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Aim: Cone beam computed tomography has become an attractive method for implant planning. However, in most cases, not all the information is taken advantage of and often the radiographic evaluation of bone quality is based on subjective assessment by the individual clinician. Therefore, the aim of this study was to examine classifications of bone tissue characteristics and methods for assessing them in dental implant planning and placement studies. Materials and Methods: Three databases (Pubmed, Scopus, Web of Science) were searched using specific index terms: "Bone quality, bone quantity, bone density, cone-beam CT and cone-beam computed tomography". Three reviewers selected titles and analyzed abstracts according to inclusion and exclusion criteria. Some descriptions of bone tissue characteristics (bone quality, density, and quantity) used before or during dental implant placement were selected and categorized. Results: The search yielded 442 titles. A total of 32 articles were selected and read in full text. Seventeen articles were considered relevant. Different classification systems were found to evaluate bone tissue characteristics as well as different examination protocols. Thirteen publications included in this review reported on bone quality and quantity using the Lekholm and Zarb classification. However, only four studies implemented and/or proposed modifications of the Lekholm and Zarb system. Four other publications described bone quality according to different classification systems such as Misch, University of California Los Angeles (UCLA), or Trisi and Rao. The assessment methods were often briefly described (or not described at all in one publication). Of the articles analyzed, five presented observer performance, whereas three presented diagnostic accuracy of the assessment method. Conclusion: Currently, there are different classification systems applied to dental implant planning and placement, particularly regarding whether bone quality or quantity affects treatment outcomes. However, most authors have not validated the diagnostic accuracy and reproducibility of the classification used. Therefore, it is necessary to develop a classification system consistent with characteristics of bone tissue, taking into consideration an adequate description of bone tissue assessment methods, their diagnostic accuracy, and observer performance.
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Aim: Stability measured by resonance frequency analysis (RFA) is an important factor to be considered in the success of dental implant treatments, which can be evaluated from the implant stability quotient (ISQ). The aim of the present case series was to map the RFA during healing of implants with nanostructured hydroxyapatite surface to describe the behavior of ISQ values related to individual factors. Materials and Methods: Twenty-three implants were placed in eight patients by conventional surgical protocol, and ISQ values were monitored from the day of implant placement until week 20. To obtain the ISQ values, an Osstell device was used and the placed implants were grouped in proportional amounts to describe the ISQ behavior considering the length (≤10 or >10 mm), the diameter (3.5 or 4.3 mm), the insertion torque (<40 N-cm or ≥40 N-cm), and the placement area (maxilla or mandible). Results: All the implants assessed decreased their values in the first 3 weeks after placement. Subsequently, the ISQ values increased by amounts similar to those obtained at the time of the placement and even more. Implants with length >10 mm, diameter 4.3 mm, and insertion torque ≥40 N-cm showed the highest ISQ values. Conclusions: A decrease in the ISQ values of dental implants with nanostructured hydroxyapatite surface was evidenced between weeks 2 and 3 considering length, diameter, insertion torque, and maxillary or mandibular placement site.
