Bioseguridad en la atención odontológica a partir de la pandemia COVID-19: un análisis global de las nuevas medidas / Biosecurity in dental care for the COVID-19 pandemic: a global analysis of the new measures

Luego del brote de COVID-19 en el mundo, en medio de una crisis sanitaria, la odontología como profesión de alto nivel de riesgo de contaminación se plantea un reto, para la restructuración de sus procedimientos. Al respecto, se han revisado diferentes enfoques de las guías internacionales con diferentes realidades y experiencias en el campo, llegando a recomendaciones para el diseño y uso del óptimo equipo de protección personal (EPP) en tiempos de escasez, minimizando los riesgos de contaminación. Sin embargo, la mayor parte de estas no están apoyadas con evidencia científica odontológica, mientras que se van desarrollando nuevos dispositivos, minimizando la exposición a procedimientos generadores de aerosoles (PGA) como barreras físicas.

After the outbreak of COVID-19 in the world, during a health crisis, dentistry as a profession with a high level of risk of contamination poses a challenge, for the restructuring of its procedures. In this regard, different approaches to international guidelines have been reviewed with diverse realities and experiences in the field, reaching recommendations for the design and use of optimal personal protective equipment (PPE) in times of scarcity, minimizing the risks of contamination. However, most of these are not supported by dental scientific evidence, while new devices are being developed, minimizing exposure to aerosol-generating procedures (PGA) as physical barriers.

Therapeutic Effect of Sodium Hyaluronate and Corticosteroid Injections on Pain and Temporomandibular Joint Dysfunction: A Quasi-experimental Study.

AIM: The aim was to evaluate and compare the therapeutic effect of sodium hyaluronate (SH) and corticosteroids (CS) on pain and temporomandibular dysfunction (TMD). MATERIALS AND METHODS: Thirty patients with TMD [characterized by painful symptoms, affectations, and limitations of the mandibular movement and noises or clicks in the temporomandibular joint (TMJ)] were selected and divided into two equal groups nonrandomized. The clinical questionnaire was applied to each patient before performing the clinical procedures and included a visual analog scale with progressive values from 0 to 10 for the measurement of pain and clinical examination: maximum oral aperture (MOA), mandibular laterotrusive movement (MLM), and maximum protrusion (MP), before and after infiltration intra-articular with SH and CS up to 2 months. RESULTS: Both groups described benefits from treatment at the 1st and 2nd weeks, and at 1 and 2 months of follow-up, presenting a reduction in TMJ pain, and improvement in mandibular mobility with an increase of the MOA, lateralities, and protrusion. No statistically significant difference was found among these variables between the two drugs. However, SH showed a greater therapeutic effect in relation to a reduction in joint noises compared to CS. CONCLUSION: Intra-articular infiltration with SH and CS in TMD is effective for the relief of TMJ pain and also reduces joint noises and improves mandibular mobility. Both drugs can be used with similar optimal results in the treatment of TMD. CLINICAL SIGNIFICANCE: This research allows to know what is the therapeutic impact of injectable CS on the TMJ.

Development of New Experimental Dentifrice of Peruvian Solanum tuberosum (Tocosh) Fermented by Water Stress: Antibacterial and Cytotoxic Activity.

AIM: "Tocosh" is a potato that has undergone a process of hydraulic oxidation that enhances its antimicrobial properties so that this natural resource can be used in medical sciences. The aim of this study was to develop and evaluate the antibacterial and cytotoxic activity of a new experimental tooth based on Solanum tuberosum "Tocosh" on the cell lines 3T3 and DU145. MATERIALS AND METHODS: To evaluate the cytotoxicity, cell cultures 3T3 and DU145 were used. Cell viability was determined by the MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) in a medium containing 10% calf serum where the cells were preincubated at a concentration of 1 × 106 cells/mL in culture medium for 3 hours at 37°C and 6.5% CO2. Then, the absorbance was measured using a microplate reader where the formazan crystals were diluted with acidic and cold isopropanol, and quantified in an ELISA reader. To evaluate the antibacterial effect, the Kirby Bauer inhibition halos method was used on strains of S. aureus (ATCC 25923), S. mutans (ATCC 25175), and S. mitis (ATCC 49456). RESULTS: Solanum tuberosum (tocosh) was not cytotoxic because it only had one CC50 at the concentration of 0.26927 mg/mL and 0.26845 mg/mL for the cell lines 3T3 and DU145, respectively. Tocosh toothpaste (TD) has an antibacterial effect against S. aureus and S. mutans. CONCLUSION: The new ecological dentifrice was not cytotoxic since it did not alter cell viability because its CC50 was only 0.268 and 0.269 µg/mL for the 3T3 and DU145 cell lines, respectively; however, it presented an optimal antimicrobial activity against the oral strains evaluated. CLINICAL SIGNIFICANCE: This research has great potential for clinical use because this new dentifrice has antimicrobial activity against different oral germs. How to cite this article: Mayta-Tovalino F, Sedano-Balbin G, Romero-Tapia P, et al. Development of New Experimental Dentifrice of Peruvian Solanum tuberosum (Tocosh) Fermented by Water Stress: Antibacterial and Cytotoxic Activity. J Contemp Dent Pract 2019;20(10):1206-1211.

