La significancia estadística y la relevancia clínica en la odontología

Dentists face very important clinical decisions in their daily dental practice, which is why they permanently require scientific support to support them, clearly for the benefit of patients. However, sometimes, in the scientific literature, results with statistically significant differences are found, which causes clinicians to have to opt for a particular treatment alternative; but it turns out that it could be a significant difference that is not clinically relevant, and this raises the question of what decision to make.Los odontólogos se enfrentan a decisiones clínicas muy importantes en su práctica dental diaria, por lo que permanentemente requieren de sustento científico que las respalde, claramente en beneficio de los pacientes. Sin embargo, algunas veces, en la literatura científica se encuentran resultados con diferencias estadísticamente significativas, lo que ocasiona que los clínicos deban optar por alguna alternativa de tratamiento en particular; pero resulta que podría tratarse de una diferencia significativa que clínicamente no sea relevante, y esto hace que surja en el profesional la interrogante de qué decisión tomar

Estudo longitudinal retrospectivo sobre a reabsorção radicular de incisivos maxilares após a tração de caninos impactados com molas

Introdução: O tratamento de caninos superiores impactados (CSI) deveria ser realizado visando sua manutenção, permitindo o desenvolvimento adequado da bossa canina. Entretanto, a reabsorção radicular, como um efeito colateral do tratamento ortodôntico, pode ser maior nessa situação. Os objetivos desse trabalho foram: 1. Comparar a reabsorção radicular de incisivos superiores após tração ortodôntica unilateral e bilateral de CSI com molas helicoidais; 2. Determinar a influência da complexidade do tratamento de tração do CSI na reabsorção radicular de incisivos superiores; e 3. Avaliar, por meio de sobreposição volumétrica, a reabsorção radicular de incisivos superiores, antes e após a tração de CSI bicorticalmente. Metodologia: Foi realizado um estudo longitudinal e retrospectivo, com amostra constituída de 60 exames de tomografia computadorizada de feixe cônico (TCFC) de pacientes com CSI, 30 antes e 30 depois da tração dos caninos com molas helicoidais. Para o primeiro objetivo, os exames foram divididos em dois grupos, 15 com impacção unilateral e 15 bilateral. Para o segundo objetivo, foram formados dois grupos, de acordo com a complexidade do tratamento ortodôntico, sendo 20 casos não- complexos e 25 complexos. Foram obtidos história clínica, modelos de estudo e radiografias para cada paciente. Um ortodontista treinado e calibrado realizou as mensurações. Variáveis demográficas, características oclusais, padrão esquelético e medidas relacionadas aos CSI foram obtidas tridimensionalmente. Para o terceiro objetivo, foram selecionados três casos em que foram avaliados as raízes dos incisivos superiores por meio da sobreposição volumétrica tridimensional usando um mapa de cores. Conclusões: Reabsorção radicular de incisivos superiores após tração de CSI com molas helicoidais foi semelhante, independente de condição uni ou bilateral ou complexidade da localização do CSI e principalmente esteve localizado no terço radicular apical.Introduction: Maxillary canine impaction (MIC) treatment should always maintain this tooth and allowing the development of canine eminence. However, the root resorption as a side effect of orthodontic treatment may be increased in this condition. The aims of this thesis were 1. To compare the root resorption of maxillary incisors after traction with coil springs of unilateral versus bilateral MIC. 2. To determine the influence of the complexity of the orthodontic treatment of MIC on the root resorption of incisors. 3. To evaluate, through of volumetric superimposition, the root resorption of maxillary incisors before and after traction of bicortically MIC located in a complex position. Methods: This study was longitudinal and retrospective, the sample included 60 Cone Beam Computed Tomographies (CBCTs) of patients with MIC, 30 before and 30 after traction of canines with coil springs. For the first objective two groups were conformed according to impaction condition, 15 with unilateral and 15 with bilateral MIC. For the second objective also two groups were conformed according to complexity of the orthodontic treatment, 20 non-complex cases and 25 complex cases. For the third objective 5 bicortically MIC were evaluated before and after treatment as a series of three cases. For the three objectives clinical histories, plasters and radiographs were obtained of each patient. A trained and calibrated orthodontist made the measurements. Demographic variables, occlusal characteristics, skeletal pattern and measures related to MIC were measured three-dimensionally; specifically, the root resorption (millimeters and area) in each maxillary incisor and for the third objective a volumetric 3D superimposition was used. Conclusions: Root resorption of maxillary incisors after traction of MIC with coil springs was similar between unilateral or bilateral cases or located in a complex or non-complex position and mainly was located in the radicular apex

