Epidemiologic characterization of endodontic diagnosis and treatment

Objetive: To characterize the endodontic diagnosis and treatments performed during 2008-2011 at School of Dentistry, University of Andrés Bello, Chile. Methos: Case series study comprising 632 endodontics clinical records, corresponding to 506 patients. Variables included were clinical and radiographic features of the tooth anatomy, and variables related to treatment. Statistics analysis was performed through Stata 11 software. For multivariate analysis, logistic regression model was used, including adjusted Odd ratio; p<0.05 was considered significative. Results: The most frequent diagnosis were pulp necrosis and asymptomatic irreversible pulpitis. Endodontic treatments were more common in women, in upper maxilla, in molars and premolars; in general, the main biomechanical preparation technique is manual and hybrid, except in molars, where mechanized technique is more common; the most used master apical file was file #40, and in upper incisors, #60; lateral condensation obturation technique was the most frequently used. A good prognosis was related with lateral and vertical obturation technique, and absence of soft tissue alterations.Conclusions: This study brought relevant information about working lengths for each root canal for each tooth type. It related tooth type with the technique used for the coronal two-thirds preparation and its instruments, obturation technique and informed about the master file used for each root canal, by means of cross tables. Also, it builds an estimation model for the postoperative prognosis 

Decellularized allografts as an alternative for reconstruction of large inferior alveolar nerve defects:a systematic review

Inferior alveolar nerve (IAN) injuries are a clinical problem with devastating consequences, causing temporary or permanent paresthesia, significantly affecting the patient's quality of life. Despite morbidity, side effects and controversy regarding its results, autologous nerve grafting is still the main treatment for these type of lesions. However, due to advances in knowledge about nerve damage and with the aim of preventing the described problems of autografts, new treatment alternatives based on decellularized allografts have emerged. The aim of this systematic review was to evaluate the reported efficacy of decellularized allografts for the treatment of IAN damage. We performed a systematic search in Pubmed, Scopus and Web of Science databases following the PRISMA guidelines. Cohort studies, randomized or non-randomized clinical studies, prospective or retrospective studies, without age limits and language restriction that included human subjects who received decellularized allograft as treatment for IAN damage were included. Six articles met the inclusion criteria and were included for data analysis. In all 6 articles, resolution of IAN damage was observed in more than 85% of patients after a 12-month follow-up period, and in 2 of them, complete resolution was observed in 100% of their patients at longer follow-ups. Decellularized allograft appears to be a promising alternative to resolve IAN lesions, without requiring a nerve autograft procedure. However, more randomized clinical trials are needed to validate adequate treatment modalities with decellularized allografts

Prevalencia de maloclusiones y hábitos orales para funcionales en preescolares de establecimientos municipales de Viña del Mar.

Introduction: Malocclusions are a public health problem at national and global level, being third in the ranking of the most prevalent oral pathologies.Its origin is multifactorial, with dysfunctional oral habits being a risk factor. The objective of this study was to determine the prevalence of malocclusions and dysfunctional oral habits in students aged between 4 and 6 years in state-run public schools in Viña del Mar, Chile. Material and methods: A prevalence study was carried out in 184 students selected by random cluster sampling. Malocclusions were assessed by clinical examination, while dysfunctional oral habits were assessed by questionnaires and clinical examination. The data were analyzed using Fisher’s exact test, Chi-square test and the PHI correlation coefficient. Results: The prevalence of malocclusions was 54.35% (95% CI [47.04% - 61.47%]), with dental crowding being the most frequent, while prevalence of dysfunctional oral habits was 95.11% (95% CI [90.82% - 97.45%]), led by lingual interposition. In none of the cases statistically significant differences of age, gender or class were noticed. The evidence provided by this study indicates that the presence of malocclusions is independent of the presence of dysfunctional oral habits, except between open bite and interposition of objects, whose magnitude of dependence was minor (0.2). Conclusion: There is a high prevalence of malocclusions and dysfunctional oral habits in preschool children, with dental crowding and lingual interposition being the most frequent, respectively. The presence of malocclusions is independent of the presence of dysfunctional oral habits.Introducción: Las maloclusiones constituyen un problema de salud pública a nivel nacional y mundial, ocupando el tercer lugar en el ranking de patologías bucodentales más prevalentes. Su origen es multifactorial, siendo algunos de sus factores de riesgo los hábitos orales disfuncionales. El objetivo fue determinar la prevalencia de maloclusiones y hábitos orales disfuncionales en alumnos entre 4 y 6 años pertenecientes a establecimientos municipales de Viña del Mar. Material y Métodos: Se realizó un estudio de prevalencia en 184 alumnos seleccionados por muestreo aleatorio por conglomerados. Las maloclusiones fueron evaluadas mediante examen clínico, mientras que los hábitos orales disfuncionales a través de cuestionarios y examen clínico. Los datos fueron analizados utilizando el test Chi2, prueba exacta de Fisher y el coeficiente de correlación Phi. Resultados: La prevalencia de maloclusiones fue de 54.35% (IC 95% [47,04% - 61,47%]), siendo el apiñamiento la más frecuente, mientras que la de hábitos orales disfuncionales fue de 95.11% (IC 95% [90,82% - 97,45%]), liderada por la interposición lingual. Para ambos casos no se observaron diferencias estadísticamente significativas con edad, género y curso. La evidencia aportada por este estudio señala que la presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales, excepto entre mordida abierta e interposición de objetos, cuya magnitud de dependencia fue leve (0.2). Conclusión: Existe una alta prevalencia de maloclusiones y hábitos orales disfuncionales en pre-escolares, siendo los más frecuentes el apiñamiento y la interposición lingual, respectivamente. La presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales