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Aims and Objectives: Excessive fear of coronavirus disease 2019 (COVID-19) in dental students could cause mood disorders, especially if there are factors in the environment that generate feelings of anxiety or uncertainty. The aim of this study was to evaluate the fear of COVID-19 and its association with depression, anxiety, and stress in Peruvian dental students according to their sociodemographic factors. Materials and Methods: This analytical, observational, and cross-sectional study was conducted in 398 dental students of a public university in the Peruvian capital during April 2021 to July 2021. The Depression, Anxiety and Stress Scale-21 items was used to diagnose depression, anxiety, and stress. The Fear of COVID-19 Scale was used to detect fear of COVID-19. The Pearson's chi-square test was used for statistical analysis. In addition, a logit model using odds ratio (OR) was performed to evaluate depression, anxiety, and stress of students with the associated factors: fear of COVID-19 and 12 sociodemographic variables (gender, age group, marital status, year of study, origin, companion, living with vulnerable people, history of mental illness, history of COVID-19, loss of close relatives due to COVID-19, occupation, and area of residence). A significance level of P < .05 was considered. In addition, predictive models were developed for the variables depression, anxiety, and stress, considering all possible significant causes. Results: The prevalence of fear of COVID-19, depression, anxiety, and stress was 19.6%, 36.2%, 40.7%, and 19.6%, respectively. According to the adjusted logit model, students who had fear of COVID-19 had OR = 2.74 (95% confidence interval [CI]: 1.62-4.64), OR = 5.59 (95% CI: 3.14-9.97), and OR = 3.31 (95% CI: 1.88-5.83) for developing depression, anxiety, and stress, respectively. In addition, those who reported history of mental illness were four times more likely to develop depression (OR = 4.02, 95% CI: 1.96-8.25) and anxiety (OR = 4.50, 95% CI: 2.06-9.82), whereas those living with people vulnerable to COVID-19 were twice as likely to develop stress (OR = 2.06, 95% CI: 1.16-3.66). Conclusion: The highest prevalence of mood disorders among dental students was anxiety. In addition, those who were afraid of COVID-19 had three times the probability of developing depression and stress, and five times the probability of developing anxiety. On the other hand, the most influential factor in the development of depression and anxiety was history of mental illness, whereas the factor of living with vulnerable people was the most influential factor in the development of stress.
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Aim: The puppet theater, due to its artistic and educational characteristics, could allow children to develop oral health self-care in an attractive and fun way. The aim of this study was to evaluate the impact of puppet theater on oral health knowledge and oral hygiene in preschoolers from a Peruvian public school. Materials and Methods: An analytical, longitudinal, and quasi-experimental study was conducted in 132 preschoolers divided into three age-matched groups (3, 4, and 5 years old) from August to November 2019 in a Peruvian public school. At 4 weeks and 4 months after performing the puppet theater, a validated questionnaire of five closed questions was used to evaluate oral health knowledge, and the Greene-Vermillion index [only bacterial plaque index (BPI) part] was used to evaluate oral hygiene, considering good (0-0.6), fair (0.7-1.8), and poor (1.9-3.0). The theater sessions were held every week for the first month and every 2 weeks for the following 3 months. To analyze the levels in the BPI, the Wilcoxon and Friedman test was used to compare related measures, and to compare the knowledge for each question of the questionnaire, the McNemar and Cochran's Q tests were used, considering a P-value less than 0.05. Results: The BPI in relation to age (3, 4, and 5 years), before and after 4 months of performing the puppet theater, was 1.9 [confidence interval (CI): 1.7-2.0], 1.8 (CI: 1.6-1.9), and 1.8 (CI: 1.7-2.0), decreasing to 0.9 (CI: 0.8-1.0), 0.8 (CI: 0.7-0.9), and 0.9 (CI: 0.8-1.00), respectively. In relation to gender (men and women), it was 1.8 (CI: 1.7-2.0) and 1.8 (CI: 1.7-1.9), decreasing to 0.9 (CI: 0.8-1.0) and 0.8 (CI: 0.8-0.9), respectively. In relation to origin (urban or rural), it was 1.8 (CI: 1.7-1.9) and 1.8 (CI: 1.4-2.2), decreasing to 0.9 (CI: 0.8-0.9) and 0.8 (CI: 0.7-0.9), respectively. The level of BPI and oral health knowledge improved significantly (P < 0.001) over time in all preschoolers, except in those who came from the rural area (P > 0.05). Conclusion: The application of the puppet theater positively influenced the preschoolers in such a way that it significantly improved their oral health knowledge and oral hygiene at 4 weeks and 4 months, in both genders of 3, 4, and 5 years of age, and in those whose origin was the urban area. However, no significant improvements in oral health knowledge and oral hygiene were observed in those preschoolers whose origin was the rural area.