Tensile Strength of Novel Nonabsorbable PTFE (Teflon®) versus Other Suture Materials: An In Vitro Study.

OBJECTIVE: To compare the in vitro tensile strength of sutures used in implant surgery according to the type of thread and the immersion time in artificial saliva. METHODS: For the development of the study, three suture materials were used: polyglactin 910 (PG), black silk (BS), and Teflon (PTFE) 4-0; 150 samples were used, which were divided among each type of suture and then subdivided into five groups of 10 according to the various immersion times (baseline, 3, 7, 14, and 21 days) in artificial saliva. A universal test machine was used to measure the tensile strength at a speed of 25 cm/min, stretch each sample until the material fails, and record the maximum strength in Newtons (N). Finally, the failure point of the samples was evaluated at 10× increase using a stereromicroscope (Leica Biosystems). RESULTS: When analyzing the tensile strength of the various groups of sutures, it was evidenced that PG maintained its strength, which was lowest at baseline and highest at 21 days. When performing the statistical inference of PG and PTFE, it was found that the force necessary to achieve detachment was not statistically significant (p < 0.05). However, it was shown that the force necessary to achieve rupture in the BS group was statistically significant (p=0.001). CONCLUSION: To sum up, when comparing the in vitro tensile strength of PG, BS, and PTFE sutures at baseline and 3, 7, 14, and 21 days, there was no statistically significant difference. This indicates that all sutures used present sufficient performance that remains resistant as time progresses.

Oral Epidemiological Profile and Risk Factors in Adolescents with Different Degrees of Down Syndrome in a Vulnerable Peruvian Rural Population.

AIM: The aim of this study is to assess the epidemiological profile of 12- to 16-year-old adolescents with Down syndrome in the Special Basic Education Center in Lima-Peru. MATERIALS AND METHODS: A cross-sectional descriptive study was performed, where the epidemiological profile was determined through the DMF-T index, oral hygiene index (OHI), and the gingival index from Silness and Löe. A sample of 107 adolescents with Down syndrome in a Peruvian rural population were considered who were evaluated with the formula of proportion estimation, of which 48 (44.8%) were females and 55 (59%) males. RESULTS: Patients with mild to moderate Down syndrome were with a caries prevalence of 42 and 27.1%, respectively. Likewise, class III malocclusion was present in 42.9 and 25.2%. The most prevalent OHI was the regular category with 66.2%. RESULTS: Patients with mild to moderate Down syndrome were with a caries prevalence of 42 and 27.1%, respectively. Likewise, class III malocclusion was present in 42.9 and 25.2%. The most prevalent OHI was the regular category with 66.2%. CONCLUSION: It was evident in mild Down syndrome adolescents, a higher prevalence of the indexes: dental caries, malocclusion, periodontal disease, and oral hygiene, moderate to severe.

An 11-Year Retrospective Research Study of the Predictive Factors of Peri-Implantitis and Implant Failure: Analytic-Multicentric Study of 1279 Implants in Peru.

AIM: To analyze the risk factors by logistic regression and perform the analysis of the survival rate of osseointegrated dental implants placed in public and private institutions. METHODS: An analytic-multicentric study was carried out, where 1279 dental implants that were placed by specialists from January 2006 to October 2017 in public and private institutions (UPCH-SI, HCFAP, CMNAVAL, UPCH-SM, and UPSJB) were evaluated. The variables sex (X1), location (X2), hypertension (X3), antibiotic prophylaxis (X4), diabetes (X5), osteoporosis (X6), bisphosphonates (X7), history of periodontitis (X8), hypercholesterolemia (X9), bone quality (X10), bone quantity (X11), design (X12), smoker (X13), connection (X14), edentulism type (X15), staging (X16), 3D guided surgery (X17), load (X18), bone graft (X19), peri-implantitis (X20), mucositis (X21), and GBR (X22) were collected and analyzed by the Kaplan-Meier survival analysis. The logit analysis was performed among all the variables to choose the best statistical model that explains the true risk factors. The analysis was performed by multivariate logistic regression and the Kaplan-Meier test, at a level of statistical significance of p < 0.05. RESULTS: It was found that the failure rate of the 1279 implants evaluated was 17.98% corresponding to only 23 implants lost as they have good longevity over time. When establishing the best multivariate logistic regression model, it was found that the variables that remained stable in relation to their statistically significant value and more stable confidence intervals were age, osteoporosis, bisphosphonates, history of periodontitis, bone quality, bone graft, connection, number of implants, GBR (guided bone regeneration), and follow-up. CONCLUSIONS: Dental implants placed by specialists in public and private institutions had a failure rate similar to that in studies previously published in other countries.

