Introduction: Non-carious lesions are an oral health pro-blem in adults, consequently it is necessary to create mechanisms for their diagnosis and prevention. Objective: To determine the frequency of erosion, abrasion and related factors in patients treated at a university dental clinic. Material and Methods: A cross-sectional study was conducted in a sample of 153 adults treated at a university clinic in Lima, Peru, in 2018. Personal aspects (age, sex, characteristics of saliva), dietary factors, health condition, oral habits, and tooth brushing were identified. The presence of abrasion was determined according to clinical criteria through direct observation. Erosion was identified using the Basic Erosive Wear index. Generalized linear models with Poisson distribution with robust variances were used. Results: The frequency of dental abrasion (70.6%) is higher than erosion (26.1%). The presence of erosion is associated with asthma (PR= 2.11), abrasion is related to age and poor dental hygiene habits (PR= 1.67 and 1.30, respectively). Conclusion: The presence of dental abrasion is greater than dental erosion. Age and poor dental habits are factors associated with tooth abrasion. The characteristics of saliva regarding pH and salivary flow were within normal p-values.
Background Malocclusion is highly reported among mixed dentition cases. Therefore, we aimed to determine the relationship of dental malocclusions in the vertical, transverse, sagittal planes with deleterious habits in pediatric patients. Methods A cross-sectional analytical study was carried out on 155 children aged 6–12 years attended at the clinic of the School of Dentistry of Universidad Nacional Mayor de San Marcos in 2017. Results Among 155 evaluated patients, 45.3% had vertical malocclusion, 52.0% had sagittal malocclusion and 13.6% had transverse malocclusion. The most frequent type of malocclusion in the vertical plane was anterior deep bite (22.2%), in the transverse plane, the edge-to-edge bite (7.1%) and the anterior crossbite (6.5%) were less frequent. Finally, in the sagittal plane, Class II Div 1 (20%) and Class III (20.7%) were the most frequent. Among the most common deleterious habits, anteroposition (58.7%) and mixed breathing (51.0%) were observed in contrast to the habit of retroposition, lip sucking and mouth breathing, which were the least frequent. Considering age and sex, children who have an atypical swallowing habit are more likely to have malocclusion in all three planes of space. Conclusions It is concluded that there is an association between the deleterious habits with the different types of malocclusions in the different planes of the space, being the atypical swallowing a habit that should be early diagnosed and treated interdisciplinary.
El Fibroma traumático es una alteración caracterizada por una producción exagerada de tejido conjuntivo fibroso, producida por traumas crónicos. Generalmente se encuentra en mucosa oral como carrillos o lengua. En este caso en particular debido a que la paciente tiene dentición en el maxilar inferior y edentulismo total superior, se puede apreciar como progresó la lesión en la mucosa labial. La paciente de ochenta años acudió por renovación de su prótesis total superior debido a que dejo de usarla porque estaba desadaptada. Al examen clínico se observa un agrandamiento a nivel de mucosa labial superior izquierda, no dolorosa a la palpación y de coloración ligeramente blanquecina. Se decide tomar una biopsia excisional para establecer el diagnóstico definitivo debido a que existen varias lesiones con presentación clínica similar, la lesión fue compatible con un fibroma traumático, este trabajo se presenta con el objetivo de presentar las características clínicas e histopatológicas de un fibroma traumático, enfatizando la importancia de un diagnóstico temprano y oportuno para efectuar un tratamiento eficaz. Es importante considerar que, si la intervención quirúrgica no se acompaña con la rehabilitación protésica oral, pudiera aparecer una recidiva de la lesión.
Background: Mixed dentition is currently the stage with the highest prevalence of malocclusion, therefore, the objective was to determine the relationship of dental malocclusions in the vertical, transverse, sagittal planes with deleterious habits in pediatric patients. Methods: A cross-sectional analytical study was carried out in 155 children aged 6 to 12 years attended at the clinic of the Dentistry School of The National University of San Marcos in 2017. Results: Of the patients evaluated, 45.3% were identified with vertical malocclusion, 52.0% with sagittal malocclusion and 13.6% with transverse malocclusion. The most frequent type of malocclusion in the vertical plane was anterior deep bite (22.2%), in the transverse plane the Bis a Bis Bite (7.1%) and the Anterior Crossbite (6.5%) were less frequent. Finally, in the sagittal plane, Class II division 1 (20%) and Class III (20.7%) are frequent. Among the most common deleterious habits, anteroposition (58.7%) and mixed breathing (51.0%) were observed in contrast to the habit of retroposition, lip sucking and mouth breathing, which were the least frequent. Considering age and sex, children who have an atypical swallowing habits are more likely to have malocclusion in all three planes of space. Conclusions: It is concluded that there is an association between the deleterious habits with the different types of malocclusion in the different planes of the space, being the atypical swallowing a habit that should be diagnosed early and treated interdisciplinary.
