Alteraciones sistémicas asociadas a Hipomineralización Molar Incisivo (HMI). Una revisión de literatura / Alterações sistêmicas associadas à Hipomineralização Molar Incisiva (HMI). Uma revisão da literatura / Systemic alterations associated with Incisor Molar Hypomineralization (HMI). A literature review

El estudio de hipomineralización en molares e incisivos fue descrito por primera vez en el año 1970, posteriormente en 2001 el término Hipomineralización Molar Incisivo (HMI) fue sugerido por la Academia Europea de Odontología Pediátrica (EAPD) para referirse a este como un defecto específico del desarrollo del esmalte; ya para el año 2003 se estandarizaron los criterios de diagnóstico clínico. La HMI es un defecto del esmalte dentario ampliamente estudiado, sin embargo, hasta la fecha los factores de riesgo no son concluyentes, pero se considera de origen sistémico y multifactorial. Las implicaciones sistémicas pueden acontecer en periodos específicos (pre, peri y posnatal) considerados periodos importantes y críticos en el desarrollo de la vida humana. Objetivo: aportar la mejor evidencia científica disponible sobre los factores sistémicos asociados a la Hipomineralización Molar Incisivo. Materiales y métodos: Se realizó una búsqueda sistematizada seleccionando estudios primarios en bases de datos electrónicas: Pub Med, biblioteca Cochrane e Hinari a través de la pregunta PICO. Resultados: 115 estudios fueron identificados a través de la búsqueda electrónica de estos solo 18 fueron elegibles según los criterios de inclusión. Conclusiones: Son múltiples los posibles factores sistémicos asociados con HMI, entre ellos resaltan complicaciones en el embarazo como: fiebres altas, hipertensión arterial, diabetes gestacional, procesos infecciosos, uso frecuente de antibióticos y desnutrición, así como parto prematuro, bajo peso al nacer y las enfermedades respiratorias, fiebre y otitis en los primeros años de vida del niño

O estudo da Hipomineralização nos molares e incisivos foi descrito pela primeira vez no ano de 1970, posteriormente no 2001 o termo Hipomineralização Molar Incisivo (HMI) foi sugerido pela Academia Europeia de Odontopediatria (EAPD) para se referir a este como um defeito específico do desenvolvimento do esmalte, já no ano 2003 se padronizaram os critérios de diagnóstico clínico. A HMI é um defeito do esmalte dentário amplamente estudado, no entanto até hoje os fatores de risco ainda não estão totalmente esclarecidos, mas se considera como de origem sistémico e multifatorial. As implicações sistémicas podem acontecer em períodos específicos (pre, peri e pós natal) que se consideram períodos importantes e críticos no desenvolvimento da vida humana. Objetivo: aportar a melhor evidencia científica disponível sobre os fatores sistémicos associados à Hipomineralização Molar Incisivo. Materiais e métodos: foi realizada uma busqueda sistematizada selecionando estudos primários em bases de dados eletrônicas: Pub Med, biblioteca Cochrane e Hinari a través da pergunta PICO. Resultados: 115 estudos foram identificados a través da busqueda eletrônica dos quais unicamente 18 foram elegíveis segundo os critérios de inclusão. Conclusões: São muitos os possíveis fatores sistémicos associados com HMI entre eles destacam complicações na gravidez como: febres altas, hipertensão arterial

The study of Hypomineralization in molars and incisors was described for the first time in the year 1970. Later in 2001, the term Molar Incisor Hypomineralization (MIH) was suggested by the European Academy of Paediatric Dentistry (EAPD) to refer to this as a specific enamel development defect, and in 2003, the clinical diagnostic criteria were standardized. MIH is a widely studied tooth enamel defect; however, to date, the risk factors are not conclusive but, it is considered of systemic and multifactorial origin. The systemic implications can occur in specific periods (pre, peri, and postnatal) considered important and critical periods of the development of human life. Objective: to provide the best available scientific evidence on the systemic factors associated with molar incisor Hypomineralization. Methodology: A systematized search was varied out selecting primary studies in electronic database: Pub Med, Cochrane and Hinari library, through the PICO question. Results: 115 studied were identified through the electronic search. Of these, only 18 were found eligible according to the inclusion criteria. Conclusions: There are multiple possible systemic factors associated with MIH. Among them, certain complications in pregnancy stand out, such as: Hugh fevers, arterial hypertension, gestational diabetes, infectious processes, frequent use of antibiotics and malnutrition, as well as premature delivery, low birth weight, and respiratory diseases, fever and otitis in the first years of the child's life

