Epidemiology of pediatric facial trauma in Chile: a retrospective study of 7,617 cases in 3 years

Objectives: To describe the epidemiology of facial trauma injuries in a group of Chilean children aged 15 years or less. Study Design: Retrospective study of case series. Between 2006 and 2009, clinical records of 293,090 patients were reviewed. Data of patients with trauma injuries to the face were collected and evaluated for: age, sex, day and month of hospital admission, cause of injury, anatomical location, type of injury and presence of associated injuries. Results: A total of 7,617 patients with 8,944 injuries were found. Boy to girl ratio was 1,7:1. Preschool age children were most frequently affected. Main cause of injury were falls, soft tissue injuries the most common type of injury. Associated injuries occurred in 11% of cases. Conclusions: Facial trauma presents a significant frequency in the group of Chilean children studied. Preeschool age boys were prone to present facial trauma of mild severity associated to falls

Is chlorhexidine mouth rinse, used as a mono-therapy or adjunct with oral hygiene, effective at reducing plaque growth and gingival inflammation?

This study describes a systematic review of the best available evidence on the effectiveness of a chlorhexidine mouth rinse as a mono-therapy or as an adjunct to mechanical oral hygiene against plaque growth and gingival inflammation. Medline, EMBASE and the Cochrane Central register of Controlled Trials were searched up to April 2011. Randomised controlled clinical trials that compared chlorhexidine to placebo or controlled mouth rinses or regular oral hygiene for a minimum duration of at least four weeks amongst gingivitis patients (≥ 18 years of age) were included. A total of 30 publications fulfilled the selection criteria. Clinical parameters measured at baseline and end of trial were plaque, gingival inflammation, bleeding and staining. Chlorhexidine reduced plaque by 33% and gingivitis by 26% compared to a placebo or a control mouth rinse. The investigators concluded that when used together with oral hygiene, chlorhexidine mouth rinses provide significant reductions in plaque and gingivitis scores in gingivitis patients, but a significant increase in staining compared to placebo or control mouth rinses.AOSIS is thanked for contributing towards the copyediting and publishing costs of this article.http://www.ojid.orgam201

The impact of four harvesting techniques on the cell viability and osteogenic behaviour of cells in autogenous bone grafts : a critical appraisal of an experimental study

The investigators tested the null hypothesis that there would be no differences between the different bone harvesting techniques with regard to cell viability, cell activity and osteogenic potential of grafted cells. Bone grafts were harvested from the mandibles of 12 miniature pigs using four different harvesting techniques: bone milling, bone scraping, bone drilling (bone slurry) and piezosurgery. Cell viability was determined according to an immunoassay of released signalling molecules and gene expression that affect bone formation and resorption. The osteogenic activity of conditioned graft-sampled media was assessed in a bioassay using isolated bone cells. Cells in autogenous bone grafts obtained by using a bone mill and a bone scraper showed a higher viability and a stronger osteogenic potential than those from piezosurgery and bone drilling (slurry). This study contributed towards the understanding of the impact of harvesting techniques on the viability and osteogenic behaviour of grafted cells.AOSIS is thanked for contributing towards the copyediting and publishing costs of this article.http://www.ojid.org/index.php/ojidam201

Does adjunctive use of metronidazole plus amoxicillin benefit patients receiving non-surgical scaling and root planning for the treatment of generalised aggressiveperiodontitis?

This article describes a double-blinded, placebo-controlled randomised clinical trial that involved 30 eligible subjects experiencing generalised aggressive periodontitis. Subjects were randomly assigned to either the test group (scaling and root planning + metronidazole [400 mg]) and amoxicillin [500 mg]) or the control group (scaling and root planning without the adjunctive antibiotics combination). Both antibiotics and placebos were administered three times per day for 14 days. Participants were examined at baseline, and again six months and one year after therapy. Both therapies led to a statistically significant improvement in all clinical parameters as measured after one year. However, subjects who received the metronidazole–amoxicillin combination showed the greatest reduction in mean probing depth, an improved clinical attachment level and a lower mean number of residual sites after one year. The investigators concluded that the non-surgical treatment of generalised aggressive periodontitis was markedly improved by the adjunctive use of metronidazole and amoxicillin up to one year after treatment.AOSIS is thanked for contributing towards the copyediting and publishing costs of this article.http://www.ojid.org/index.php/ojidam201