Hiperplasia condilar, un enfoque actual del diagnóstico y tratamiento. Revisión de la literatura / Condylar hyperplasia, approach to diagnosis and treatment. Review of the literature

La Hiperplasia condilar (HC) fue descrita inicialmente por Robert Adams en 1836. Esta patología mandibular presenta varios tipos que afectan el tamaño y la morfología ósea, alteran la oclusión y las estructuras dentolabiales, afectan indirectamente al maxilar superior, dando como resultado patrones faciales que se pueden caracterizar por: prognatismo mandibular, aumento unilateral del cóndilo, el cuello, la rama y el cuerpo, asimetría facial, disfunción de la articulación temporomandibular, desequilibrio neuromuscular y patología dolorosa miofacial. Esta condición de la HC, hace que requiera de un trata-miento multidisciplinario, que según su severidad, compete a cirujanos bucomaxilofaciales, ortodoncistas, fisioterapeutas y cirujanos plásticos. El diagnóstico de la HC se basa en la anamnesis, el examen clínico y la evaluación imagenológica, consistente en radiografías panorámica cefalométrica, tomografía macizo facial (TEM-CBCT), gammagrafía ósea y en algunos casos estudio anátomo-patológico. El propósito de esta revisión es conocer de manera detallada el comportamiento y pronóstico de esta patología de acuerdo al tipo, con la finalidad de facilitar el diagnóstico y las opciones terapéuticas, según la severidad, la edad del paciente y la patología en su forma activa o inactiva. Palabras clave: Asimetría facial; Cóndilo mandibular; Prognatismo; Anomalías maxilo-faciales; Tomografía; Cirugía ortognática.

Condylar hyperplasia (HC) was first described by Robert Adams in 1836. This mandibular pathology presents several types that affect bone size and morphology, alter occlusion and dentolabial structures, indirectly affect the maxilla, resulting in facial patterns that can be characterized by: mandibular prognathism, unilateral increase of the condyle, neck, branch and body, facial asymmetry, temporomandibular joint dysfunction, neuro-muscular imbalance and myofacial pain pathology. This condition of the HC, requires a multidisciplinary treatment, which according to its severity, is the responsibility of oral and maxillofacial surgeons, orthodontists, physiotherapists, plastic surgeons. The diagnosis of HC is based on the anamnesis, the clinical examination and the imaging evaluation, consisting of panoramic cephalometric radiographs, macizo-facial tomography (TEM-CBCT), bone scintigraphy and in some cases anatomo-pathological study. The purpose of this review is to know in detail the behavior and prognosis of this pathology according to the type, in order to facilitate diagnosis and therapeutic options, according to the severity, the age of the patient and the pathology in its active form or inactive. Keywords: Facial asymmetry; Mandibular condyle; Prognathism; Maxillofacial abnormalities; Tomography; Orthognathic surgery.

Remineralizing Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate and Sodium Fluoride on Artificial Tooth Enamel Erosion: An In Vitro Study.

AIM: To compare in vitro the remineralizing effect of toothpastes with casein phosphopeptide-amorphous calcium phosphate (FPC-FCA) and sodium fluoride on the artificial erosion of tooth enamel. MATERIALS AND METHODS: For the first phase of artificial erosion, group I was considered as the control group without treatment or erosion. For groups II and IV, the drink was used (Coca-Cola®), for groups III and V, the drink (Inca-Kola®), and the four groups were demineralized four times a day (every 3 hours for 2 minutes) for 5 days. In the treatment phase in groups II and III, brushing was performed with sodium fluoride paste (Colgate®), groups IV and V received brushing with FPC-FCA complex (MiPaste®), and for all groups, the same procedure was performed four times a day (every 3 hours for 5 minutes) for 90 days. At the end, the microroughness of the surfaces of all the groups was evaluated by means of a Rugosimeter (Mitutoyo). RESULTS: It was evidenced that the group of sodium fluoride presented a microroughness of 2.79 µm being the group of least remineralization, but the FPC-FCA complex showed a microroughness of 1.96 µm; however, the control group presented a microroughness of 3.20 µm, and the groups sodium fluoride, FPC-FCA compared to the control group proved to be statistically significant with a p < 0.05. CONCLUSION: The remineralizing effect of FPC-FCA (MiPaste®) complex proved to be greater than sodium fluoride paste (Colgate®) under artificial enamel erosive conditions. CLINICAL IMPORTANCE: The results of this research serve as a basis for industries to generate products that have the potential for remineralization against various erosive beverages that are consumed daily. How to cite this article: Pirca K, Balbín-Sedano G, Romero-Tapia P, et al. Remineralizing Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate and Sodium Fluoride on Artificial Tooth Enamel Erosion: An In Vitro Study. J Contemp Dent Pract 2019;20(11):1254-1259.