Performance of ICDAS e-learning program in teaching graduate students on the detection of occlusal caries / Desempenho do programa de aprendizagem eletrônico ICDAS no ensino de alunos de pós-graduação na detecção de cáries oclusais

ABSTRACT Objective: The aim was evaluate the validity and reproducibility of the International Caries Detection and Assessment System (ICDAS) in detecting occlusal caries among graduate students after training using the e-learning program. Methods: A sample of forty-two primary teeth with different ranges of occlusal caries was selected. All teeth were mounted on a wax support and standardized photographs (EOS Rebel XTI, Canon, NY, USA) of the occlusal surfaces were taken. An experienced researcher randomly selected one specific site on the occlusal surface of each tooth to be examined later. Fifteen graduate students with no previous experience in the ICDAS scores completed the ICDAS e-learning program in Portuguese. After the training, visual examination of the occlusal surfaces was taken twice, independently, with a two-week interval. After visual examination, the teeth were longitudinally sectioned 1mm away from the previously selected occlusal site. The teeth were fixed on a wax support and photographed. Histological analysis was performed from these photographs by an experienced researcher to evaluate the depth of demineralization. Results: The Intraclass Correlation Coefficient (ICC) inter-examiner values among all participants varied from 0.54 to 0.96 and intra-examiner ICC reproducibility of the examiners ranges from 0.61 to 0.85, showing good to excellent reproducibility. For detection of enamel and dentine lesions (D1), ICDAS obtained sensitivity 0.835 and specificity 0.756. For dentine lesions (D3), the method revealed an increase in sensitivity but specificity was similar to D1. Conclusion: ICDAS e-learning training program was efficient for the training of caries lesions detection among graduate students.

RESUMO Objetivo: O objetivo foi avaliar a validade e a reprodutibilidade do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) na detecção de cárie oclusal entre estudantes de pós-graduação após o treinamento usando o programa de e-learning. Métodos: Foi selecionada uma amostra de 42 dentes decíduos com diferentes faixas de cárie oclusal. Todos os dentes foram montados em um suporte de cera e foram tiradas fotografias padronizadas (EOS Rebel XTI, Canon, NY, EUA) das superfícies oclusais. Um pesquisador experiente selecionou aleatoriamente um local específico na superfície oclusal de cada dente para ser examinado posteriormente. Quinze estudantes de pós-graduação sem experiência anterior com o ICDAS concluíram o programa de e-learning em português. Após o treinamento, o exame visual das superfícies oclusais foi realizado duas vezes, independentemente, com intervalo de duas semanas. Após o exame visual, os dentes foram seccionados longitudinalmente a 1mm do local oclusal previamente selecionado. Os dentes foram fixados em um suporte de cera e fotografados. A análise histológica foi realizada a partir dessas fotografias por um pesquisador experiente para avaliar a profundidade da desmineralização. Resultados: Os valores interexaminadores do Coeficiente de Correlação Intraclasse (ICC) entre todos os participantes variaram de 0,54 a 0,96 e a reprodutibilidade intra-examinador do ICC dos examinadores variou de 0,61 a 0,85, mostrando reprodutibilidade boa a excelente. Para detecção de lesões de esmalte e dentina (D1), o ICDAS obteve sensibilidade 0,835 e especificidade 0,756. Para lesões de dentina (D3), o método revelou um aumento na sensibilidade, mas a especificidade foi semelhante ao D1. Conclusão: O programa de treinamento em e-learning do ICDAS foi eficiente no treinamento de detecção de lesões de cárie em estudantes de pós-graduação.

