Maestría Odontología

URI permanente para esta colecciónhttp://hdl.handle.net/11634/13487

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Identificación microbiológica de tres nichos orales y su asociación con las características clínicas y sociodemográficas de pacientes con caries dental. Estudio Piloto.
(Universidad Santo Tomás, 2023-10-26) Jaime Ospina, Gustavo Andrés; Flórez Salamanca, Elkin Jahir; Herrera Sandoval, Laura Viviana
Introduction: Dental caries is a disease that affects a large percentage of the population. Its origin is associated with the presence of microorganisms that inhabit oral biofilms that metabolize sugars from the diet into organic acids that produce demineralization of tooth surfaces. Understanding the variations in the composition of these biofilms allows us to develop better strategies for the prevention of pathology and the control of its progression. Objective: To evaluate the microbiological composition present in three niches of the oral cavity of patients with dental caries and their relation with clinical and sociodemographic characteristics. Materials and methods: A cross-sectional study was carried out with 28 adult patients who attended the clinics at the Dental School of the Santo Tomás University, divided into two groups of 14 participants according to the presence or absence of active cavitational caries (moderate or severe). Data on sociodemographic aspects, food frequency, habits associated with the oral cavity and DMF index were recorded. Collection of saliva, supragingival biofilm and carious dentin samples. Microbiological culture on agar plates for four microbial groups, CFU counting and macro-microscopic identification. Statistical analysis in STATA 14. Results: Greater presence of mutans streptococci in saliva vs dentin (p=0.0078) in caries group and in saliva vs biofilm (p<0.0001) in healthy group, Lactobacillus spp. in saliva vs biofilm (p=0.0166) in healthy group, Candida spp. in saliva vs biofilm (p=0.0887) in caries group. Greater presence of streptococci in participants with good oral hygiene in saliva (p=0.0308) and biofilm (p=0.0051) and with active cavitated caries lesions in saliva (p=0.0001) and biofilm (p=0.0149 ), Lactobacillus spp. in healthy participants in saliva (p=0.0002) and biofilm (p=0.0003), Candida spp. in participants who consume more than 4 meals a day in saliva (p=0.0156). Moderate positive correlation for Candida spp. in saliva (p=0.0208; r=0.4347). Presence of Enterococcus spp. too low to perform analysis. Conclusions: There is variation in the microbiological composition of the three anatomical niches between health and the varying stages of disease.
Comportamiento biomecánico de prótesis híbridas implanto soportadas en el maxilar inferior en función de las características geométricas de la subestructura: Estudio de caso de un paciente totalmente edéntulo con pérdida ósea severa
(Universidad Santo Tomás, 2023-08-23) Rodriguez Cuellar, Lina Maria; López Vaca, Oscar Rodrigo; Valencia Niño, Cesar Hernando; Martínez Vega, Ruth Aralí
Hybrid implant-supported prostheses are used for totally edentulous patients, in 0.17% of the population. The failure of this type of prosthesis is related to mechanical failures due to occlusal overload and a geometry of the substructure that does not allow an adequate distribution of stresses on the prosthesis, the bone and the implants, specifically in patients with severe bone loss. For this reason, it is important to determine the biomechanical behavior of an implant-supported hybrid prosthesis in the lower jaw based on the geometric characteristics of the substructure for a totally edentulous patient with severe bone loss, by planning the clinical case for the personalized design of the substructure of the substructure. implant-supported hybrid prosthesis in order to establish the geometric characteristics and the material for the design of the substructure of the prosthesis considering the anatomical conditions of the patient and in this way numerically determine the state of stresses and deformations by means of computational simulation of the implant-bone interface according to the conditions established for the design of the hybrid prosthesis.
Diseño y validación de una propuesta para promover la práctica formal de la odontología en los odontólogos independientes del Área Metropolitana del Departamento de Santander, Colombia
(Universidad Santo Tomás, 2023-03-27) Hernández González, Yelitza Lilibeth; Angarita Moncada, Diego Andrés
In the practice of dentists in the country and especially in the Department of Santander, an important phenomenon occurs, such as the existence of professionals who work on their own account or for third parties, without a formal employment relationship and without the full of the requirements that in terms of safety and health at work and given this, they are subjected to dangers with a high probability that chemical, biological, psychosocial and physical risks materialize. Given the above, this project designed a proposal that facilitates the formal practice of dentistry in independent dentists in the metropolitan area of the department of Santander, through the analysis of the applicable legal requirements and the particularity of the conditions of service provision. To achieve this, an analysis of the legal requirements applicable to the provision of dental services was carried out, comparing the criteria of the "PAIS" policy and the "MAITE" model, the characterization of the provision of dental services provided by dentists; a projection of a proposal for the promotion of the formal practice of dentistry; an analysis of the factors that intervene in the provision of dental services and finally it was supported with a panel of experts for the respective validation. The result was the identification of 4 axes, with their respective activities and indicators: first, human talent strengthened by strengthening their professional profile, entrepreneurial capacity and balance between their workload and the service offer; second, public health for all with a differential approach, governance and equity in the exercise of the dental profession; third, the inter-institutional articulation to ensure integrity with better physical and mental health conditions for dentists; and a last axis identified was risk management and sustainability of the dentistry profession.
