Background Folate is a naturally occurring, water-soluble B vitamin. The synthetic form of this compound is folic acid (FA), the deficiency of which is linked to neural tube disorders (NTD), which can be prevented by consuming it before, or during the early months of, pregnancy. However, the effect of FA on oral cleft formation remains controversial. The aim of the present study was to review the evidence concerning the effect of FA on the formation of cleft lip and palate (CLP) in both animals and humans, as well as its impact on different cell types. A search was conducted on various databases, including MEDLINE, EMBASE, and Central, for articles published until January 2020. Main body Current systematic reviews indicate that FA, alone or in combination with other vitamins, prevents NTD; however, there is no consensus on whether its consumption can prevent CLP formation. Conversely, the protective effect of FA on palatal cleft (CP) induction has been inferred from animal models; additionally, in vitro studies enumerate a cell-type and dose-dependent effect of FA on cell viability, proliferation, and differentiation, hence bolstering evidence from epidemiological studies. Conclusions Meta-analysis, animal models, and in vitro studies demonstrated the protective effect of FA against isolated CP; however, the heterogeneity of treatment protocols, doses, and FA administration method, as well as the different cell types used in in vitro studies, does not conclusively establish whether FA prevents CLP formation.

Introduction. The aim of the present study was to determine the effects of vitamins D and E on the proliferation, morphology, and differentiation of human dental pulp stem cells (hDPSCs). Methods. In this in vitro experimental study, hDPSCs were isolated, characterized, and treated with vitamins D and E, individually and in combination, utilizing different doses and treatment periods. Changes in morphology and cell proliferation were evaluated using light microscopy and the resazurin assay, respectively. Osteoblast differentiation was evaluated with alizarin red S staining and expression of RUNX2, Osterix, and Osteocalcin genes using real-time RT-PCR. Results. Compared with untreated cells, the number of cells significantly reduced following treatment with vitamin D (49%), vitamin E (35%), and vitamins D + E (61%) after 144 h. Compared with cell cultures treated with individual vitamins, cells treated with vitamins D + E demonstrated decreased cell confluence, with more extensive and flatter cytoplasm that initiated the formation of a significantly large number of calcified nodules after 7 days of treatment. After 14 days, treatment with vitamins D, E, and D + E increased the transcription of RUNX2, Osterix, and Osteocalcin genes. Conclusions. Vitamins D and E induced osteoblastic differentiation of hDPSCs, as evidenced by the decrease in cell proliferation, morphological changes, and the formation of calcified nodules, increasing the expression of differentiation genes. Concurrent treatment with vitamins D + E induces a synergistic effect in differentiation toward an osteoblastic lineage.

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Los incisivos impactados tienen una incidencia del 4 %. Este artículo presenta el caso de una niña de 9 años de edad, quien fue remitida a la clínica de posgrado en odontología pediátrica de la Universidad El Bosque para exodoncia de un incisivo central superior permanente. La paciente tenía antecedentes de trauma dentoalveolar a los 7 años de edad y ventana quirúrgica para erupción del diente 21. Mediante examen clínico, radiografías y tomografía axial computarizada se confirmó la retención del diente 11. Se decidió realizar manejo quirúrgico-ortodóntico con ventana quirúrgica para exponer el 11, tracción ortodóntica y péndulo para reganar espacio en un sector posterior durante 16 meses y técnica de 4 × 2 para alinear los incisivos superiores. Se presenta el seguimiento de la paciente durante 3 años y se analizan los posibles riesgos y complicaciones. El manejo integral es importante para lograr los objetivos propuestos, y minimizar las posibles complicaciones que puedan presentarse en el tratamiento los dientes impactados. PALABRAS CLAVE diente impactado; posición ectópica de los dientes; incisivo; tomografía; tracción ortodóntica ÁREAS TEMÁTICAS ortodoncia; cirugía bucal; odontología pediátrica ABSTRACT The incidence of impacted incisor teeth is 4%. This article presents the case of a 9-year-old female patient who was referred to the postdoctoral pediatric dentistry clinic at the University El Bosque for extraction of an upper central incisor with a history of dentoalveolar trauma at age seven and surgical window to allow eruption of tooth 21. The retention of tooth 11 was confirmed through clinical examination, X-ray analysis, and computerized axial tomography scan. The treatment included performing surgical-orthodontic procedures through surgical window to expose tooth 11, orthodontic tooth traction and pendulum movement to regain space for 16 months, and 4×2 orthodontic technique to align upper incisors. The report includes a three-year follow-up of the case with analysis of possible risks and complications. A comprehensive management is important to achieve the goals, minimize possible complications that may arise in the treatment of impacted teeth. KEYWORDS impacted tooth; ectopic tooth eruption; incisor; computerized axial tomography; orthodontic traction THEMATIC FIELDS orthodontics; oral surgery; pediatric dentistry Manejo quirúrgico y ortodóntico del incisivo central permanente impactado en posición ectópica: reporte de un caso

Object To identify the perception of barriers to the comprehensive management of cleft lip and palate (CLP) by parents/caregivers of Colombian children with this condition. Setting and Sample Population Fifty parents/caregivers of children with CLP under 12 years attending a center specialized in the management of craniofacial congenital conditions in Bogota, Colombia. Materials and Methods This study consisted of 2 phases: a quantitative phase (descriptive cross-sectional) and a qualitative phase (focus group [FG]). Chi-square and Fisher exact tests were used to analyze the association variables. The barriers and alternative ways to overcome barriers were analyzed in the FG. Results Comprehensive management was mostly defined as access to multiple treatments (54%), and this concept was expanded in the FG toward understanding CLP at all levels. Monoparental families spend their income on treatments (29%) than nuclear families (0%) ( P = .001). All parents with high education levels were familiar with healthcare centers specialized in CLP as opposed to 66.7% of parents with basic primary education ( P < .05). Regarding the timeliness of appointments, 12.2% of parents earning between 1 and 2 minimum wages reported some kind of difficulty, whereas those earning less than one minimum wage reported difficulties in 66.7% of cases ( P = .046). Conclusions All participants reported barriers, which increased or decreased depending on their socioeconomic status. The FG allowed the discussion of alternatives to overcome barriers, such as structural, solidarity, and self-management actions.