Acta odontológica latinoamericana/Acta odontológica latinoamericana, Dec 29, 2023
Fluorosis is a worldwide public health problem. One of the factors related to it is the type of w... more Fluorosis is a worldwide public health problem. One of the factors related to it is the type of water consumed, such as groundwater. High fluoride concentration in groundwater may be explained by contamination from local industries. Since fluoride and arsenic are the main pollutants of groundwater, some studies correlate groundwater consumption with high prevalence of fluorosis. Aim: The aim of this study was to conduct a systematic review to determine whether children's risk of fluorosis is related to drinking groundwater. Materials and Method: The protocol for this systematic review was registered at the National Institute of Health Research Database (CRD42021227298). A comprehensive search was conducted to identify potentially relevant studies by exploring a range of electronic databases
Background:In 2020, CariesCare International (CCI)-derived from ICCMS-was plannedto be tested for... more Background:In 2020, CariesCare International (CCI)-derived from ICCMS-was plannedto be tested for caries-control effectiveness in children by means of a multicenter randomized clinical trial (RCT). Nevertheless, due to the pandemic, RCTs proved unfeasible and aerosol-generating procedures (AGP) were associated with a spread of COVID-19. Consequently, the study design required to be modi ed to a single-interventional study and CCI had to be adapted excluding AGP and reducing on-site consultation (CCI-adapted). Objective: This 12-month multicenter single-group interventional study aimed at assessing the effect of a pandemic CCI-adapted protocol on caries control in children. Methods: Twenty-one Latin American and European centers with n³20 3-8-year-old children per center were invited to participate; 17 obtained IRB and signed written informed consents. Trained examiners assessed at baseline (T0) and 1-year follow-up (T1y) (blind to the intervention): CCI-caries risk, oralhealth-related practices; dmf/DMFS with ICDAS-merged-Epi visual caries severity and activity criteria; dental sepsis and toothache. Individual-and tooth-surface-level personalized care plan was then performed by dental practitioners previously trained in CCI-adapted. After 5 months, parents' and dentists' dental-care-process acceptance (Treatment Evaluation Inventory) was assessed. The one-year cariescontrol effect of CCI-adapted was assessed in terms of tooth-surface and individual-level cariesprogression control; oral-health behavior improvement, and caries-care system acceptability. Results: Sixteen centers nished the study (94.1%; Latin America: n=13; Europe: n=3), with 337 children (78.6%;mean age of 5.5±1.6 years). There was a T0 to T1y signi cant decrease (p<0.05) in the mean number of tooth surfaces with caries lesions (7.7±9.1 to 2.8±4.6), with active caries lesions (6.8±8.8 to 0.8±2.2), and a tooth-surface caries-progression control of 99.3%. In the majority of children there was a signi cant (p<0.05) control of: caries progression (79.5%), high-caries risk (86.6%), and non-adequate oral-health behavior (72.7%). There was a very high (parents) and a high-very high (dentists) acceptability of CCI. Conclusion: Given the challenge of the pandemic, this single-group interventional CCI-adapted study showed one-year control of caries progression, caries risk, and high parents' and dentists' CCI acceptance. Trial registration:Retrospectively-registered-ClinicalTrials.gov NCT04666597 07/12/2020 (Protocol version 2): https://register.clinicaltrials. gov/prs/app/action/SelectProtocol? sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h barriers which prevent the translation of caries management best practices into the dental practice setting (Vernazza et al., 2021a,b; Pitts et al., 2021a; Urquhart et al., 2019). CariesCare International is a practice-friendly, health outcomes-focused, patient-centered, risk-based approach to caries management designed for the dental practice setting and organized in a CCI 4-D cycle (Martignon et al., 2019; Beltran et al., 2019). It uses and adapts evidence-based tools and resources developed systematically by ICDAS since 2012 and ICCMS since 2013 (Pitts et al., 2021b), sharing same principles. These are being followed globally in many settings, with local adaptations, including a large number of dental schools and cariology-teaching consensus guides for undergraduates in Colombia (Martignon et al., 2014), the USA (Fontana et al., 2016) and Caribbean countries (Abreu-Placeres et al., 2016), as well as in the practice and the academy in Colombia (Abreu-Placeres et al., 2023). In 2019, the FDI called for "a shift in caries management from restorative treatment to measures that arrest and prevent caries development including monitoring, following the concepts of ICCMS" (FDI, 2020). Cariologists, clinicians, educators and policy makers agree that the CCI consensus guide promotes best practice in the control of caries and in maintaining oral health in patients (Martignon et al., 2019; Beltran et al., 2019). CCI has been included as a core part of a Policy Lab conducted with the Global Collaboratory for Caries Management (GCCM) to raise awareness and to promote a cavity-free future; this involved experts in public health, the industry and the profession (Vernazza et al., 2021b). To our knowledge there are no studies