Asociación entre la presencia de conductos no tratados y periodontitis apical en dientes con tratamiento endodóntico en una población colombiana
(2021-07-13) Blanco Fuentes, Bibiana Yorley; Moreno Monsalve, Jaime Omar
Introduction: Persistent infection leads to the permanence of apical periodontitis and one of the causes may be the presence of untreated canals. Within the associated variables, the permanence of microorganisms, the quality of the endodontics, the quality of the coronal restoration, the previous pulp state, the anatomical variations and the presence of untreated canals. 2D radiographic images have some limitations for the identification or interpretation of the root anatomy, these have been overcome with CBCT due to its high sensitivity to observe three-dimensional changes in dental tissues and supporting structures, Abuabara et al. In 2013 reported that only 8% of MV2 conducts were identified using periapical radiographs, while 54% of MV2 conducts were identified with CBCT. Objective: To investigate the association between the frequency of untreated canals and apical periodontitis in teeth with endodontic treatment. Materials and methods: In 462 teeth by means of computerized axial tomography, each root was evaluated independently, centered and aligned in the three planes to identify the presence of untreated canals and apical periodontitis, which was measured in the sagittal and coronal cuts drawing a perpendicular from the root apex to the upper limit of the hypodense area in its greatest extension; the teeth were analyzed by two endodontists and a radiologist dentist. The kappa coefficient of agreement was ≥95% for both evaluators. Results: The frequency of untreated canals was 18.61%, and the prevalence of apical periodontitis was 95.3%. The upper molars exhibited the highest percentage of untreated canals in the vestibular mesial root with 55.23% and the vestibular mesial canal 2 was the most frequent untreated canal in 88.52%. Conclusion: The risk of developing apical periodontitis is 10.5 times higher when an untreated canal is present.
Evaluación de la reproducibilidad y validez de criterio de la radiovisiografia digital y radiografías digitalizadas ps pix para identicar variaciones anatómicas en premolares inferiores observadas en tomografía computarizada de haz cónico (CBCT)
(2021-07-14) Rincón Rodríguez, Martha Liliana; Duarte Monsalve, Martha Lucely; Martínez Vega, Ruth Aralí
Introduction: The existence of anatomical variations cause failures in endodontic treatments, so it is important to diagnose them. The objective was to determine the reproducibility and criterion validity of phosphor plate radiographs and sensor radiovisiography to identify anatomical variations detected by cone-beam computed tomography (CBCT) in lower premolars. Methods: 140 CBCT, radiographs and radiovisography premolar images were taken. Independent interpretations by two Endodontists were carried out to evaluate the Vertucci classification and teeth ramifications. Intra-observer and interobserver reproducibility were determined. Sensitivity, specificity and areas under the operator-receptor curve (AUC) were calculated using CBCT as the gold standard. Results: The intra-observer and interobserver reproducibility of the radiography was higher than the radiovisiography. For Vertucci Class I, radiography had higher sensitivity (94.7%), specificity (64.9%) and AUC (0.7952) than radiovisiography (89.3%, 62.2% and 0.7574, respectively), similarly in Class V (Radiography 69.2%, 93% and 0.8111; radiovisiography 50%, 84.2% and 0.6711, respectively). None of the techniques contributed to the diagnosis of Class III (AUC <0.5). Ramifications were infrequent (2.9%) and their detection was low (Sensitivity 25% for radiography and 0% for radiovisiography). Discussion: This is the first study thar evaluates the reproducibility and validity of these two radiographic techniques compared to CBCT for the detection of anatomical variations in teeth. Conclusions: Phosphor plate radiography showed higher reproducibility and validity for the diagnosis of Vertucci Class I and V, that were the most frequent observed premolar variations.
Influencia del gradiente social sobre la salud bucal de mujeres vinculadas laboralmente a la Universidad Santo Tomás seccional Bucaramanga en el año 2020
(2021-07-12) Almario Barrera, Andrea Johanna; Concha Sánchez, Sonia Constanza; Universidad Santo Tomás
Introduction. Oral pathologies such as dental caries, periodontal disease and edentulism are highly prevalent diseases among women, influenced by living conditions, and social factors, framed in the concept of social gradient.Objetivo. Evaluate the influence of the social gradient on the oral health of women laborally linked to the Universidad Santo Tomás sectional in Bucaramanga in 2020.Materiales ymetos.Type of analytical observational study, cross-sectional, participated 84 women; A clinical examination was carried out to determine the state of oral health, a survey to determine social, labor, economic, family and surrounding factors, an adapted instrument was applied to assess the social position of the participants. The output variables were related to each of the explanatory variables, statistical tests were applied such as the squared chi test, Fisher's exact test for qualitatives and Student's T test or the Wilcoxon Ranges test for the quantitative ones considering a level of significance of alpha≤ 0.05.Resultados.There was a prevalence of dental caries with 85.7%, periodontal disease with 79.8%, and edentulism with 40.5%; The social factors that will be present with greater frequency and will show a relationship with the oral conditions of the age, ethnicity, marital status, educational level, the work performed daily, the socioeconomic stratum, the economic responsibility within the house. Women participating in a low social position have a higher frequency of oral pathologies studied. Conclusion. It is established that women who are located in a high social position have less burden of oral diseases; whereas women who are found in a social position have a lower prevalence of these pathologies, showing the influence of the social gradient on the oral condition of women who work at the University in 2020.