La urgencia de vacunación contra la covid-19 en los odontólogos

The requirement of vaccines for the prevention of Covid-19 has become one of the health priorities of different countries worldwide (1, 2). However, most societies still do not have the necessary number of vaccines to cover their entire target population (3, 4). This is especially true in countries that delayed negotiations with the supply companies, and which will, unfortunately, have to wait a long time for the arrival of sufficient quantities to protect their populations. On the other hand, the global vaccination process has established priority levels among its citizens, specifically starting with the so-called first line of action which is health professionals attending to Covid-19 patients, due to the great risk to which they are exposed. Additionally, the health organizations of the different countries have proposed to continue the vaccination process according to different criteria, one being the risk levels of the professions. This criterion is aimed at prioritizing professionals most exposed to contagion, but according to their daily practice, what professionals are really the most exposed to contagion?El requerimiento de vacunas para la prevención del Covid-19 se ha convertido en una de las prioridades sanitarias de diferentes países a nivel mundial. Sin embargo, la mayoría de las sociedades aún no cuentan con el número necesario de vacunas para cubrir a toda su población objetivo. Esto es especialmente cierto en países que retrasaron las negociaciones con las empresas proveedoras y que, lamentablemente, tendrán que esperar mucho tiempo para la llegada de cantidades suficientes para proteger a sus poblaciones. Por otra parte, el proceso mundial de vacunación ha establecido niveles de prioridad entre sus ciudadanos, concretamente comenzando por la denominada primera línea de actuación que son los profesionales sanitarios que atienden a los pacientes de Covid-19, por el gran riesgo al que están expuestos. Adicionalmente, las organizaciones de salud de los diferentes países han propuesto continuar con el proceso de vacunación de acuerdo a diferentes criterios, uno de ellos es el nivel de riesgo de las profesiones. Este criterio está dirigido a priorizar a los profesionales más expuestos al contagio, pero según su práctica diaria, así, ¿cuáles son realmente los profesionales más expuestos al contagio

Reproducibilidad en el diagnóstico de los estados de maduración esquelética según el método de Fishman en radiografías carpales evaluadas por odontólogos entrenados.

Objetivo: Determinar la reproducibilidad en el diagnóstico de los estadios de maduración esquelética según el método de Fishman en radiografías cárpales evaluados por odontólogos entrenados. Metodología: La población de estudio estuvo constituida por evaluaciones del diagnóstico carpal de 34 radiografías cárpales estandarizadas, realizadas por 4 observadores entrenados (3 especialistas en ortodoncia y un estudiante de último ciclo de odontología calibrado). Las mediciones se realizaron en tres momentos establecidos tiempo 1, tiempo 2 (a la semana del tiempo 1), tiempo 3 (al mes del tiempo 1). Haciendo un total de 102 diagnósticos por evaluador y un total de 408 diagnósticos entre los 4 evaluadores. Se evaluaron 10radiografías por día para eliminar el efecto memoria de los observadores hasta terminar con las 34 radiografías. Resultados: Los resultados de la evaluación de la concordancia del diagnóstico de maduración esquelética entre los cuatro operadores en los tres tiempos evaluados, muestran una correlación de Spearman con valores superiores a 0.8, consideradas correlaciones muy buenas. En la evaluación de la concordancia intra operador en los 3 tiempos evaluados se encontró concordancias buenas y moderadas, y en la evaluación de la concordancia inter operador en los 3 tiempos se encontró concordancias buenas, el valor de concordancia intra operador más alto fue 0.800 y la concordancia inter operador más alta fue de 0.507. Conclusiones: La concordancia del diagnóstico en el método de maduración esquelética de Fishman evaluado por cuatro clínicos de odontología un mes después de su primer diagnóstico fue moderada a alta