to date which have reported on the caries-control effect of CCI. In 2020, with ethical approval from the lead center, the so called Caries OUT collaboration (21 centers in 13 countries) attempted to conduct a 12-month multicenter pragmatic RCT in schoolchildren to compare the CCI system versus standard care in the control of individual and tooth-level caries progression. Plans were revised due to the COVID-19 pandemic and the consequent restrictions imposed by universities' Ethical Boards to conduct randomized controlled trials (RCT). To permit caries care to be offered to children, we modi ed CCI protocols by avoiding aerosol generating procedures (AGPs) and reducing ino ce appointment time (CCI-adapted). Furthermore, we modi ed the study design from a pragmatic RCT to a single-group interventional study (see study protocol, Martignon et al., 2021). All of the original 21 centers were willing to attempt the revised study and were invited to participate. Seventeen centers agreed to participate with Institutional Review Board approval. The aim of this 12-month multicenter single-group interventional study was to assess the effect of a pandemic-adapted CCI protocol on caries control in children. Methods Design This was a 12-month multicenter single-group interventional study with approval from the Research Institutional Ethical Committee at Universidad El Bosque (PCI 2019-10718). Written informed consents
Acta odontológica latinoamericana/Acta odontológica latinoamericana, Dec 29, 2023
To prepare a consensus document of the cariology contents and competences included in the curricu... more To prepare a consensus document of the cariology contents and competences included in the curriculum for the dentistry degree at Argentine dental faculties/schools. Materials and Method: Planning the process in stages: Stage 1-Diagnosis of the situation (Google Form) and invitation to participate extended to the 20 academic units (AU) that offer dentistry degrees. Stage 2-Assessment process of Content (C) and Competences (I) agreements in the five domains: D1 Basic Sciences, D2 Risk and diagnosis of dental caries, D3 Decision-making for non-invasive treatments, D4 Decision-making for invasive treatment, and D5 Evidence-based cariology at community level. Stage 3-Consensus. Stages 2 and 3 were held in Workshop format in virtual mode (W). Results: Stage 1-Of the total 20 Google forms sent to the AU, 13 responses were received: 7 from National Universities and 6 from Private Universities. All participants agreed to be part of the consensus. Stage 2-W: 20 representatives from 10 AU participated. It began with a contextualizing conference, after which the representatives were divided into 5 groups to assess the agreements of each D. Stage 3-The Cariology Curriculum document was organized into 5 Domains, and 23 C and 31 I of clinical application were defined for teaching cariology. The contents and competences for each domain were agreed upon. The final document was sent to all W participants for their approval and dissemination in each AU involved. Conclusion: Cariology contents were defined for dentistry students at Universities in the Argentine Republic.
The aim of the present work was to explore whether there is a relationship between oral health st... more The aim of the present work was to explore whether there is a relationship between oral health status and oral health-related quality of life in pregnant women from socially deprived populations in Buenos Aires City. Eighty pregnant women (age 18-39 x = 25.19 +/- 6.56) in their 1st/2nd trimester were sampled from the population of women visiting a health center located in the south of Buenos Aires City for their pregnancy check-ups. The impact of oral disease was assessed using the Spanish validated version (López, 2006) of OHIP-49 (Slade and Spencer, 1994), which includes 49 items grouped into 7 domains. Each question has five possible answers, to which values ranging from 1 to 5 were assigned. To assess oral health status, 4 calibrated researchers performed a clinical examination and recorded: Gingival Index (Löe and Silness, 1963); depth on probing, clinical attachment level, bleeding on probing and DMFT discriminating its components. Variables were analyzed in the population as a whole and in groups regarding previous dental attention (presence of fillings). Statistical analysis included: Chi Square test to establish association between variables and t-test to compare groups. 93.75% of the patients showed clinical signs of gingivitis, 2.5% showed clinical signs of periodontitis. Mean DMFT was 12.24 +/- 6.48 (D/DMFT = 6.46 +/- 4.64; M/DMFT = 4.09 +/- 4.31; F/DMFT = 2.53 +/- 3.52); 73.3% of the patients had at least one missing tooth; 92.1% presented active caries lesions; 53.7% had at least one filling. Most frequent impacts were reported in the domains: psychological discomfort (59.9% = frequent concern about dental problems) and functional limitation (51.1% = frequent perception that "a tooth did not look good"). Oral health status and oral health-related quality of life showed no significant association. Domains involving functional limitation (p < 0.04) and physical disability (p < 0.01) showed higher levels of impact in the group of patients with previous dental care (presence of fillings). Oral health-related quality of life did not reflect health status; nevertheless, it may be an intervenient variable regarding demand for dental service.
