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PellGregory and Winter classifications are basic in third molar categorization; Sánchez-Torres classification is used in Mexico, but it has not been previously evaluated.To assess the degree of agreement in the radiographic evaluation of impacted mandibular third molar with the use of three classifications: PellGregory, Winter and Sánchez-Torres.Observational, descriptive, inter-observer degree of agreement study that included 10 oral and maxillofacial surgeons and 10 training residents, who recorded the radiographic categorization of third mandibular molars (left and right) according to Pell and Gregory, Sánchez-Torres and Winter classifications. Inter-observer degree of agreement was assessed with Fleiss' kappa test.Pell and Gregory classification obtained the lowest degree of agreement (kappa = 0.05 and 0.185), followed by Sánchez-Torres classification (kappa = 0.125 and 0.326); Winter had the best agreement, with kappa = 0.28 and 0.636 for oral and maxillofacial surgeons and training residents, respectively.The Winter classification showed an acceptable (moderate) degree of agreement to classify mandibular third molars by training residents.Las clasificaciones de Pell y Gregory y de Winter son básicas en la categorización de terceros molares; la clasificación de Sánchez Torres es usada en México, pero no había sido evaluada previamente.Evaluar el grado de acuerdo en la valoración radiográfica de terceros molares mandibulares impactados, con el empleo de tres clasificaciones: Pell y Gregory, Winter y Sánchez Torres.Estudio observacional, descriptivo, de concordancia interobservador, que incluyó a 10 cirujanos orales y maxilofaciales y 10 residentes en formación, quienes registraron la categorización radiográfica de terceros molares mandibulares (izquierdos y derechos) de acuerdo con las clasificaciones de Pell y Gregory, Sánchez Torres y Winter. Se evaluó el grado de acuerdo entre observadores mediante la prueba de kappa de Fleiss.La clasificación de Pell y Gregory obtuvo el menor grado de acuerdo (kappa = 0.05 y 0.185), seguida de la clasificación de Sánchez Torres (kappa = 0.125 y 0.326); el mejor valor lo obtuvo la clasificación de Winter, con kappa = 0.28 y 0.636 para cirujanos orales y maxilofaciales y residentes en formación, respectivamente.La clasificación de Winter mostró un grado de acuerdo aceptable (moderado) para categorizar terceros molares mandibulares en los residentes en formación.

Arsenic (As) is a common contaminant in drinking water in northeastern Mexico, which reduces the expression of cytochrome P450 (CYP 450). This enzyme group metabolizes numerous drugs, such as oral antidiabetic drugs such as pioglitazone (61% CYP 3A4, 49% CYP 2C8). When CYP 450’s function is inadequate, it has decreased therapeutic activity in type 2 diabetes mellitus (T2DM). This study aimed to establish the effect of As on pioglitazone metabolism in patients with T2DM. Methodology: Urine, water, and plasma samples from a healthy population (n = 11) and a population with T2DM (n = 20) were obtained. Samples were analyzed by fluorescence spectroscopy/hydride generation (As) and HPLC (pioglitazone). Additionally, CYP 3A4 and CYP 2C8 were studied by density functional theory (DFT). Results: The healthy and T2DM groups were exposed via drinking water to >0.010 ppm, Ka values with a factor of 4.7 higher, Cl 1.42 lower, and ABCt 1.26 times higher concerning the healthy group. In silico analysis (DFT) of CYP 3A4 and CYP 2C8 isoforms showed the substitution of the iron atom by As in the active sites of the enzymes. Conclusions: The results indicate that the substitution of Fe for As modifies the enzymatic function of CYP 3A4 and CYP 2C8 isoforms, altering the metabolic process of CYP 2D6 and CYP 3A4 in patients with T2DM. Consequently, the variation in metabolism alters the bioavailability of pioglitazone and the expected final effect.