Effect of pediatric mouthwashes on the color stability of dental restorations with composite resins. In vitro comparative study

To evaluate in vitro the effect of three pediatric mouth rinses on the color stability of three different composite resins. One hundred thirty-two disc-shaped samples (n = 132) were prepared, with 44 for each type of composite resin (n = 44), and the in

Clinical and epidemiological profile of cleft lip and palate patients in Peru, 2006 ? 2019

The purpose of this study was to determine the clinical-epidemiological profile of patients with cleft lip and / or palate in Peru from 2006 to 2019. This retrospective and cross-sectional study analyzed 3,923 patients with cleft lip and palate attende

Evaluación cefalométrica del perfil facial según el análisis de Holdaway en adultos peruanos armónicos

OBJETIVO: Establecer los parámetros de normalidad de los tejidos blandos en una población adulta peruana con características cefalométricas armónicas, según el análisis de Holdaway. METODOLOGÍA: La muestra estuvo conformada por 25 radiografías cefalométricas de pacientes de 20-40 años de edad con perfil facial armónico, de clase I, en los cuales se midió el análisis cefalométrico de Holdaway y se comparó con las normas existentes. RESULTADOS: La mayoría de las medidas lineales y angulares coincidieron con las normas de Holdaway, excepto la prominencia nasal en que la muestra de peruanos presenta una nariz más pequeña(12.34mm ±3.03), el ángulo H presenta una mayor prominencia del labio superior(14.08 ±2.41) y la medida del labio inferior a la línea H muestra una posición labial inferior aumentada (1.44 ±0.95). CONCLUSIÓN: El análisis de Holdaway puede ser aplicado en sujetos peruanos; ya que, los valores en pacientes armónicos no difieren estadísticamente de los valores propuestos en su análisis, excepto en la prominencia nasal, ángulo H y medida del labio inferior a la línea H.  CEPHALOMETRIC EVALUATION OF FACIAL PROFILE IN PERUVIAN ADULTS BY THEHOLDAWAY HARMONIC ANALYSISOBJECTIVE: To establish the parameters of normal soft tissue in a Peruvian population with harmonic cephalometriccharacteristics, according to the cephalometric analysis of soft tissue Holdaway in Peruvian adult patients.SAMPLE: consisted of 25 cephalometric radiographs of patients 20-40 years old with harmonious facial profile, Class I. RESULTS: Most linear and angular measures coincided with the standard Holdaway, except nasal prominence, the angle H and the measurement lower line H. lip Holdaway analysis can be applied in Peruvian subject; because the values in harmonics patients did not differ statistically from the values proposed in its analysis; except in the nasal prominence in the Peruvian sample it has a smaller nose, angle H has a greater prominence of the upper lip and lower lip to the H line shows a lower lip position increased. CONCLUSION: The analysis can be applied Holdaway Peruvian subject; because the values in harmonics patients did not differ statistic ally from the values proposed in its analysis

Reporting Sample Size Calculation in Randomized Clinical Trials Published in 4 Orthodontic Journals