Background:: Argentina has progressed with industrialization in comparison to other Latin America... more Background:: Argentina has progressed with industrialization in comparison to other Latin American countries and this process had a direct impact on the innovative capacity of the national economy. A constant search for market leadership, including the dentistry field and dental materials, stimulates the industries to launch new products daily. Inventions related to health researches are mostly protected by patents as intellectual property. A patent landscape analysis through searches in patent banks is a tool used to identify trends in different areas of innovations. Objective:: This study aims to identify and evaluate the scenario of research, development and innovation of dental products in Argentina by a technological prospecting based on patents. Methods:: A survey of patent documents was conducted by searching for deposited and granted patents of dental products. The search was carried out during January 2020 in the patent database of the National Institute of Industrial Property of Argentina (INPI-AR). The terms “dentistry”, “buccal”, “dental” and “oral” were used to select the titles and abstracts of patent application reports. The information extracted from patent reports was organized in tables and Figs using Fig.Pad Prism 6 software to evaluate the applications. Results:: A total of 363 patents were published from 1989 to 2016, mainly by international industries, 93.3% as patent invention and 3.0% as utility model applications on dentistry. Only two patents (0.5%) were deposited by universities, as the University of Melbourne (Patent number 20060102378) and Universidad Nacional del Nordeste (Patent number 20140104149), among which only the last one is national. Among the deposits, only 6.6% were granted; mostly were in force, denied or lost. According to the specialties, most patents were related to compositions (64.7%) and personal products (21.7%), also on dentistry/cariology (6.33%) and prostheses/implants (4.68%). Conclusion:: In general, we find that most patent applications are related to the preventive area, personal products and compositions for formulations. Few dental patents deposits are currently available in Argentina, suggesting that the importation of products into the area remains large, which can make dental products more expensive. It is important to invest in technology-based companies to promote increased economic activity, being a consequence of an investment in knowledge creation and intellectual property to the Dentistry area.
Various theories have endeavored to explain how knowledge is accessed. Students, in order to lear... more Various theories have endeavored to explain how knowledge is accessed. Students, in order to learn, need a good repertoire of appropriate metacognitive and self-regulating strategies and knowledge, which they use consciously or unconsciously. Teachers, in addition to knowing how to teach, need to be aware of students’ learning strategies, metacognition, and self-regulation, and of the impact of changes associated with recent pandemic scenarios. Aim: The aim of this study was to identify the study strategies preferred by dental students in two different scenarios: prior to and during the pandemic. Materials and Method: The sample consisted of third-year dentistry students at Buenos Aires University (UBA) during 2019 (Group GP, 141 students, face-toface activity) and 2021 (Group GE, 60 students, e-learning during the pandemic). Participants were asked (a) to provide demographic information (sex and age) and (b) to answer the abridged ACRA scale. Statistical treatment included descript...
and white tea. Fluoride and pH appeared not to be correlated (Pearson test). All the studied tea ... more and white tea. Fluoride and pH appeared not to be correlated (Pearson test). All the studied tea samples presented fluoride concentrations greater than the threshold recommended for drinking water. The pH proved to be low, which could be a risk for erosive tooth wear.
To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infant... more To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the ‘Child Impact’ section in the LAC was 4.0(±8.3), in the ‘Family Impact’ section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the ‘Child Impact’ section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In t...
The aim of this study was to determine the effect of SDF on the dentin-pulp complex using two mod... more The aim of this study was to determine the effect of SDF on the dentin-pulp complex using two models: teeth after SDF application (ex vivo) and experimental animal molars. A descriptive study was performed using two models. In the first model, primary teeth (ex vivo) with enamel-dentin caries, without pulp involvement and previously treated with 38% SDF, were evaluated by means of two techniques: (a) Scanning Electron Microscopy (SEM) and energy-dispersive X-ray detector (EDS) to determine qualitative and quantitative composition, and (b) brightfield optical microscopy (OM) after decalcification. The second model used laboratory animal molars from 12 male Wistar rats. Standardized enamel-dentin cavities approximately 0.5 mm deep were made the distal fossa of the occlusal face of both first lower molars, to one of which a 38% SDF solution was applied, while the other was used as a control. Histological sections were prepared and dental pulp was evaluated qualitatively in both groups....
Learning strategies are a set of organized, conscious, intentional tasks performed by a student t... more Learning strategies are a set of organized, conscious, intentional tasks performed by a student to achieve a learning objective effectively in a given social context. The aim of the present study was to determine the type and frequency of use of different learning strategies among students taking the subject "Comprehensive Clinic II ", which corresponds to the 3rd year of the 6-year general syllabus of the undergraduate course at the School of Dentistry, Buenos Aires University, and to analyze the use of these learning strategies according to the number of years elapsed between each students admission to dental school and the time he/she took that subject. Dental students (n=189) filled in the Learning and Study Strategies Inventory (LASSI). Seventy-five percent were female. The tool includes 10 dimensions, organized in 77 items. Responses to each question were recorded using a Likert type scale (5 choices). Total scores were obtained by assigning values to the responses. ...
International Journal of Clinical Pediatric Dentistry, Mar 21, 2023
Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have o... more Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have obtained written informed consent from the patient's parents/legal guardians for publication of the case report details and related images.