This study evaluated the association of surface degradation and formation of Streptococcus mutans (S. mutans) biofilm in resin-based composites (RBCs) after storage in different acidic liquids.To evaluate microhardness and surface micromorphology, hybrid and nanohybrid RBC discs were stored in artificial gastric acid, cola drink, orange juice, artificial saliva, and distilled water for three intervals of 15 min per day for 7, 15, and 30 days. After 30 days of storage, surface roughness was analyzed, and the RBC discs were placed in a biofilm reactor inoculated with S. mutans to evaluate surface biofilm formation.As compared with nanohybrid RBCs, roughness and surface microhardness values were significantly lower (P0.05) for hybrid RBCs stored in artificial gastric acid, followed by specimens stored in cola drink and orange juice. Artificial gastric acid caused greater surface degradation, which increased the biomass of S. mutans on the surface of both RBC types.Surface degradation of hybrid and nanohybrid RBCs correlated with the pH of the liquid, while S. mutans biofilm formation was associated with increased surface roughness in hybrid RBCs.

The study aimed to perform a systematic scoping review with the need of exploring the actual clinical applications of the chloramphenicol-tetracycline-ZOE antibiotic paste (CTZ) as a lesion sterilization tissue repair (LSTR) therapy agent. Following a scoping framework suggested by Arksey and O’Malley, relevant articles (randomized controlled trials, literature reviews, observational studies, in vitro studies, and clinical case-series reports) published over the last 15 years (in English, Spanish, or Portuguese languages) were identified and retrieved from five internet databases: PubMed, Embase/Ovid, Cochrane Library, Google Scholar, and EBSCO. By title and abstract screening and after removing duplicates, 11 articles were finally included in the present scoping review: five randomized/non-randomized clinical trials, five in vitro studies, and one case-series report. According to the collected information, there were no differences between CTZ paste and conventional pulpectomy, antibiotic pastes, and intracanal filling materials, considering the clinical, radiographic, antimicrobial activity, and periapical tissue biocompatibility outcomes. CTZ has shown excellent rates of clinical success and good radiographic results, with adequate antimicrobial effects; however, its biocompatibility has been put into doubt. Contemporary pediatric dentists should carefully consider the CTZ paste as an alternative endodontic approach for pulpally involved primary molars, with the advantages of being simple and fast, and taking into account the limitations of instrumental pulpectomy such as the microbiological and morphological complexity of primary root canals.

The composition of autogenous dentin differs from that of extracted deciduous and permanent teeth, as graft material must undergo procedures prior to implantation. The aim of this study was to characterize the physicochemical and morphological properties of dentin from deciduous (DTs) and permanent teeth (PTs) that had been demineralized (DMA), deproteinized (DPA), and decellularized (DSA). The dentin particles were DMA with ethylenediaminetetraacetic acid (EDTA), DPA with isopropanol, and DSA with sodium dodecyl sulfate (SDS). Sound dentin (SD) was used as the control group. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), Fourier transform infrared (FTIR) and X-ray diffraction (XRD) were used to examine the surface and physicochemical properties of the dentin. DMA and DPA dentin had lower concentrations of calcium and protein respectively than SD, showing a significant difference compared with DMA and DPA dentin from DTs and PTs (p < 0.05). In the DSA dentin, it was possible to eliminate the cellular residues of dentin from DTs and PTs, and the gene GAPDH was not expressed. The results of FTIR and XRD revealed a different physicochemical composition according to the dentin processing. EDS demonstrated that DMA dentin obtained the lowest values of calcium and phosphate, and the micrographs obtained by SEM exhibited a porous matrix structure in DMA dentin to a greater degree than in DPA or DSA dentin. The physicochemical properties and morphology of dentin as an autograft material differ depending on whether the teeth are deciduous or permanent; the processing method conditions the characteristics of the dentin substrate as a matrix for tissue regeneration.

