ABSTRACT
New paradigms in caries conceptualization have emerged during the last decades, leading to intense debate and discussion on how to approach the disease, both from a preventive and a therapeutic perspective. Among many new ideas, research discoveries and technologies, one major concept can be highlighted that created a deep frontier between the old and the new paradigm in caries conceptualization; the non-communicable nature of the disease, firmly associated with behaviors and lifestyles. This article synthetizes the conceptual construction of dental caries as a non-communicable disease (NCD) based on the current evidence and discusses the appropriate management of the disease in this context. Dental caries has shifted from being considered transmissible and infectious to an ecological and non-communicable disease. Environmental factors such as frequent sugars intake, disrupt the symbiosis of the dental biofilm leading to a dysbiosis, which favors caries lesion initiation and progression. As an NCD, dental caries shares characteristics with other NCDs such as cardiovascular and chronic respiratory diseases, cancer and diabetes, including long duration and slow progression, not being transmissible from person-to-person, being strongly related to modifiable behavioral risk factors, and affecting preferentially disadvantaged populations with a strong inequality gradient. Given the high prevalence of dental caries, and its consequences on people's health and quality of life, a recognizable conceptual view of caries as a NCD is required to target an effective management. Current understanding of dental caries supports prevention through acting on the modifiable risk factors (behaviors) and involves management based on an interdisciplinary approach. Communicating these modern concepts among researchers, clinicians and policymakers is needed to decrease the global high burden of the disease.
ABSTRACT
Several factors associated with graft preparation for the surgery of the anterior cruciate ligament (ACL) like the wrong thawed, prophylaxis, bone cuts, excessive bone removal as well as positioning problems like a tunnels-graft mismatch, insufficient harvesting of the donor's tendon, size graft limitations (length and diameter), uncontrolled rotation of graft in their longitudinal axis, over or under tensioned graft, fixation mistakes, bone defects, secondary arthrofibrosis or morbidity of the donor site, and others factors importantly affect the outcomes of the ACL surgery. In this sense, the Achilles tendon Allograft is an advantageous technique where many of the previous limitation factors described can be controlled during an appropriate preparation. However, to obtain the maximum potentialities of the graft a detailed knowledge of the preparation is required. Hence, we aimed to describe how to prepare the Achilles tendon Allograft to control the graft's length and diameter, bone removal, and fixation requirements.
ABSTRACT
RESUMEN: El manejo terapéutico de lesiones de caries primarias y secundarias concentra gran parte del quehacer de los dentistas en el mundo. Recientes cambios en la concepción de la enfermedad de caries llevaron a un panel de expertos de la Organización Europea para la Investigación en Caries (ORCA), la Federación Europea de Odontología Conservadora (EFCD) y la Federación Alemana de Odontología Conservadora (DGZ) a analizar la evidencia y consensuar recomendaciones sobre manejo de caries en adultos. Mediante una reunión en Berlín, Alemania en 2019 y con metodología e-Delphi, los expertos analizaron la evidencia y propusieron recomendaciones clínicas. El propósito de este artículo es presentar una adaptación idiomática de las principales recomendaciones, que incluyen terapias no invasivas (higiene, uso de fluoruros y control de dieta), terapias microinvasiva (sellantes e infiltrantes), terapias necesariamente invasivas y la reparación de restauraciones. Todas las recomendaciones se basan en un enfoque mínimamente invasivo, con un adecuado manejo restaurador. Los dentistas de países hispanoparlantes podrán encontrar recomendaciones basadas en evidencia, provenientes de un consenso de expertos a nivel global, que orienten sus decisiones clínicas, apoyándose en los principios de la odontología de mínima intervención.
ABSTRACT: Therapeutic management of primary and secondary caries lesions concentrates much of the work of dentists throughout the world. Recent changes in caries disease conception and therapeutic management led a panel of experts from the European Organisation for Caries Research (ORCA), the European Federation for Conservative Dentistry (EFCD) and the German Federation for Conservative Dentistry (DGZ) to analyze the evidence and reach consensus on recommendations for caries management in adults. Through a meeting held in Berlin, Germany in 2019 and using an e-Delphi methodology, the experts analyzed the evidence and proposed clinical recommendations. The purpose of this article is to present an idiomatic adaptation to Spanish of the main recommendations, which include non-invasive therapies (hygiene, use of fluoride and diet control), microinvasive therapies (sealants and infiltrants), invasive therapies and repair of restorations. All recommendations are based on a minimally invasive dentistry approach, with a technically adequate restorative management. Spanish-speaking dentists may use these consensus recommendations to guide their clinical decisions, based on the most recent evidence and experts opinions, under the principles of minimal intervention dentistry.
Subject(s)
Humans , Dental Care/methods , Dental Caries/therapy , Consensus , Dental Caries/diagnosisABSTRACT
En la actualidad la obesidad es considerada como una pandemia, además de los cambios metabólicos ya sabidos, se producen alteraciones estructurales como las generadas en el sistema ventilatorio. Sin embargo, se ha observado que dependiendo de la forma de categorización de esta condición, puede o no existir alteración sobre este sistema generando así una complicación al momento de la elección de esta herramienta. Por lo tanto el objetivo de esta investigación fue comparar parámetros de la función pulmonar en individuos obesos (O) y normo-peso (Np) según índice de masa corporal (IMC) y porcentaje de grasa corporal (PGC). Se midió la función ventilatoria en 57 participantes, posteriormente estas variables se contrastaron entre los sujetos normo-peso (Np) y obesos (O) según IMC y PGC. Se observó un aumento significativo en el valor de la capacidad inspiratoria (CI) de O versus Np y del volumen de reserva espiratoria (VRE) y capacidad residual funcional (CRF) de Np en relación a O, tanto para la división por IMC como por PGC, en el grupo dividido por IMC las variables de resistencia especifica de las vías aéreas (sRaw) y presión inspiratoria máxima (PImáx) fueron significativamente mayor en los participantes O, asimismo, la conductancia específica de las vías aéreas (sGaw) fue significativamente mayor en sujetos Np. En conclusión, el IMC mostró mayor versatilidad como predictor de la función ventilatoria, sin embargo, se necesitan mayores estudios de los efectos mecánicos de este indicador y del PGC sobre las vías aéreas.
Currently, obesity is considered a pandemic, in addition to the known metabolic changes, structural alterations such as those generated in the ventilatory system occur. However, it has been observed that depending on the form of categorization of this condition, there may or may not be alteration on this system, thus generating a complication when choosing this tool. Therefore, the objective of this study was to compare parameters of lung function in obese individuals and normo-weight according to body mass index (BMI) and body fat percentage (BFP). The ventilatory function was measured in 57 participants, later these variables were contrasted between the subjects normal weight (Nw) and obese (O) according to BMI and BFP. A significant increase in the inspiratory capacity (IC) value of O versus Nw was observed and of the expiratory reserve volume (ERV) and functional residual capacity (FRC) of Nw in relation to O, both for the division by BMI and by BFP. In the group divided by BMI, the variables of specific resistance of the airways (sRaw) and maximal inspiratory pressure (MIP) were significantly higher in the participants O. In addition, specific airway conductance (sGaw) was significantly higher in subjects Nw. In conclusion, the BMI showed greater versatility as a predictor of ventilatory function, however, more studies are needed on the mechanical effects of this indicator and the BFP on the airways.