The aim of this study is to compare the efficacy of two methods for collecting saliva samples fro... more The aim of this study is to compare the efficacy of two methods for collecting saliva samples from infants under 2 years of age for cariogenic streptococci (CS) count. Two collection methods were applied in 11 infants. In Method (A), saliva samples were collected by swabbing the inner cheek mucosa and floor of the mouth in figure of eight motions with a sterile cotton swab until it was soaked. In method (B), saliva samples were collected by aspiration of 1 ml of saliva with a sterile plastic syringe on the floor of the mouth, after stimulation with glove. The samples were cultured in modified Gold's broth (MSMG), and on trypticase, yeast extract, sucrose, cystine and bacitracin culture medium (TYSCB). In method (A), the swab with the sample was unloaded in situ on TYSCB and placed in PBS medium for transport. Then, 100 µl of the eluate was seeded in MSMG. In method (B) 100 µl were seeded in TYSCB and 100 µl in MSMG. Both culture media were incubated under capnophilic conditions for 48 hours at 37 °C. Colony forming units (CFU/ml) were counted by calibrated operators (kappa = 0.75). The presence of cariogenic streptococci (CS) (Streptococcus mutans-Streptococcus sobrinus) was determined by qPCR in the samples collected by both methods. The CFU/ml counts in MSMG differed significantly between methods (p = 0.021). In TYSCB, the recovery of CFU/ml was higher in method (A), without significant difference (p = 0.705). The molecular technique detected presence of CS, with no difference between collection methods. Collecting saliva samples by swabbing proved more effective in terms of recovery of microorganisms, and did not affect the detection of presence of CS by molecular techniques..
In this study, comprehensive clinics (CC) are interpreted as a pragmatic projection of the comple... more In this study, comprehensive clinics (CC) are interpreted as a pragmatic projection of the complexity of health. The aim of the study was to analyze the characteristics of the CCs at different schools of dentistry in Argentina. Data were collected from document analysis and interviews with key respondents at 8 universities, classified according to the criteria of Bray and Thomas. Interviews were developed and analyzed according to discourse analysis. The convergences and divergences among curricula were established and analyzed statistically. Triangulation of results showed that: (a) Most curricula (7/8) included subjects called CC; (b) the permanence of CCs in the curricula was not stable, with changes recorded in different periods; and (c) in the so-called CCs, the complex clinical approach showed frequent displacements based on teacher values or competence. It was concluded that there are divergences between theory and practice, and that it would be recommendable to have more rigorous curricular design taking into account current trends regarding the complexity of health and its transfer to educational management.
The aim of this work was to assess the score variation of scales 1 and 2 of the DCBS (Dental Copi... more The aim of this work was to assess the score variation of scales 1 and 2 of the DCBS (Dental Coping Beliefs Scale) of beliefs on oral health regarding oral health needs, clinical progression of the viral infection, medical care needs, age and gender in HIV+ patients. The DCBS was randomly administered to 102 HIV+ patients at the "Juan A. Fernandez Hospital", Buenos Aires, Argentina. For each of the 29 items, patients indicated their responses on a five point scale ranging from "strongly disagree" to "strongly agree". Oral health needs were assessed through the CCITN (Community Caries Index of Treatment Need) and the CPITN (Community Periodontal Index of Treatment Need). Data on CD4 cell count, pharyngeal-esophageal candidiasis, tuberculosis, pneumonia and hospitalization because of HIV-related opportunistic diseases were recorded. A linear regression model was built in which the number of items reporting wrong dental beliefs was the dependent variable and the remaining variables were independent. Altogether 65.7% were male (36.0 +/- 0.87 y.o.) and 34.3% were female (36.11 +/- 1.21 y.o.) patients. The eight independent variables were significant for the model (F(8.93)= 93.20, p < 0.05; R = 0.80). The estimated parameters were all positive except for CD4 cell counts. The results demonstrate that the DCBS was useful to identify HIV+ patients as a caries and periodontal disease risk group because of their wrong dental beliefs and suggests the need of dental education interventions.
Lack of communication between the medical and dental professions impacts healthcare quality, espe... more Lack of communication between the medical and dental professions impacts healthcare quality, especially in hospitals. Different authors have described the oral status of inpatients. Following that line of research, the current study set the following aims: to characterize the dynamics of medical-dental healthcare interaction at a university hospital and to describe oral status and identify need for dental treatment in a sample of 150 inpatients at a hospital in Buenos Aires City, Argentina.A descriptive study was conducted on patients who were referred to dentistry by their physicians. The following variables were surveyed: personal data, medical history, oral health status, need for dental treatment and oral self-care habits.Patient median age was 60 years, 60.7% were male, 68.7% had diseases of the circulatory system, average number of medications per day was 7, of which 28.1% were for the cardiovascular system. Seventy percent of the referrals came from the Cardiology Service and 48% were requested for preoperative evaluation. Percentage of visible plaque was 73.6% and bleeding on probing 75.4%. DMFT was 19.9; 57.3% of patients had periodontal pockets deeper than 4 mm, and 97.2% required surgery, endodontic or prosthetic rehabilitation treatments. The frequency of daily brushing decreased during hospitalization: 28.7% reported not brushing daily and only 5.3% reported brushing 3 times a day. Referrals to dentistry came mainly from the cardiology service in pre-surgical situations. Inpatients presented high levels of oral pathology and need for dental treatment.