Pentoxifylline and tocopherol for the treatment of osteoradionecrosis of the jaws. A systematic review

Osteoradionecrosis of the jaws (ORNJ) is a severe and challenging complication of head and neck radiation therapy. Despite its aggressiveness and controversy respect to its efficacy, surgical intervention remains the main treatment modality. Nevertheless, due to advances in the understanding of ORNJ physiopathology, new treatment alternatives such as the combination of pentoxifylline with tocopherol (PENTO) have emerged. The aim of this systematic review was to assess the reported efficacy of PENTO for the treatment of ORNJ.  Studies were search using Pubmed, The Cochrane Library, Scopus, and Web of Science data bases following the PRISMA guidelines. Inclusion criteria were cohort, case series, randomized or non-randomized clinical studies published in English including human subjects who received PENTO as treatment for ORN of the jaws.  Eleven articles met the inclusion criteria and were included for data analysis. All studies reported patients with complete mucosal coverage with no exposed bone (considered healthy) after PENTO treatment, ranging from 16.6% to 100% of the patients, depending on the study. Clinical improvement or disease stabilization was reported between 7.6% and 66.6% of studied individuals, while disease progression was seen in only 5 studies involving 7.6 - 32% of patients. PENTO treatment achieved a complete disease control in a significant number of patients in all studies. However, there is no standardized protocol for administering the therapy. It is necessary to determine the pharmacological doses and to evaluate the benefits of adding antibiotics and clodronate. Good quality clinical trials are needed to develop a successful algorithm for the management of ORN of the jaws

From Neural Arbors to Daisies

Pyramidal neurons in layers 2 and 3 of the neocortex collectively form an horizontal lattice of long-range, periodic axonal projections, known as the superficial patch system. The precise pattern of projections varies between cortical areas, but the patch system has nevertheless been observed in every area of cortex in which it has been sought, in many higher mammals. Although the clustered axonal arbors of single pyramidal cells have been examined in detail, the precise rules by which these neurons collectively merge their arbors remain unknown. To discover these rules, we generated models of clustered axonal arbors following simple geometric patterns. We found that models assuming spatially aligned but independent formation of each axonal arbor do not produce patchy labeling patterns for large simulated injections into populations of generated axonal arbors. In contrast, a model that used information distributed across the cortical sheet to generate axonal projections reproduced every observed quality of cortical labeling patterns. We conclude that the patch system cannot be built during development using only information intrinsic to single neurons. Information shared across the population of patch-projecting neurons is required for the patch system to reach its adult state

Prevalence of malocclusions and dysfunctional oral habits in preschool children of municipal establishments in Viña del Mar.