Oximetría de pulso y su eficacia para diagnosticar vitalidad pulpar / Pulse oximetry and its use in diagnosing pulp vitality

Objetivo: Identificar y analizar en la literatura científica reciente el uso de la oximetría de pulso como método diagnóstico de vitalidad pulpar. Metodología: En este trabajo se llevó a cabo una revisión de la literatura en las plataformas de PubMed y Google Académico, en la cual se analizó el uso de la oximetría de pulso en el diagnóstico y monitoreo odontológico del estado pulpar. Resultados: Después de una exhaustiva revisión, y de acuerdo con los criterios de inclusión y exclusión, se analizaron 21 artículos. La mayoría de los trabajos consideran la oximetría de pulso un método alternativo de diagnóstico indoloro, seguro y eficaz; sin embargo, la adaptación de un instrumento de uso exclusivo odontológico es necesaria para una medición exacta de la saturación de oxígeno en la pulpa dental. Los avances tecnológicos en el campo clínico de la odontología nos han llevado a la búsqueda de nuevas técnicas diagnósticas clínicas para mejorar la atención y los tratamientos de los pacientes que acuden día con día a recibir una consulta odontológica. Conclusiones: En los últimos años la oximetría de pulso ha demostrado ser una herramienta de diagnóstico eficaz para el diagnóstico de la vitalidad pulpar. El análisis de los artículos incluidos en esta revisión concluye que la oximetría de pulso es una técnica innovadora que puede ser utilizada como una herramienta diagnóstica adyuvante en el diagnóstico de la vitalidad pulpar (AU)

Objective: To identify and analyze in the recent scientific literature the use of pulse oximetry as a diagnostic method for pulp vitality. Methodology: In this work, a literature review was carried out on the PubMed and Google Scholar platforms in which the use of pulse oximetry in the dental diagnosis and monitoring of pulp status was analyzed. Results: After an exhaustive review and in accordance with the inclusion and exclusion criteria, 21 articles were analyzed. Most of the studies consider pulse oximetry an alternative method of painless, safe and effective diagnosis, however, the adaptation of an instrument for exclusive dental use is necessary for an exact measurement of the oxygen saturation in the dental pulp. Technological advances in the clinical field of dentistry have led us to search for new clinical diagnostic techniques to improve the care and treatment of patients who come every day to receive a dental consultation. Conclusions: In recent years, pulse oximetry has proven to be an effective diagnostic tool for the diagnosis of pulp vitality. The analysis of the articles included in this review concludes that pulse oximetry is an innovative technique that can be used as an adjunct diagnostic tool in the diagnosis of pulp vitality (AU)

Repercusiones oculares del Síndrome de Alport: A propósito de dos casos / Alport syndrome. Report of two cases

Alport syndrome is an inherited progressive form of glomerular disease that is often associated with sensorineural hearing loss and ocular abnormalities. We report two men with Alport syndrome. Both had chronic kidney disease and consulted for long-term loss of visual acuity. One had auditory abnormalities. On the ophthalmological examination, both had anterior lenticonus and one had dot or fleck retinopathy. Those findings are described in up to 50% and 70% of men with X-linked Alport syndrome, respectively. Both patients had a family history of Alport syndrome or suggestive signs and symptoms.

Demarcated opacity in primary teeth increases the prevalence of molar incisor hypomineralization

Abstract This cross-sectional study aimed to assess the prevalence of molar incisor hypomineralization (MIH) and its relationship with the number of primary teeth with developmental defects of enamel (DDE). A representative population-based sample of 731 schoolchildren was randomly selected from the public school system in Curitiba, Brazil. Schoolchildren aged 8 years with fully erupted permanent first molars and incisors were eligible for the study. MIH and DDE were classified by four calibrated examiners (kappa > 0.75) according to EAPD criteria and to the FDI-modified DDE index. Clinical data were collected in a school environment. Socioeconomic information was collected through a self-administered semistructured questionnaire applied to the children's caregivers. Statistical analyses were carried out using Poisson multiple regression with robust variance (α = 0.05). MIH prevalence was 12.1% (95%CI: 10-15), and opacities were the most prevalent defect. Socioeconomic factors were not associated with MIH. Children with demarcated opacity in primary teeth presented a higher prevalence of MIH than those without DDE in primary teeth. In the multiple analysis, the increase of one primary tooth affected by demarcated opacity increased the prevalence of MIH by 33% (PR = 1.33, 95%CI: 1.15-1.53, p < 0.001). Asian children had a higher prevalence of MIH (PR = 2.91, 95%CI: 1.08-8.09 p = 0.035) than did Caucasian children.Conclusion: Based on these findings, the prevalence of MIH in Curitiba was 12.1%. Demarcated opacity in primary teeth could be considered a predictor of MIH.