Background: Comprehensive caries care has shown effectiveness in controlling caries progression a... more 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
Acta odontológica latinoamericana/Acta odontológica latinoamericana, Dec 29, 2023
Fluorosis is a worldwide public health problem. One of the factors related to it is the type of w... more Fluorosis is a worldwide public health problem. One of the factors related to it is the type of water consumed, such as groundwater. High fluoride concentration in groundwater may be explained by contamination from local industries. Since fluoride and arsenic are the main pollutants of groundwater, some studies correlate groundwater consumption with high prevalence of fluorosis. Aim: The aim of this study was to conduct a systematic review to determine whether children's risk of fluorosis is related to drinking groundwater. Materials and Method: The protocol for this systematic review was registered at the National Institute of Health Research Database (CRD42021227298). A comprehensive search was conducted to identify potentially relevant studies by exploring a range of electronic databases
Background:In 2020, CariesCare International (CCI)-derived from ICCMS-was plannedto be tested for... more Background:In 2020, CariesCare International (CCI)-derived from ICCMS-was plannedto be tested for caries-control effectiveness in children by means of a multicenter randomized clinical trial (RCT). Nevertheless, due to the pandemic, RCTs proved unfeasible and aerosol-generating procedures (AGP) were associated with a spread of COVID-19. Consequently, the study design required to be modi ed to a single-interventional study and CCI had to be adapted excluding AGP and reducing on-site consultation (CCI-adapted). Objective: This 12-month multicenter single-group interventional study aimed at assessing the effect of a pandemic CCI-adapted protocol on caries control in children. Methods: Twenty-one Latin American and European centers with n³20 3-8-year-old children per center were invited to participate; 17 obtained IRB and signed written informed consents. Trained examiners assessed at baseline (T0) and 1-year follow-up (T1y) (blind to the intervention): CCI-caries risk, oralhealth-related practices; dmf/DMFS with ICDAS-merged-Epi visual caries severity and activity criteria; dental sepsis and toothache. Individual-and tooth-surface-level personalized care plan was then performed by dental practitioners previously trained in CCI-adapted. After 5 months, parents' and dentists' dental-care-process acceptance (Treatment Evaluation Inventory) was assessed. The one-year cariescontrol effect of CCI-adapted was assessed in terms of tooth-surface and individual-level cariesprogression control; oral-health behavior improvement, and caries-care system acceptability. Results: Sixteen centers nished the study (94.1%; Latin America: n=13; Europe: n=3), with 337 children (78.6%;mean age of 5.5±1.6 years). There was a T0 to T1y signi cant decrease (p<0.05) in the mean number of tooth surfaces with caries lesions (7.7±9.1 to 2.8±4.6), with active caries lesions (6.8±8.8 to 0.8±2.2), and a tooth-surface caries-progression control of 99.3%. In the majority of children there was a signi cant (p<0.05) control of: caries progression (79.5%), high-caries risk (86.6%), and non-adequate oral-health behavior (72.7%). There was a very high (parents) and a high-very high (dentists) acceptability of CCI. Conclusion: Given the challenge of the pandemic, this single-group interventional CCI-adapted study showed one-year control of caries progression, caries risk, and high parents' and dentists' CCI acceptance. Trial registration:Retrospectively-registered-ClinicalTrials.gov NCT04666597 07/12/2020 (Protocol version 2): https://register.clinicaltrials. gov/prs/app/action/SelectProtocol? sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h barriers which prevent the translation of caries management best practices into the dental practice setting (Vernazza et al., 2021a,b; Pitts et al., 2021a; Urquhart et al., 2019). CariesCare International is a practice-friendly, health outcomes-focused, patient-centered, risk-based approach to caries management designed for the dental practice setting and organized in a CCI 4-D cycle (Martignon et al., 2019; Beltran et al., 2019). It uses and adapts evidence-based tools and resources developed systematically by ICDAS since 2012 and ICCMS since 2013 (Pitts et al., 2021b), sharing same principles. These are being followed globally in many settings, with local adaptations, including a large number of dental schools and cariology-teaching consensus guides for undergraduates in Colombia (Martignon et al., 2014), the USA (Fontana et al., 2016) and Caribbean countries (Abreu-Placeres et al., 2016), as well as in the practice and the academy in Colombia (Abreu-Placeres et al., 2023). In 2019, the FDI called for "a shift in caries management from restorative treatment to measures that arrest and prevent caries development including monitoring, following the concepts of ICCMS" (FDI, 2020). Cariologists, clinicians, educators and policy makers agree that the CCI consensus guide promotes best practice in the control of caries and in maintaining oral health in patients (Martignon et al., 2019; Beltran et al., 2019). CCI has been included as a core part of a Policy Lab conducted with the Global Collaboratory for Caries Management (GCCM) to raise awareness and to promote a cavity-free future; this involved experts in public health, the industry