications more than 110 in the last five years. Developed countries were the main source of contributions and the average centrality was greater than 0.2. The research of forensic odontology involved multiple disciplines, including stomatology, biology, computer science and medical imaging, with a distinct interdisciplinary feature. A total of 115 nodes were obtained by keyword cluster analysis. The principal line of forensic odontology mainly included individual identification and age estimation and the emergence of hotspots was closely related to new technologies. Population-based odontology investigation, improvement of traditional dental age estimation method and dental age estimation based on new technology were popular research in forensic odontology.@*CONCLUSIONS@#Developing countries urgently need to increase the focus on related research. It may be an important direction for the development of forensic odontology to establish and enrich the regional dental database, develop new odontology identification technology combined with frontier and high-end technology, and develop the identification program based on advanced information technology.

El concepto de etnia en un país pluriétnico y multicultural: una representación desde un grupo de estudiantes de odontología / The concept of ethnicity in a multi-ethnic and multicultural country: a representation from a group of dental students

Objetivo: explorar el concepto de <<etnias>>, en un grupo de estudiantes de Odontología de una universidad privada. Métodos: Se realizó un estudio cualitativo con 11 estudiantes entre 18 y 21 años en una Facultad de Odontología de una Universidad de Bogotá, en el curso de Socio Humanística I. Se efectuó una entrevista semiestructurada a cada estudiante; se obtuvo el consentimiento informado, el estudio fue clasificado como sin riesgo. Se aplicó en una sesión una entrevista semiestructurada, organizada en forma de historia donde el estudiante se involucra al leer el relato y contestar los interrogantes a medida que transcurría la lectura, lo que sirvió como base para el análisis de contenido. Resultados: Se determinaron tres categorías a saber: concepto de etnia, grupos étnicos en Colombia y enfoque diferencial étnico en salud, encontrándose que la etnia para los estudiantes es el reconocimiento de multietnicidad y pluriculturalidad del país, acompañado de diversidad. Conclusión: Con relación al concepto de etnia, se resalta que para algunos de los encuestados hay una confusión con representar los grupos étnicos como: madres cabeza de hogar, desplazados y población LGBTI. Los estudiantes respondieron "Raizales, negritudes, indígenas, Rom, desplazados, adultez, vejez, niñez, LGTBI." Que, aunque tienen relación con el enfoque diferencial, no corresponden al interrogante planteado en la historia.

Objective: to explore the concept of ethnicity in a group of odontology students of a private university. Methods: A qualitative study was carried out with 11 students between 18 and 21 years of age in an odontology faculty of a university in Bogota, in the course of socio-humanistic I. A semi-structured interview was conducted with each student, aninformed consent was obtained, and the study was classified as risk-free. A semi-structured interview was applied in one session, organized in the form of a story where the student was involved by reading the story and answering the questions as the reading progressed, which served as a basis for the content analysis. Results: Three categories were determined: concept of ethnicity, ethnic groups in Colombia and ethnic differential approach in health, finding that ethnicity for students is the recognition of multiethnicity and multiculturalism of the country, accompanied by diversity. Conclusion: In relation to the concept of ethnicity, a highlight is that for some of the participants there is confusion with representing ethnic groups such as: single mothers, displaced people and LGBTI population. The students answered "Raizal, black people, indigenous people, Rom, displaced, adults, elders, children, LGTBI". Although they are related to the differential approach, they do not correspond to the question raised in the story.

Determination of ABO Blood Group and Rhesus Factor from Teeth: A Double-Blinded Randomized Controlled Trial.

Background: Identification of a deceased subject can be established not only from the skeletal remains (including the congenital peculiarities in setting of teeth) but it can also be precisely established by blood grouping from the teeth with the help of the absorption-elution technique. Objectives: Our study was conducted to evaluate if dental pulp can be used as a reliable source for determination of ABO blood group and rhesus factor in an individual. Materials & Method: This double-blinded randomized controlled trial was conducted on a sample of 250 extracted teeth. An attempt to establish the blood group from pulp was made by absorption-elution method. The collected data were coded, and statistical analysis for comparison of ABO blood groups was done using Cronbach's alpha to check the reliability of the absorption-elusion method in the detection of blood group from dental pulp. Results: On comparison of capillary blood group (slide agglutination method) with pulp blood group (absorption elution technique) of the subjects, we found that positive results were obtained in 235 cases while 15 cases showed negative results. Hence, the sensitivity (ability to measure) of pulp in establishment of blood group was found to be 94%. Conclusion: On the basis of the results obtained from the present study, it could be concluded that pulp is a reliable source of blood group determination for ABO blood grouping where teeth happen to be the only remnants available for personal identification.

¿Los pacientes odontológicos están dispuestos a pagar por medidas de bioseguridad ante COVID-19? Variaciones en el tipo de tratamiento y la presencia de comorbilidades / ¿Are dental patients willing to pay for biosecurity measures against COVID-19? Variations in the type of treatment and the presence of comorbidities

Resumen Objetivo: Estimar si los pacientes odontológicos están dispuestos a pagar (DAP) más por sus citas sabiendo que la clínica donde asisten implementó medidas de bioseguridad para evitar el contagio del COVID-19. De igual manera, si dicho pago varía dependiendo del tipo de tratamiento odontológico, así como si el paciente presenta algún tipo de comorbilidad. Materiales y métodos: Desarrollo y aplicación de encuestas en línea a una muestra de 423 pacientes odontológicos en México con diferentes tratamientos y presencia de comorbilidad si estuvieran dispuestos a pagar por su atención ante la emergencia COVID por las medidas de bioseguridad utilizando un análisis estadístico de medias. La encuesta se aplicó en los meses de septiembre a noviembre de 2020. Resultados: Se estimó que aproximadamente el 32% cancelaría sus citas dentales por miedo a contraer COVID-19; sin embargo, casi un 45% estarían DAP un monto extra en la cita, si el consultorio o clínica implementa estrictas medidas de bioseguridad. Estos porcentajes, tanto de la cancelación de cita, como de la disponibilidad a pagar adicional, se incrementa si el paciente presenta alguna comorbilidad. Conclusiones: Los pacientes de la muestra están dispuestos a pagar un monto excedente por sus citas sabiendo que los consultorios implementaron medidas de bioseguridad, y más si son pacientes que presentan alguna comorbilidad. Así mismo, dichos consultorios podrían recibir algún apoyo del Gobierno para el bienestar de toda la sociedad.

Abstract Objective: Estimate whether dental patients are willing to pay (DAP) more for their appointments knowing that the clinic where they attend implemented biosecurity measures to prevent the spread of COVID-19. Similarly, if said payment varies depending on the type of dental treatment, as well as if the patient has some type of comorbidity. Materials and methods: Development and application of online surveys to a sample of 423 dental patients in Mexico with different treatments and presence of comorbidity if they were willing to pay for their care in the face of the COVID emergency for biosecurity measures using a statistical analysis of means . The survey was applied in the months of September to November 2020. Results: It was estimated that approximately 32% would cancel their dental appointments for fear of contracting COVID-19; however, almost 45% would be DAP an extra amount in the appointment, if the office or clinic implements strict biosecurity measures. These percentages, both for appointment cancellation and willingness to pay additional, are increased if the patient has any comorbidity. Conclusions: The patients in the sample are willing to pay an excess amount for their appointments knowing that the offices have implemented biosafety measures, and more so if they are patients with some comorbidity. Likewise, these clinics could receive some support from the Government for the well-being of the entire society.