Background: The anterior loop is the extension of the inferior dental nerve which is one of the most important anatomical landmarks to consider when placing dental implants or any other surgical procedure that involves the chin region. Determining the frequency and characteristics of the anterior loop is important to reduce the risk of complications in the chin region as a result of the implant or regenerative surgeries. For this reason, the objective of the study was to determine the prevalence and characteristics of the anterior loop in adult patients using Cone Beam computed tomography. Methods: A Cross-sectional study of 93 Cone Beam computed topographies (CBCT) obtained from patients of the Faculty of Dentistry of the UNMSM during the period 2016-2017. CBCTs were analyzed and measurements of the anterior projection (AP) and caudal projection (CP) of the anterior loop were performed. In addition, the distance of the anterior loop to the alveolar ridge (D-AR) and the buccal table (D-BP) was evaluated. Results: The prevalence of the anterior loop was 95.1% (n=177) and with an average AP of 2.67 ± 1.36 mm. In AP and CP, a significant difference was evidenced concerning dental status on the right side (p <0.05). The CP of the anterior loop was 5.27 ± 1.69 mm; the rods presented a higher value on the side with 5.94 ± 2.01 mm (p = 0.01); the completely edentulous patients presented a higher value on the side with 7.00 ± 1.13 mm (p = 0.036). The D-AR was 15.33 ± 2.45 mm and the D-BP was 4.97 ± 1.40 mm. Conclusions: In this study, it was found that there is a high prevalence of the anterior loop (95.1%) with an average length of 2.67 mm. In addition, some characteristics associated with the anterior loop were found, such as its anterior projection with dental status and its caudal projection with gender and dental status.
Objectives The general objective of this study is to test the hypothesis that administration of convalescent plasma from donors with previous diagnosis of severe COVID-19 pneumonia is safe and associated with a decrease in all-cause in-hospital mortality among hospitalized patients with COVID-19 at 30 days in comparison with standard treatment alone. The secondary objectives are: 1) to assess the efficacy of convalescent plasma to reduce the length of hospitalization; 2) to assess the efficacy of convalescent plasma to reduce the length of ICU stay; and 3) to assess the efficacy of convalescent plasma on reducing the requirement of invasive mechanical ventilation or ICU stay. Trial design PERUCONPLASMA is a IIb phase open label, randomised, superiority clinical trial with 1:1 allocation taking place in real life routine clinical practice at public hospitals in Lima, Peru. Participants will be randomised to receive convalescent plasma along with local standard treatment or local standard treatment alone. After allocation all participants will be followed for a total of 30 days or until hospital discharge, whichever occurs first.