and the profession (Vernazza et al., 2021b). To our knowledge there are no studies to date which have reported on the caries-control effect of CCI. In 2020, with ethical approval from the lead center, the so called Caries OUT collaboration (21 centers in 13 countries) attempted to conduct a 12-month multicenter pragmatic RCT in schoolchildren to compare the CCI system versus standard care in the control of individual and tooth-level caries progression. Plans were revised due to the COVID-19 pandemic and the consequent restrictions imposed by universities' Ethical Boards to conduct randomized controlled trials (RCT). To permit caries care to be offered to children, we modi ed CCI protocols by avoiding aerosol generating procedures (AGPs) and reducing ino ce appointment time (CCI-adapted). Furthermore, we modi ed the study design from a pragmatic RCT to a single-group interventional study (see study protocol, Martignon et al., 2021). All of the original 21 centers were willing to attempt the revised study and were invited to participate. Seventeen centers agreed to participate with Institutional Review Board approval. The aim of this 12-month multicenter single-group interventional study was to assess the effect of a pandemic-adapted CCI protocol on caries control in children. Methods Design This was a 12-month multicenter single-group interventional study with approval from the Research Institutional Ethical Committee at Universidad El Bosque (PCI 2019-10718). Written informed consents
Acta odontológica latinoamericana/Acta odontológica latinoamericana, Dec 29, 2023
To prepare a consensus document of the cariology contents and competences included in the curricu... more To prepare a consensus document of the cariology contents and competences included in the curriculum for the dentistry degree at Argentine dental faculties/schools. Materials and Method: Planning the process in stages: Stage 1-Diagnosis of the situation (Google Form) and invitation to participate extended to the 20 academic units (AU) that offer dentistry degrees. Stage 2-Assessment process of Content (C) and Competences (I) agreements in the five domains: D1 Basic Sciences, D2 Risk and diagnosis of dental caries, D3 Decision-making for non-invasive treatments, D4 Decision-making for invasive treatment, and D5 Evidence-based cariology at community level. Stage 3-Consensus. Stages 2 and 3 were held in Workshop format in virtual mode (W). Results: Stage 1-Of the total 20 Google forms sent to the AU, 13 responses were received: 7 from National Universities and 6 from Private Universities. All participants agreed to be part of the consensus. Stage 2-W: 20 representatives from 10 AU participated. It began with a contextualizing conference, after which the representatives were divided into 5 groups to assess the agreements of each D. Stage 3-The Cariology Curriculum document was organized into 5 Domains, and 23 C and 31 I of clinical application were defined for teaching cariology. The contents and competences for each domain were agreed upon. The final document was sent to all W participants for their approval and dissemination in each AU involved. Conclusion: Cariology contents were defined for dentistry students at Universities in the Argentine Republic.
The aim of the present work was to explore whether there is a relationship between oral health st... more The aim of the present work was to explore whether there is a relationship between oral health status and oral health-related quality of life in pregnant women from socially deprived populations in Buenos Aires City. Eighty pregnant women (age 18-39 x = 25.19 +/- 6.56) in their 1st/2nd trimester were sampled from the population of women visiting a health center located in the south of Buenos Aires City for their pregnancy check-ups. The impact of oral disease was assessed using the Spanish validated version (López, 2006) of OHIP-49 (Slade and Spencer, 1994), which includes 49 items grouped into 7 domains. Each question has five possible answers, to which values ranging from 1 to 5 were assigned. To assess oral health status, 4 calibrated researchers performed a clinical examination and recorded: Gingival Index (Löe and Silness, 1963); depth on probing, clinical attachment level, bleeding on probing and DMFT discriminating its components. Variables were analyzed in the population as a whole and in groups regarding previous dental attention (presence of fillings). Statistical analysis included: Chi Square test to establish association between variables and t-test to compare groups. 93.75% of the patients showed clinical signs of gingivitis, 2.5% showed clinical signs of periodontitis. Mean DMFT was 12.24 +/- 6.48 (D/DMFT = 6.46 +/- 4.64; M/DMFT = 4.09 +/- 4.31; F/DMFT = 2.53 +/- 3.52); 73.3% of the patients had at least one missing tooth; 92.1% presented active caries lesions; 53.7% had at least one filling. Most frequent impacts were reported in the domains: psychological discomfort (59.9% = frequent concern about dental problems) and functional limitation (51.1% = frequent perception that "a tooth did not look good"). Oral health status and oral health-related quality of life showed no significant association. Domains involving functional limitation (p < 0.04) and physical disability (p < 0.01) showed higher levels of impact in the group of patients with previous dental care (presence of fillings). Oral health-related quality of life did not reflect health status; nevertheless, it may be an intervenient variable regarding demand for dental service.