Antiplatelet therapy in patients undergoing oral surgery : a systematic review and meta-analysis

The number of patients under antiplatelet therapy (APT) continues to raise as current recommendations foster this practice. Although some recommendations to manage this treatment during oral surgery procedures exist, these have methodological shortcomings that preclude them from being conclusive. A systematic review and meta-analysis of the best current evidence was carried out; The Cochrane Library, EMBASE and MEDLINE databases were searched for Randomized Controlled Trials (RCT) concerning patients undergoing oral surgery with APT, other relevant sources were searched manually. 5 RCTs met the Inclusion criteria. No clear tendency was observed (RR= 0.97 CI 95%: 0,41?2,34; p=0,09; I2= 51%), moreover, they weren?t clinically significant. According to these findings and as bleeding is a manageable complication it seems unreasonable to undermine the APT, putting the patient in danger of a thrombotic event and its high inherent morbidity, which isn?t comparable in severity and manageability to the former.

Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial

The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars. A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia. 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Difference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99, ?=0.41) NNTB=26. Rescue analgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49 (95%CI 0.32-0.75, ?<0.05) NNTB=3. The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk of postoperative infections from impacted mandibular third molars extraction, when compared to placebo. Nevertheless, antibiotic prophylaxis was associated with a reduced need for rescue analgesia

Determination of susceptibility to sensitization to dental materials in atopic and non-atopic patients

Introduction: Some studies report that atopic patients have a greater frequency of delayed-type sensitization than non-atopic patients. Objective: To determine the influence of the atopic condition on delayed sensitization to dental materials. Design: cross-sectional study. Methods: Forty (40) atopic subjects and forty (40) non-atopic subjects, of both sexes, between 20 and 65 years of age were included. The determination of delayed sensitization to dental materials was performed using patch test. An oral exam was also carried out to check for lesions of the oral mucosa. Results: 61.25% of the patients were positive for delayed-type sensitization to one or more allergens, being palladium chloride (21.25%), ammoniated mercury (20%), benzoyl peroxide (12.5%) and amalgam (10%) the most frequent. The frequency of sensitization was 67.5% in the group of atopic patients, compared to 55% in the non atopic group (p>0.05). The materials with the greatest difference of sensitization in atopic compared to non-atopic patients were ammoniated mercury, benzoyl peroxide, amalgam and Bisphenol A Dimethacrylate (BIS-GMA). Conclusion: The atopic condition is not related to a higher frequency of delayed sensitization to a battery of dental materials. © Medicina Oral

Minimal important changes in standard deviation units are highly variable and no universally applicable value can be determined

[Objectives] This study aims to describe the distribution of anchor-based minimal important change (MIC) estimates in standard deviation (SD) units and examine if the robustness of such estimates depends on the specific SD used or on the methodological credibility of the anchor-based estimates. [Design and Setting] We included all anchor-based MIC estimates from studies published in MEDLINE and relevant literature databases upto October 2018. Each MIC was converted to SD units using baseline, endpoint, and change from baseline SDs. We performed a descriptive analysis of MICs in SD units and checked how the distribution would change if MICs with low methodological credibility were excluded from the analysis. [Results] We included 1, 009 MIC estimates from 182 studies. The medians and interquartile ranges of MICs in SD units were 0.43 (0.25 to 0.69), 0.42 (0.22 to 0.70), and 0.51 (0.28 to 0.78) for baseline, endpoint, and change SD units, respectively. Some MICs were extremely large or small. The distribution did not change significantly after excluding MICs estimated by less credible methods. [Conclusions] The size of the universally applicable MIC in SD units could not be determined. Anchor-based MICs in SD units were widely distributed, with more than half in the range of 0.2 to 0.8

Evidence-based clinical practice guideline for the use of pit-and-fissure sealants

AbstractBackgroundThis article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces.Types of Studies ReviewedThis is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions.ResultsThe guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others.Conclusions and Practical ImplicationsThese recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians reorient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents