Morbimortalidad postoperatoria en pacientes infectados con SARS-COV-2 sometidos a apendicetomía urgente en el Hospital Obrero N°1 La Paz ­ Bolivia, 2020 / Postoperative morbimortality in patients infected with SARS-COV-2 undergoing urgent appendectomy at Obrero Hospital N°1 La Paz - Bolivia, 2020

Objetivo: conociendo la frecuencia de pacientes infectados con SARS-CoV-2 sometidos a apendicectomía de urgencia en el Hospital Obrero N°1 en la gestión 2020, el presente estudio busca describir las complicaciones relacionadas a la morbimortalidad postoperatoria en estos pacientes; siendo éstas un reflejo de la repercusión de esta infección en la práctica quirúrgica. Material y métodos: el estudio es descriptivo transversal. Se utilizó la revisión documental como técnica para la recolección de información. Tras revisar la estadística quirúrgica anual se identifican pacientes infectados con SARS-CoV-2 sometidos a apendicectomía urgente, se revisan sus expedientes clínicos digitales recolectando información perioperatoria con énfasis en el postoperatorio. Resultados: 1847 cirugías realizadas en 2020, 18 apendicectomías de urgencia en pacientes infectados con SARS-CoV-2. La mayoría de pacientes se encontraba entre 21 y 40 años, el género masculino fue el más frecuente. 39% de los casos presentaron apendicitis aguda gangrenada y otro 39% apendicitis perforada. 11% presentó peritonitis generalizada. La morbilidad postoperatoria corresponde a 6 pacientes que presentan complicaciones: 5 casos de seroma de herida operatoria, 2 casos de íleo paralítico transitorio, 1 caso de íleo paralítico prolongado y 1 solo caso de neumonía atípica por SARS-CoV-2. No se identificaron casos de mortalidad postoperatoria. Conclusiones: descritas la morbilidad y la ausencia de mortalidad postoperatorias en los pacientes infectados con SARS-CoV-2 que fueron sometidos a apendicetomía de urgencia, se observa que las conductas y prácticas adoptadas, acompañadas de las medidas de seguridad pertinentes fueron seguras para esta población

Objective: knowing the frequency of patients infected with SARS-CoV-2 who underwent emergency appendectomy at Obrero Hospital N°1 in the 2020, this study seeks to describe the complications related to postoperative morbidity and mortality in these patients; these being a reflection of the repercussion of this infection in surgical practice. Material and methods: the study is descriptive crosssectional. Documentary review was used as a technique for collecting information. After reviewing the annual surgical statistics, patients infected with SARS-CoV-2 undergoing emergency appendectomy are identified, their digital clinical records are reviewed, collecting perioperative information with emphasis on the postoperative period. Results: 1847 surgeries performed in 2020, 18 emergency appendectomies in patients infected with SARSCoV-2. Most of the patients were between 21 and 40 years old, the male gender was the most frequent. 39% of the cases presented acute gangrenous appendicitis and another 39% perforated appendicitis. 11% presented generalized peritonitis. Postoperative morbidity corresponds to 6 patients presenting complications: 5 cases of surgical wound seroma, 2 cases of transient paralytic ileus, 1 case of prolonged paralytic ileus, and only 1 case of atypical pneumonia due to SARS-CoV-2. No cases of postoperative mortality were identified. Conclusions: after describing the postoperative morbidity and absence of mortality in patients infected with SARS-CoV-2 who underwent emergency appendectomy, it is observed that the behaviors and practices adopted, accompanied by the relevant security measures, were safe for this population

Canting of the occlusal plane: Perceptions of dental professionals and laypersons

Objectives: To determine if canting of the occlusal plane influences esthetic evaluation of the smile among orthodontists, dentists and laypersons. Study Design: A frontal photo of a smile with 0º occlusal plane canting in relation to the bipupillary plane was modified using Adobe Photoshop C3 (Adobe Systems Inc, San José, California) to generate two images with occlusal plane inclinations of 2º and 4º. The three images were evaluated esthetically by orthodontists (n=40) general dentists (n=40) and laypersons (n=40). Each image was awarded a score as follows: 1=esthetically acceptable;2=moderately acceptable; 3=esthetically unacceptable. Evaluators also placed the three images in order in preference. Data were analyzed using the Kruskal-Wallis (p<0.05) and the Mann-Whitney tests, applying the Bonferroni Correction (p<0.016).Results: No significant differences (p> 0.05) were found between the three groups for 0º and 2º cants (median for orthodontists=1; general dentists=1; laypersons=1). Orthodontists (median score=3) made evaluations of the image with 4º occlusal plane that were significantly different from general dentists (median=2) and laypersons(median=2). All three groups put the 0º image in first place in order of esthetic acceptability, the 2º image in second place and the 4º image in third place. Orthodontists placed the 0º image in first place with significantly greater frequency (p<0.016) than laypersons. Conclusions: Occlusal plane canting of 0º and 2º were evaluated as esthetically acceptable by the three groups. The 4º occlusal plane cant was evaluated more negatively by orthodontists than by general dentists and laypersons. All three groups placed the 0º image in first place of esthetic acceptability, 2º in second place and 4º in third. Orthodontists put the 0º image in first place with significantly greater frequency than laypersons (AU)