Background:: Argentina has progressed with industrialization in comparison to other Latin America... more Background:: Argentina has progressed with industrialization in comparison to other Latin American countries and this process had a direct impact on the innovative capacity of the national economy. A constant search for market leadership, including the dentistry field and dental materials, stimulates the industries to launch new products daily. Inventions related to health researches are mostly protected by patents as intellectual property. A patent landscape analysis through searches in patent banks is a tool used to identify trends in different areas of innovations. Objective:: This study aims to identify and evaluate the scenario of research, development and innovation of dental products in Argentina by a technological prospecting based on patents. Methods:: A survey of patent documents was conducted by searching for deposited and granted patents of dental products. The search was carried out during January 2020 in the patent database of the National Institute of Industrial Property of Argentina (INPI-AR). The terms “dentistry”, “buccal”, “dental” and “oral” were used to select the titles and abstracts of patent application reports. The information extracted from patent reports was organized in tables and Figs using Fig.Pad Prism 6 software to evaluate the applications. Results:: A total of 363 patents were published from 1989 to 2016, mainly by international industries, 93.3% as patent invention and 3.0% as utility model applications on dentistry. Only two patents (0.5%) were deposited by universities, as the University of Melbourne (Patent number 20060102378) and Universidad Nacional del Nordeste (Patent number 20140104149), among which only the last one is national. Among the deposits, only 6.6% were granted; mostly were in force, denied or lost. According to the specialties, most patents were related to compositions (64.7%) and personal products (21.7%), also on dentistry/cariology (6.33%) and prostheses/implants (4.68%). Conclusion:: In general, we find that most patent applications are related to the preventive area, personal products and compositions for formulations. Few dental patents deposits are currently available in Argentina, suggesting that the importation of products into the area remains large, which can make dental products more expensive. It is important to invest in technology-based companies to promote increased economic activity, being a consequence of an investment in knowledge creation and intellectual property to the Dentistry area.
Various theories have endeavored to explain how knowledge is accessed. Students, in order to lear... more Various theories have endeavored to explain how knowledge is accessed. Students, in order to learn, need a good repertoire of appropriate metacognitive and self-regulating strategies and knowledge, which they use consciously or unconsciously. Teachers, in addition to knowing how to teach, need to be aware of students’ learning strategies, metacognition, and self-regulation, and of the impact of changes associated with recent pandemic scenarios. Aim: The aim of this study was to identify the study strategies preferred by dental students in two different scenarios: prior to and during the pandemic. Materials and Method: The sample consisted of third-year dentistry students at Buenos Aires University (UBA) during 2019 (Group GP, 141 students, face-toface activity) and 2021 (Group GE, 60 students, e-learning during the pandemic). Participants were asked (a) to provide demographic information (sex and age) and (b) to answer the abridged ACRA scale. Statistical treatment included descript...
and white tea. Fluoride and pH appeared not to be correlated (Pearson test). All the studied tea ... more and white tea. Fluoride and pH appeared not to be correlated (Pearson test). All the studied tea samples presented fluoride concentrations greater than the threshold recommended for drinking water. The pH proved to be low, which could be a risk for erosive tooth wear.
To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infant... more To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the ‘Child Impact’ section in the LAC was 4.0(±8.3), in the ‘Family Impact’ section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the ‘Child Impact’ section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In t...
The aim of this study was to determine the effect of SDF on the dentin-pulp complex using two mod... more The aim of this study was to determine the effect of SDF on the dentin-pulp complex using two models: teeth after SDF application (ex vivo) and experimental animal molars. A descriptive study was performed using two models. In the first model, primary teeth (ex vivo) with enamel-dentin caries, without pulp involvement and previously treated with 38% SDF, were evaluated by means of two techniques: (a) Scanning Electron Microscopy (SEM) and energy-dispersive X-ray detector (EDS) to determine qualitative and quantitative composition, and (b) brightfield optical microscopy (OM) after decalcification. The second model used laboratory animal molars from 12 male Wistar rats. Standardized enamel-dentin cavities approximately 0.5 mm deep were made the distal fossa of the occlusal face of both first lower molars, to one of which a 38% SDF solution was applied, while the other was used as a control. Histological sections were prepared and dental pulp was evaluated qualitatively in both groups....
Learning strategies are a set of organized, conscious, intentional tasks performed by a student t... more Learning strategies are a set of organized, conscious, intentional tasks performed by a student to achieve a learning objective effectively in a given social context. The aim of the present study was to determine the type and frequency of use of different learning strategies among students taking the subject "Comprehensive Clinic II ", which corresponds to the 3rd year of the 6-year general syllabus of the undergraduate course at the School of Dentistry, Buenos Aires University, and to analyze the use of these learning strategies according to the number of years elapsed between each students admission to dental school and the time he/she took that subject. Dental students (n=189) filled in the Learning and Study Strategies Inventory (LASSI). Seventy-five percent were female. The tool includes 10 dimensions, organized in 77 items. Responses to each question were recorded using a Likert type scale (5 choices). Total scores were obtained by assigning values to the responses. ...
International Journal of Clinical Pediatric Dentistry, Mar 21, 2023
Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have o... more Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have obtained written informed consent from the patient's parents/legal guardians for publication of the case report details and related images.