Objectives The general objective of this study is to test the hypothesis that administration of convalescent plasma from donors with previous diagnosis of severe COVID-19 pneumonia is safe and associated with a decrease in all-cause in-hospital mortality among hospitalized patients with COVID-19 at 30 days in comparison with standard treatment alone. The secondary objectives are as follows: (1) to assess the efficacy of convalescent plasma to reduce the length of hospitalization, (2) to assess the efficacy of convalescent plasma to reduce the length of ICU stay, and (3) to assess the efficacy of convalescent plasma on reducing the requirement of invasive mechanical ventilation or ICU stay. Trial design PERUCONPLASMA is a IIb phase open label, randomized, superiority clinical trial with 1:1 allocation taking place in real life routine clinical practice at public hospitals in Lima, Peru. Participants will be randomized to receive convalescent plasma along with local standard treatment or local standard treatment alone. After allocation, all participants will be followed for a total of 30 days or until hospital discharge, whichever occurs first. Participants The population for the study are patients with severe disease with a confirmed laboratory test for SARS-CoV-2 infection hospitalized in 3 tertiary-care hospitals in Lima, Peru. Subjects are eligible for the trial if they meet all of the following inclusion criteria: Age 18 or older Hospitalization due to COVID-19 with laboratory confirmation (either with serologic, molecular, or antigen test along with a compatible clinical presentation) Severe or critical COVID-19 disease Severe illness was defined by 2 or more of the following: Respiratory rate of 22 or more Hypoxemia with oxygen saturation equal or less than 93% Abnormal blood gas analysis (PaO2 < 60 mmHg, PaCO2 > 50 mmHg, or Pa/FiO2 < 300) Critical disease was defined by either: Mechanical ventilation requirement less than 72 h. Shock. Capacity to provide informed consent (patient or patient’s direct relative) Availability of convalescent plasma units compatible with ABO blood type of the subject. Exclusion criteria: Subjects are not eligible for the trial if they meet any of the following criteria: Contraindication for transfusion (e.g., prior anaphylaxis, congestive heart failure) Hemodynamic instability (PA < 60 mmHg refractory to vasopressors) Uncontrolled concomitant infections\ Stupor or coma Platelets < 50,000/μL or disseminated intravascular coagulation Serum creatinine > 3.5 mg/dL or dialysis requirement Total bilirubin > 6 mg/dL or jaundice of unknown etiology Myocardial infarction or acute coronary syndrome Active or recent (< 7 days) intracranial hemorrhage Pregnancy Donors: The donors have to meet the following criteria: male between 30 and 60 years with a previous diagnosis of severe COVID-19-associated pneumonia within the last 3 months, with resolution of symptoms of at least 28 days. The rationale for including donors with severe disease is to maximize the probability of collecting convalescent plasma units with high titer of neutralizing antibodies, as the technology to measure this specific type of antibodies is not routinely available in Peru. Aliquots of plasma will be stored for future quantification of neutralizing antibodies. Intervention and comparator Convalescent plasma from donors with previous severe COVID-19 is the investigational medical product. The experimental group will receive 1 to 2 units of 200 to 250 ml of convalescent plasma along with local standard treatment. The control group will receive local standard treatment alone. The participants randomized to plasma will have evaluations at 6 h and 24 h to specifically evaluate possible post transfusion events. All the participants will be evaluated at day 3, day 7, and day 30 after enrolment. Main outcomes Safety outcome: Incidence of serious adverse reactions related to convalescent plasma transfusion within 24 h after convalescent plasma administration. Efficacy outcomes: Mortality from any cause during hospitalization at 30 days post randomization. Length of hospitalization at 30 days post randomization or until hospital discharge. Duration of mechanical ventilation at 30 days post randomization or until hospital discharge. Length of hospitalization in an intensive care unit at 30 days post randomization or until hospital discharge. Exploratory: Oxygen requirement evolution at days 3 and 7. Score Sequential Organ Failure Assessment (SOFA) evolution at days 3 and 7. Dynamics of inflammatory marker (lymphocyte, C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH)) evolution at days 3 and 7. Proportion of patients progressing to multi-organ failure at 30 days post randomization or until hospital discharge. Proportion of transfusion related adverse reactions at 30 days post randomization or until hospital discharge. Randomization Randomization will be carried out within the electronic case report form (eCRF) in 1:1 ratio (receive plasma/control) in a randomization process established by blocks of size 2, 4, and 6. Allocation to the treatment arm of an individual patient will not be available to the investigators before completion of the whole randomization process. Randomization blocks will be performed with “ralloc”, Stata’s randomization process v.16.0. Randomization through the eCRF will be available 24 h every day. Blinding (masking) Both the participants and study staff will be aware of the allocated intervention. Blinded statistical analysis will be performed. Numbers to be randomized (sample size) The sample size was calculated using the Fleiss formula with continuity correction to detect a mortality reduction from 50 to 20% between the two treatment arms with a confidence level of 95% and a power of 80%. Based on this information, a total of 45 patients per arm would be needed. After adjustment for a drop-out rate of 10% after enrolment, a total of 50 patients per arm (100 patients in total) will be enrolled. Trial status Current protocol version: 5.0 dated January 04, 2021. Recruitment started on September 21, 2020, and is expected to finish by the end of March 2021. Trial registration Peruvian Register of Clinical Trials (REPEC) ID: PER-016-20, registered on June 27, 2020. Clinicaltrials.gov ID: NCT04497324, registered on August 4, 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.
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