The present study aimed to compare the adhesion and proliferation of human periodontal ligament fibroblasts (hPDL) in transverse sections of the teeth sealed with two different obturation techniques, BioRoot RCS/hydraulic obturation (HO) and AH-Plus/continuous-wave condensation (CWC). The techniques were tested using an in vitro model to simulate the interaction between periodontal tissues and the materials. The root canals were instrumented and sterilized. A total of 15 samples were obturated with BioRoot RCS/HO and 15 samples with AH-Plus/CWC. Then, roots were sectioned to obtain obturated teeth slices, and hPDL cells were seeded onto the root slices. The results were obtained at intervals of 4 and 24h for cell adhesion; and at 3,7,14, and 21 days for cell proliferation. Empty cell culture plates were use as controls. The cell adhesion was increased at 4 and 24h for both groups, with an increased response observed in the BioRoot RCS/HO group (p

Pediatricians are primary health care professionals who supervise the growth and development and treat infants and children during the first years of life. Thus, they should possess knowledge regarding oral health care, to provide anticipatory guidance, as well as dental education to parents in order to make appropriate clinical decisions. For many years, several surveys have been performed worldwide to assess the pediatricians' knowledge, awareness, and experience regarding oral health care and prevention. This work aimed to scope the existing literature and summarize the most relevant evidence about knowledge, practices, and attitudes on oral health/care among pediatricians worldwide. PubMed, Cochrane Library, Google Scholar, and DentistryOral Sciences Source were explored. Under a structured PCC question and eligibility criteria, for relevant clinical trials and observational studies, published during the last decade. Titles and abstracts were screened. Full-text articles were critically reviewed for bias risk and a data charting table was constructed. A total of 44 references were initially identified, and 37 titles remained for abstract screening after removing duplicates; then, 27 potential full-text articles were carefully reviewed. Finally, 25 relevant and most informative studies were included. The selected studies were conducted in India, Lebanon, Saudi Arabia, and Paraguay, Europe, Australia, Qatar, Iran, Turkey, United Arab Emirates, Nigeria, Brazil, Chile, Germany, Taiwan, Canada, and the USA. Through included surveys, researchers have reported different levels of knowledge, practice involvement, and attitude on children's oral health among pediatricians. In general, unsatisfactory knowledge of oral health was reported. The main impediments for a better professional involvement or practice include inappropriate education, poor auto-confidence, and lack of time. So, it has been suggested that some oral health training or clinical guidelines should be included in the current medical curricula.

The aim of this study was to characterize the morphological properties of amorphous silica nanoparticles (SiO2 NPs), their cytotoxicity and intracellular location within Human Osteoblasts (HOB). Additionally, SiO2 NPs were explored for their effectivity as carriers of CRTC3-siRNA on Human Preadipocytes (HPAd), and thus downregulate RGS2 gene expression. SiO2 NPs were synthesized using the method of Stöber at 45 °C, 56 °C, and 62 °C. These were characterized via TEM with EDS, Zeta Potential and FT-IR. Cytotoxicity was evaluated by XTT at three concentrations 50, 100 and 500 µg/mL; SiO2 NPs intracellular localization was observed through Confocal Laser Scanning Microscope. Delivering siRNA effectivity was measured by RT-qPCR. Morphology of SiO2 NPs was spherical with a range size from 64 to 119 nm; their surface charge was negative. Confocal images demonstrated that SiO2 NPs were located within cellular cytoplasm. At a SiO2 NPs concentration of 500 µg/mL HOB viability decreased, while at 50 µg/mL and 100 µg/mL cell viability was not affected regardless SiO2 NPs size. SiO2 NPs-CRTC3-siRNA are effective to down-regulate RGS2 gene expression in HPAd without cytotoxic effects. The developed SiO2 NPs-CRTC3-siRNA are a promising tool as a delivery vehicle to control obesity.