Canting of the occlusal plane: perceptions of dental professionals and laypersons.

OBJECTIVES: To determine if canting of the occlusal plane influences esthetic evaluation of the smile among orthodontists, dentists and laypersons. STUDY DESIGN: A frontal photo of a smile with 0 occlusal plane canting in relation to the bipupillary plane was modified using Adobe Photoshop C3 (Adobe Systems Inc, San José, California) to generate two images with occlusal plane inclinations of 2 and 4 . The three images were evaluated esthetically by orthodontists (n=40) general dentists (n=40) and laypersons (n=40). Each image was awarded a score as follows: 1=esthetically acceptable; 2=moderately acceptable; 3=esthetically unacceptable. Evaluators also placed the three images in order in preference. Data were analyzed using the Kruskal-Wallis (p<0.05) and the Mann-Whitney tests, applying the Bonferroni Correction (p<0.016). RESULTS: No significant differences (p> 0.05) were found between the three groups for 0 and 2 cants (median for orthodontists=1; general dentists=1; laypersons=1). Orthodontists (median score=3) made evaluations of the image with 4 occlusal plane that were significantly different from general dentists (median=2) and laypersons (median=2). All three groups put the 0 image in first place in order of esthetic acceptability, the 2 image in second place and the 4 image in third place. Orthodontists placed the 0 image in first place with significantly greater frequency (p<0.016) than laypersons. CONCLUSIONS: Occlusal plane canting of 0 and 2 were evaluated as esthetically acceptable by the three groups. The 4 occlusal plane cant was evaluated more negatively by orthodontists than by general dentists and laypersons. All three groups placed the 0 image in first place of esthetic acceptability, 2 in second place and 4 in third. Orthodontists put the 0 image in first place with significantly greater frequency than laypersons.

Third molar agenesis and craniofacial morphology.

OBJECTIVE: To test the null hypothesis that agenesis of wisdom teeth is not related with any particular craniofacial morphology. MATERIALS AND METHODS: Ninety-seven patients (aged 13-19 years) were selected and divided into three groups: (1) bilateral agenesis of maxillary third molars, (2) bilateral agenesis of mandibular third molars, and (3) control group without agenesis. Presence or absence of third molars was determined using ortopantomographs. Cephalometric analysis was carried out from lateral teleradiographs, which included linear, angular, and proportional measurements. When data obtained were distributed normally it was analyzed by means of single-factor variance analysis and the Scheffé test (P < .05). When data did not show normality, the Kruskal-Wallis test (P < .05) and the Mann-Whitney test were applied using Bonferroni correction (P < .017). Multivariance discrimination analysis was also carried out. RESULTS: Values obtained for the mandibular plain of Groups 1 and 2 were significantly lower than those of the Control Group (P =.00 and P =.00, respectively). For Group 2 lower face height was significantly less than for the control group (P =.01), whilst the mandibular arch and the articular angle were significantly greater than in the Control Group (P =.000 and P = .02, respectively). Multivariance discrimination analysis obtained a correct classification in 58.8% of cases. CONCLUSION: The hypothesis is rejected. Agenesis of the maxillary third molars was related to a reduced mandibular plane angle. Patients with agenesis of the mandibular third molars showed a diminished lower third and a mandibular morphology characteristic of the brachyfacial pattern.

Water and saliva contamination effect on shear bond strength of brackets bonded with a moisture-tolerant light cure system.

