Odontología mínimamente invasiva. Tratamiento restaurador atraumático

El Tratamiento Restaurador Atraumático (TRA), constituye una nueva visión de la odontología. Es una técnica basada en la filosofía de mínima intervención; es decir, mínimamente invasiva y altamente conservadora. Estos tratamientos consisten en eliminar la menor cantidad de tejido dentario, empleando instrumentos manuales y cemento de ionómero de vidrio como material de obturación. Un aspecto clave de la técnica consiste en orientar al paciente en métodos profilácticos y hábitos nutricionales que propicien un cambio en la flora bacteriana de la cavidad bucal, impidiendo la proliferación de agentes patógenos causantes de la caries dental. Su empleo es posible gracias a la asociación entre: los conocimientos acerca de la patología de la caries dental, la efectividad de los métodos preventivos y el desarrollo de materiales restauradores adhesivos que liberan flúor. A pesar de la aparente simplicidad de este procedimiento, es esencial que todas las etapas operatorias y restauradoras sean seguidas, así como la cuidadosa selección de los casos clínicos y manipulación e inserción del material restaurador con el fin de obtener resultados satisfactorios. Este caso clínico procura presentar las etapas clínicas de forma detallada, así como las indicaciones, contraindicaciones, ventajas y limitaciones de la técnica del Tratamiento Restaurador Atraumático (TRA).publishedVersio

CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol

Fil: Martignon, Stefania. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Douglas, Gail V. A. University of Leeds. Dental Public Health. Dental Institute; United Kingdom.Fil: Cortes, Andrea. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Newton, J. Timothy. King’s College. Faculty of Dentistry. Oral and Craniofacial Sciences; United Kingdom.Fil: Pitts, Nigel B. King’s College. Faculty of Dentistry. Oral and Craniofacial Sciences; United Kingdom.Fil: Ávila, Viviana. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Usuga Vacca, Margarita. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Usuga Vacca, Margarita. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Gamboa, Luis F. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Deery, Christopher. University of Sheffield. School of Clinical Dentistry; United Kingdom.Fil: Abreu - Placeres, Ninoska. Universidad Iberoamericana. Biomaterials and Dentistry Research Center. Academic Research Department; República Dominicana.Fil: Bonifacio, Clarisa. Academic Center for Dentistry Amsterdam. Department of Pediatric Dentistry; Países Bajos.Background: Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based cariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. Methods: In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing carieslesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion: The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time.publishedVersionFil: Martignon, Stefania. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Douglas, Gail V. A. University of Leeds. Dental Public Health. Dental Institute; United Kingdom.Fil: Cortes, Andrea. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Newton, J. Timothy. King’s College. Faculty of Dentistry. Oral and Craniofacial Sciences; United Kingdom.Fil: Pitts, Nigel B. King’s College. Faculty of Dentistry. Oral and Craniofacial Sciences; United Kingdom.Fil: Ávila, Viviana. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Usuga Vacca, Margarita. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Usuga Vacca, Margarita. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Gamboa, Luis F. Universidad El Bosque. Caries Research Unit. Research Department; Colombia.Fil: Deery, Christopher. University of Sheffield. School of Clinical Dentistry; United Kingdom.Fil: Abreu - Placeres, Ninoska. Universidad Iberoamericana. Biomaterials and Dentistry Research Center. Academic Research Department; República Dominicana.Fil: Bonifacio, Clarisa. Academic Center for Dentistry Amsterdam. Department of Pediatric Dentistry; Países Bajos.Otras Ciencias de la Salu

CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol

Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021

Serotype diversity of Streptococcus mutans and caries activity in children in Argentina

Aim: The purpose of this study was to analyze the serotype distribution of S. mutans and their association with caries activity in scholar children from Córdoba, Argentina. Material and methods: Clinical examination was performed in 133 children. The dmft+DMFT and Significant Caries (SiC) indices were calculated to identify individuals with high caries activity. After DNA extractions of S. mutans strains, serotypes were determined by PCR amplifications. The median caries activity of each serotype group was compared using a non-parametric Kruskall-Wallis test. Results and Statistics: We obtained S. mutans strains from stimulated saliva of 94 children. The mean dmft+DMFT was 4.14 and the mean SiC group was 8.65. Serotype c was the most frequent (53.2%), followed by e (31.9%), f (8.5%) and k (6.4%). The comparison between the SiC and Non-Sic groups showed significant differences in the frequency of serotypes c and k. The median caries activity was non-significant in the different serotypes. Conclusion: The difference between the serotype frequencies detected in Argentina compared to those of other countries could be related with contrasting dietary habits. The results obtained in the present study would increase the knowledge about the epidemiology of dental caries in children from Argentina.Fil: Carletto Körber, F. P. M.. Universidad Nacional de Córdoba; ArgentinaFil: González Ittig, Raúl Enrique. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Cordoba. Instituto de Diversidad y Ecologia Animal; Argentina. Universidad Nacional de Colombia; ColombiaFil: Jiménez, M. G.. Universidad Nacional de Colombia; ColombiaFil: Cornejo, L. S.. Universidad Nacional de Colombia; Colombi