Ectopic eruption of the first permanent molar (EFUPM) is defined as its local disturbed eruptive behaviour, positioning too mesially against the distal aspect of the second upper primary molar during the developing mixed dentition. The EFUPM prevalence is up to 6% and affects both genders equally. The present study aimed to perform a scoping review to collect the most relevant studies published in the last 30 years and focused on the different strategies, traditional and novel, for treating irreversible uni- or bilateral EFUPM in children. This review also aimed to make recommendations and map the gaps in this clinical topic.An electronic and manual search was conducted in five databases according to previously established eligibility criteria, using different combinations of keywords, MeSH terms, and Boolean operators. Titles, abstracts, and full-text articles were screened and selected by pre-calibrated reviewers. A data charting was also accomplished for summarising the overview of the evidence.Paediatric dentists must learn to diagnose and treat this condition early in order to allow the prevention of future malocclusions and other clinical sequelae. Practitioners have at their disposal a variety of corrective options available for the successful resolution of EFUPM.

In 2020, two important changes were adapted by the international health community: a new definition of pain and a new classification for orofacial pain conditions. With these changes new tasks and challenges also emerged, and clinicians from several disciplines begun to adopt and reconsidered classic paradigms, and the policies derived from them. This new perspective article, examine the new definition of pain proposed by the International Association for the Study of Pain, and the new International Classification of Orofacial Pain; analyzing the positive impact and further perspectives of these. Resumen En 2020, dos importantes cambios fueron adaptados por la comunidad internacional en salud: una nueva definición de dolor y una nueva clasificación para las condiciones de dolor orofacial. Con estos cambios, también emergieron nuevos retos y tareas, y los clínicos de diversas disciplinas empezaron adaptar y reconsiderar los paradigmas clásicos; y las políticas derivadas de estos. En este artículo de nueva perspectiva, examinaremos nueva definición de dolor propuesta por la Asociación Internacional para el Estudio del Dolor, y la nueva Clasificación Internacional de Dolor Orofacial; analizando el impacto positivo y las próximas perspectivas de estos cambios.

Secondary/persistent infections are present in teeth with previous root canal treatment, and a great variety of anaerobic microorganisms has been observed in these infections. The antibiotics prescription is occasional; however, in some cases, it is essential, particularly when the general health condition of the patient is compromised. The aims of this study were to identify the associated microorganisms in diagnosis of persistent or secondary apical periodontitis and to evaluate the susceptibility level to the antibiotics most used. Fifteen patients with persistent or secondary apical periodontitis requiring endodontic re-treatment were included. Microbiological samples were taken from the root canals and incubated in thioglycollate under anaerobic conditions. Anaerobic CDC agar (formulated by the Center for Disease Control and Prevention) was employed as a culture medium and the microorganisms were identified using the API system. The microorganisms were subjected to antibiograms with three different antibiotics. Twenty-six microorganisms were identified, the most common genus was Enterococcus (26.8%), Streptococcus (19.22%), Aerococcus (19.1%), and Clostridium (11.4%). 48% of them were susceptible to amoxicillin, with 28% of resistance. For clavulanic acid/amoxicillin, the susceptibility occurred in 32%, with 28% of resistance; and for clindamycin, the susceptibility was present in 40%, with 52% of resistance. The most frequently detected associated microorganism for secondary infections was genus Enterococcus, which exhibited high resistance to the studied antibiotics.

This study sought to evaluate the biocompatibility of Neomineral Trioxide Aggregate (Neo-MTA), MTA Repair High Plasticity (MTA-HP), and Mineral Trioxide Aggregate-Angelus white (MTA-Ang) in fibroblasts of human dental pulp.Morphology was evaluated after 24 h of incubation.Morphological changes were observed in all groups. Neo-MTA and MTA-Ang were associated with increased cell viability, and all materials induced apoptosis, with a higher percentage in the MTA-HP group than in the other groups. In the LIVE/DEAD assay, there was more damage to the cell membrane in the group of cells treated with MTA-HP than in the other groups.Neo-MTA and MTA-Ang presented similar biocompatibility, and both showed greater biocompatibility than MTA-HP. MTA-HP and MTA-Ang increased Col-1A gene expression, and Neo-MTA and MTA-Ang increased TGF