OBJECTIVE: To evaluate the effects of water and saliva contamination on shear bond strength of brackets bonded with a moisture-tolerant light cure system. MATERIALS AND METHODS: Brackets were bonded to 240 bovine lower incisors divided into 12 groups. Four bonding procedures were evaluated, including (1) TSEP/Transbond XT, (2) TMIP/ Transbond XT, (3) TSEP/Transbond PLUS, and (4) TMIP/Transbond PLUS, each under three different bonding conditions: without contamination, with water contamination, and with saliva contamination. Shear bond strength was measured with a universal testing machine. The adhesive remnant on the teeth was quantified with the use of image analyzing equipment. RESULTS: Without contamination, bond strengths for the four procedures were similar (P > .05). TSEP/Tranbond PLUS and TMIP/Transbond PLUS left significantly less adhesive on the teeth after debonding than TSEP/Transbond XT and TMIP/Transbond XT (P < .008). Bond strength and adhesive remaining for TMIP/Transbond XT contaminated with water or saliva showed significantly worse performance than the other procedures evaluated (P < .008). Contamination (with water or saliva) did not affect either bond strength or adhesive remaining on the teeth for TSEP/ Transbond XT, TSEP/Transbond PLUS, or TMIP/Transbond PLUS (P > .017), although for TMIP/ Transbond XT, both variables showed significant reductions after contamination (P < .017). CONCLUSION: TSEP/Transbond PLUS, TMIP/Transbond PLUS, and TSEP/Transbond XT showed greater tolerance to wet conditions than was shown by TMIP/Transbond XT.

Shear bond strength of precoated and uncoated brackets using a self-etching primer.

OBJECTIVE: To test the hypothesis that there are no significant differences in the shear bond strength or the adhesive remaining on the tooth after debonding between precoated and uncoated brackets using a self-etching primer. MATERIALS AND METHODS: APC Plus precoated brackets and uncoated brackets were bonded with Transbond XT adhesive using the self-etching primer Transbond Plus Self-Etching Primer (TPSEP). The brackets were bonded to extracted human premolars and categorized into two groups: (1) TPSEP/Transbond XT and (2) TPSEP/APC Plus. Shear bond strength was measured with a universal testing machine. The adhesive remnant on each tooth after debonding was quantified with image analysis equipment. Scanning electron microscope (SEM) observations of enamel surfaces treated with TPSEP were also carried out. RESULTS: No significant differences were observed in the shear bond strengths for the two groups evaluated (P < .05). TPSEP/APC Plus left significantly less adhesive on the tooth after debonding than did TPSEP/Transbond XT (P < .05). It was observed that SEM left a porous and potentially retentive surface. CONCLUSIONS: There was no significant difference in the bond strength of the two systems tested, but there was a significant difference in the percentage of area of adhesive remaining on the tooth.

Effect of saliva contamiination on the shear bond strength of orthodontic brackets bonded with a self-etching primer.

This study evaluates the effect of saliva contamination at different stages of the bonding brackets procedure using the self-etching primer Adper Prompt L-Pop (3M ESPE, Minneapolis, Minn) and the resin orthodontic adhesive system Transbond XT (3M). A total of 70 brackets were bonded to human extracted premolars, which were divided into four groups: group 1, uncontaminated (control); group 2, saliva application before priming; group 3, saliva application after priming; and group 4, saliva application before and after priming. Shear bond strength was measured with a universal test machine. The adhesive remnant on the tooth after debonding was determined using image analysis equipment. Significant differences were only observed between group 1 (12.42 +/- 3.27) and groups 2 (9.93 +/- 4.50) and 4 (9.59 +/- 2.92) (P < .05). Concerning the adhesive remnant, no significant differences were found between the groups evaluated (P > .05).

Influence of a nonrinse conditioner on the bond strength of brackets bonded with a resin adhesive system.

The objective of this study was to compare the effect of a nonrinse conditioner (NRC) and the conventional acid-etch technique on the shear bond strength and the adhesive remnant on the tooth after debonding brackets bonded with the resin orthodontic adhesive system Transbond XT. A total of 40 human premolars were divided into group I, phosphoric Acid/Transbond XT (n = 25) and group II, NRC/ Transbond XT (n = 15). Shear bond strength was measured with a universal test machine with a crosshead speed of 1 mm/min. The adhesive remnant was quantified using image analysis equipment. Scanning electron microscope (SEM) observations were also carried out to observe enamel surfaces treated with each product. No significant differences were observed in the bond strengths of the two groups evaluated. The amount of adhesive remnant on the tooth after debonding was significantly less when conditioning the enamel with NRC compared with phosphoric acid. SEM observations showed that the NRC produced a more conservative etch pattern than phosphoric acid.