Introduction: Malocclusions are a public health problem at national and global level, being third in the ranking of the most prevalent oral pathologies.Its origin is multifactorial, with dysfunctional oral habits being a risk factor. The objective of this study was to determine the prevalence of malocclusions and dysfunctional oral habits in students aged between 4 and 6 years in state-run public schools in Viña del Mar, Chile. Material and methods: A prevalence study was carried out in 184 students selected by random cluster sampling. Malocclusions were assessed by clinical examination, while dysfunctional oral habits were assessed by questionnaires and clinical examination. The data were analyzed using Fisher’s exact test, Chi-square test and the PHI correlation coefficient. Results: The prevalence of malocclusions was 54.35% (95% CI [47.04% - 61.47%]), with dental crowding being the most frequent, while prevalence of dysfunctional oral habits was 95.11% (95% CI [90.82% - 97.45%]), led by lingual interposition. In none of the cases statistically significant differences of age, gender or class were noticed. The evidence provided by this study indicates that the presence of malocclusions is independent of the presence of dysfunctional oral habits, except between open bite and interposition of objects, whose magnitude of dependence was minor (0.2). Conclusion: There is a high prevalence of malocclusions and dysfunctional oral habits in preschool children, with dental crowding and lingual interposition being the most frequent, respectively. The presence of malocclusions is independent of the presence of dysfunctional oral habits.Introducción: Las maloclusiones constituyen un problema de salud pública a nivel nacional y mundial, ocupando el tercer lugar en el ranking de patologías bucodentales más prevalentes. Su origen es multifactorial, siendo algunos de sus factores de riesgo los hábitos orales disfuncionales. El objetivo fue determinar la prevalencia de maloclusiones y hábitos orales disfuncionales en alumnos entre 4 y 6 años pertenecientes a establecimientos municipales de Viña del Mar. Material y Métodos: Se realizó un estudio de prevalencia en 184 alumnos seleccionados por muestreo aleatorio por conglomerados. Las maloclusiones fueron evaluadas mediante examen clínico, mientras que los hábitos orales disfuncionales a través de cuestionarios y examen clínico. Los datos fueron analizados utilizando el test Chi2, prueba exacta de Fisher y el coeficiente de correlación Phi. Resultados: La prevalencia de maloclusiones fue de 54.35% (IC 95% [47,04% - 61,47%]), siendo el apiñamiento la más frecuente, mientras que la de hábitos orales disfuncionales fue de 95.11% (IC 95% [90,82% - 97,45%]), liderada por la interposición lingual. Para ambos casos no se observaron diferencias estadísticamente significativas con edad, género y curso. La evidencia aportada por este estudio señala que la presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales, excepto entre mordida abierta e interposición de objetos, cuya magnitud de dependencia fue leve (0.2). Conclusión: Existe una alta prevalencia de maloclusiones y hábitos orales disfuncionales en pre-escolares, siendo los más frecuentes el apiñamiento y la interposición lingual, respectivamente. La presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales

Prevalence of malocclusions and dysfunctional oral habits in preschool children of municipal establishments in Viña del Mar.

Introduction: Malocclusions are a public health problem at national and global level, being third in the ranking of the most prevalent oral pathologies.Its origin is multifactorial, with dysfunctional oral habits being a risk factor. The objective of this study was to determine the prevalence of malocclusions and dysfunctional oral habits in students aged between 4 and 6 years in state-run public schools in Viña del Mar, Chile. Material and methods: A prevalence study was carried out in 184 students selected by random cluster sampling. Malocclusions were assessed by clinical examination, while dysfunctional oral habits were assessed by questionnaires and clinical examination. The data were analyzed using Fisher’s exact test, Chi-square test and the PHI correlation coefficient. Results: The prevalence of malocclusions was 54.35% (95% CI [47.04% - 61.47%]), with dental crowding being the most frequent, while prevalence of dysfunctional oral habits was 95.11% (95% CI [90.82% - 97.45%]), led by lingual interposition. In none of the cases statistically significant differences of age, gender or class were noticed. The evidence provided by this study indicates that the presence of malocclusions is independent of the presence of dysfunctional oral habits, except between open bite and interposition of objects, whose magnitude of dependence was minor (0.2). Conclusion: There is a high prevalence of malocclusions and dysfunctional oral habits in preschool children, with dental crowding and lingual interposition being the most frequent, respectively. The presence of malocclusions is independent of the presence of dysfunctional oral habits.</jats:p