The aim of this study is to compare the efficacy of two methods for collecting saliva samples fro... more The aim of this study is to compare the efficacy of two methods for collecting saliva samples from infants under 2 years of age for cariogenic streptococci (CS) count. Two collection methods were applied in 11 infants. In Method (A), saliva samples were collected by swabbing the inner cheek mucosa and floor of the mouth in figure of eight motions with a sterile cotton swab until it was soaked. In method (B), saliva samples were collected by aspiration of 1 ml of saliva with a sterile plastic syringe on the floor of the mouth, after stimulation with glove. The samples were cultured in modified Gold's broth (MSMG), and on trypticase, yeast extract, sucrose, cystine and bacitracin culture medium (TYSCB). In method (A), the swab with the sample was unloaded in situ on TYSCB and placed in PBS medium for transport. Then, 100 µl of the eluate was seeded in MSMG. In method (B) 100 µl were seeded in TYSCB and 100 µl in MSMG. Both culture media were incubated under capnophilic conditions for 48 hours at 37 °C. Colony forming units (CFU/ml) were counted by calibrated operators (kappa = 0.75). The presence of cariogenic streptococci (CS) (Streptococcus mutans-Streptococcus sobrinus) was determined by qPCR in the samples collected by both methods. The CFU/ml counts in MSMG differed significantly between methods (p = 0.021). In TYSCB, the recovery of CFU/ml was higher in method (A), without significant difference (p = 0.705). The molecular technique detected presence of CS, with no difference between collection methods. Collecting saliva samples by swabbing proved more effective in terms of recovery of microorganisms, and did not affect the detection of presence of CS by molecular techniques..
In this study, comprehensive clinics (CC) are interpreted as a pragmatic projection of the comple... more In this study, comprehensive clinics (CC) are interpreted as a pragmatic projection of the complexity of health. The aim of the study was to analyze the characteristics of the CCs at different schools of dentistry in Argentina. Data were collected from document analysis and interviews with key respondents at 8 universities, classified according to the criteria of Bray and Thomas. Interviews were developed and analyzed according to discourse analysis. The convergences and divergences among curricula were established and analyzed statistically. Triangulation of results showed that: (a) Most curricula (7/8) included subjects called CC; (b) the permanence of CCs in the curricula was not stable, with changes recorded in different periods; and (c) in the so-called CCs, the complex clinical approach showed frequent displacements based on teacher values or competence. It was concluded that there are divergences between theory and practice, and that it would be recommendable to have more rigorous curricular design taking into account current trends regarding the complexity of health and its transfer to educational management.
The aim of this work was to assess the score variation of scales 1 and 2 of the DCBS (Dental Copi... more The aim of this work was to assess the score variation of scales 1 and 2 of the DCBS (Dental Coping Beliefs Scale) of beliefs on oral health regarding oral health needs, clinical progression of the viral infection, medical care needs, age and gender in HIV+ patients. The DCBS was randomly administered to 102 HIV+ patients at the "Juan A. Fernandez Hospital", Buenos Aires, Argentina. For each of the 29 items, patients indicated their responses on a five point scale ranging from "strongly disagree" to "strongly agree". Oral health needs were assessed through the CCITN (Community Caries Index of Treatment Need) and the CPITN (Community Periodontal Index of Treatment Need). Data on CD4 cell count, pharyngeal-esophageal candidiasis, tuberculosis, pneumonia and hospitalization because of HIV-related opportunistic diseases were recorded. A linear regression model was built in which the number of items reporting wrong dental beliefs was the dependent variable and the remaining variables were independent. Altogether 65.7% were male (36.0 +/- 0.87 y.o.) and 34.3% were female (36.11 +/- 1.21 y.o.) patients. The eight independent variables were significant for the model (F(8.93)= 93.20, p < 0.05; R = 0.80). The estimated parameters were all positive except for CD4 cell counts. The results demonstrate that the DCBS was useful to identify HIV+ patients as a caries and periodontal disease risk group because of their wrong dental beliefs and suggests the need of dental education interventions.
Lack of communication between the medical and dental professions impacts healthcare quality, espe... more Lack of communication between the medical and dental professions impacts healthcare quality, especially in hospitals. Different authors have described the oral status of inpatients. Following that line of research, the current study set the following aims: to characterize the dynamics of medical-dental healthcare interaction at a university hospital and to describe oral status and identify need for dental treatment in a sample of 150 inpatients at a hospital in Buenos Aires City, Argentina.A descriptive study was conducted on patients who were referred to dentistry by their physicians. The following variables were surveyed: personal data, medical history, oral health status, need for dental treatment and oral self-care habits.Patient median age was 60 years, 60.7% were male, 68.7% had diseases of the circulatory system, average number of medications per day was 7, of which 28.1% were for the cardiovascular system. Seventy percent of the referrals came from the Cardiology Service and 48% were requested for preoperative evaluation. Percentage of visible plaque was 73.6% and bleeding on probing 75.4%. DMFT was 19.9; 57.3% of patients had periodontal pockets deeper than 4 mm, and 97.2% required surgery, endodontic or prosthetic rehabilitation treatments. The frequency of daily brushing decreased during hospitalization: 28.7% reported not brushing daily and only 5.3% reported brushing 3 times a day. Referrals to dentistry came mainly from the cardiology service in pre-surgical situations. Inpatients presented high levels of oral pathology and need for dental treatment.
Background: Comprehensive caries care has shown effectiveness in controlling caries progression a... more 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
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