Objective: The purpose of this study was to describe sample size calculations in randomized clinical trials (RCTs) published in 4 orthodontic journals.Methods:This cross-sectional study evaluated 142 RCTs published between 2015 and 2019 in the 4 journals with the highest impact factor in orthodontics according to the SCIMAGO 2018 ranking. In the study, 2 trained and experienced orthodontists assessed whether the RCTs evaluated reported their sample size calculations, and whether they adequately described the criteria for the calculations, including the level of significance, test power, precision or effect size (clinically relevant difference), and expected variability. The sample size calculation was considered adequately reported when the above 4 criteria were described.Results: We identified 120 publications (84.5%) reporting the sample size calculation, but only 70 (58.3%) fully described the above parameters. Inadequate calculation included failure to report the confidence level (ranging from 0% to 12.9%), test power (ranging from 0% to 20%), effect size (ranging from 0% to 22.5%), and expected variability (ranging from 22.6% to 80%). According to the journal, some parameters of sample size calculation were more frequently reported.Conclusions:RCTs published in the 4 leading orthodontic journals frequently do not report the parameters used for sample size calculations

Skeletal and dentoalveolar bilateral dimensions in unilateral palatally impacted canine using cone beam computed tomography

Abstract Background The aim of this investigation was to compare skeletal and dentoalveolar measurements of subject with unilateral palatally impacted canine versus the unaffected contralateral side on cone beam computed tomography (CBCT). Methods A cross-sectional study (split mouth design) that included 28 CBCTs (i.e., 56 sides) with unilaterally impacted maxillary canines was performed. After conducting a pilot test to gauge the researcher, heights and widths of skeletal and dentoalveolar variables obtained in the maxilla were measured using coronal and axial views. The angulations of incisors were also measured, and the side with impaction and the unaffected side were compared. Paired sample t test and Wilcoxon signed-rank test were used. Results Significant statistical differences (2 mm, p < 0.001) were found between the impacted and non-impacted side measurements from the mid-palatine raphe to the first premolar (proximal alveolar bone crest between the canine (deciduous or permanent) and first premolar); the distance were significantly lower (12.72 ± 2.25 mm) than in the side without impaction (14.67 ± 2.00 mm). Also, the central and lateral incisor angulations showed significant reductions; presenting disto-angulated incisors on the impacted canine side (86.14 ± 7.70° and 74.75 ± 12.67°, respectively) and mesial-angulated incisors on the non-impacted side (91.63 ± 6.79° and 81.21 ± 8.56° respectively). The other skeletal and dentoalveolar measurements showed no significant differences. Conclusions The width from the median raphe to the first premolar is lower in the side of maxillary palatal impacted canines than in the side without impaction. Lateral angulations of incisors were disto-angulated on the side of impacted canines. Both conditions have clinical implications in the orthodontic treatment

Midpalatal suture maturation stage assessment in adolescents and young adults using cone-beam computed tomography

Background The aim of this study was to evaluate the midpalatal suture maturation stages in adolescents and young adults using cone-beam computed tomography (CBCT). Methods The sample comprised 200 CBCT scans of individuals aged 10 to 25 years old (95 males and 105 females) divided into three groups, adolescents (n = 48), post-adolescents (n = 52), and young adults (n = 100). The Planmeca ProMax 3D software was used for the midpalatal suture maturation stage evaluation according to Angieleri’s method, using cross-sectional axial slice. Two previously calibrated examiners analyzed the images and classified according to five different maturation stages. A, B, and C stages were considered with open midpalatal suture, and D and E were considered without open midpalatal suture. Association tests were performed using chi-square test also, and a binary logistic regression was evaluated (P < 0.05). Results The possibility to find open midpalatal suture in individuals of 10 to 15 years old was 70.8%, in subject aged 16 to 20 and 21 to 25 years old was 21.2% and 17%, respectively. Furthermore, this possibility in individuals older than 16 years was greater in males than in females. Conclusions The possibility to find open midpalatal suture in post-adolescents and young adults is greater than the orthodontists considered years ago. Furthermore, men are more likely to find midpalatal suture opening. These implications might be considered by the orthodontists when maxillary expansion is required. Besides, the ossification of the middle palatal suture is very variable, and therefore, the use of CBCT might be recommended to clarify this possibility