Diseño de un modelo in vitro de células epiteliales primarias gingivales humanas para evaluar infectividad de Helicobacter pylori (ATCC 43504)
(2019-10-02) Macías Gómez, Fabio; Bautista Amorocho, Henry
Background: Evidence on oral pathologies associated with Helicobacter pylori is controversial, especially because there is no certainty about the infecting capacity of the bacteria in oral tissue. Therefore, it is important to evaluate methodologies to establish the adhesion capacity of H. pylori to the host cell in the process of pathogenesis. Objective: To evaluate infectious capacity of H. pylori (ATCC 43504) to infect on Human Primary Gingival Epithelial Cells. Methodology: Human gingival biopsies from healthy donors were mechanically disrupted and digested with proteolytic enzymes and antioxidants. The cell pellet was suspended in Williams’ medium supplemented with antimicrobials, fetal bovine serum and growth factors. Cells were cultured for two weeks in 12-well plates at 37°C and 10% CO2 atmosphere. The epithelial phenotype was confirmed by Hematoxylin & Eosin staining (H&E) and immunohistochemistry for membrane epithelial membrane antigen (EMA) and cytokeratin cocktail AE1/AE3. The evaluation of the infectious capacity was carried out by indirect immunofluorescence (IFI) with anti-H.pylori antibody. A multiplicity of infection MOI (bacteria: cell) of 100 in monolayers with 70% confluence was used; As positive and negative controls of the infection, gastric tumor cell lines (AGS) and kidney embryonic cells (293TN) of human origin were used, respectively. Results and conclusions: Viable and proliferating gingival cells were isolated, with initial confluence of 20% at 72 hours and 100% at ten days of incubation. H&E staining evidenced the epithelial morphology of flat cells with a cylindrical shape and a prominent nucleus; and the phenotype of epithelial origin was confirmed with EMA and AE1/AE3 (positivity of 80% and 60%, respectively). IFI demonstrated absence of H. pylori in the primary gingival cells with fluorescence 0.4 ± 0.5%, while the positive and negative controls showed 99.4 ± 0.9% and 19.2 ± 1.1% positivity, respectively. The results obtained suggest that strain ATCC 43504 of H. pylori does not have the capacity of adhesion to human primary gingival epithelial cells. Therefore, it can be suggested that the evaluated strain of H. pylori would participate as a transient commensal microorganism in the oral cavity.
Análisis mecánico entre diferentes conexiones y plataformas protésicas mediante el método de elementos finitos
(Universidad Santo Tomás, 2019) Mantilla Ronderos, Claudia Lucía; Villabona López, Camilo Andrés; López Gualdrón, Clara Isabel
Dental implants have been widely used for the rehabilitation of total and partially edentulous patients; In the last decade, the mismatch, loosening and fracture of screws and / or prosthetic components in clinical treatments with supported implanted prosthesis, are referred to as mechanics that compromise function, health and oral aesthetics. For this reason it is important to know the biomechanics that includes aspects such as the distribution of stress on all the components, the behavior of the occlusal forces on the periimplant bone tissue along the axis of the implant. A condition for the stable and biocompatible operation of the screwed prostheses on implants is the balance of all the prosthetic components. The most known and used connections since the beginning of implantation are implants with External Hexagon (HE), the concept used by Branemark since the 60s and the most current connection with conical geometry internally as Cone Morse (CM). The latter has been highlighted by presenting favorable characteristics, the risk of loosening of the screw of the prosthesis and / or prosthetic components has been reduced.
Determinación social y caries dental en niños escolarizados. Bucaramanga, Colombia
(2019-05-10) Alonso González, Sandra Milena; Concha Sánchez, Sonia Constanza
Introduction. Oral pathologies, especially dental caries, register high prevalence in Colombia infantile population. This situation is developed in the middle of a complex dynamic biological phenomena and its relationship with the family dynamics in a political, economic and socio-cultural context. For this reason, an approach that made it possible to understand its reality and the processes was essential. Objective. Characterize the oral health conditions of the school population from 6 to 12 years of age that attends the Maria Reina de las Misiones community dinning facility and comprehens the processes of the social determination of the caries of the participants, from the perspective of the different actors involved Materials and methods. The methodological formulation of the research process was focused on the Social Determination of Health, a mixed method with a qualitative central component was developed, through the Grounded Theory, which first implied the execution of the quantitative component. In the developed process, extensive techniques were triangulated, including surveys of 49 participants obtained from secondary sources and intensive techniques that included in-depth interviews with caregivers, focus groups on children, observation and documentary analysis of the different health-related policies. Results. Social determination and dental caries in school children presents processes of the singular level, related to the oral conditions of children, processes of the particular level that involve labor, consumption and sociocultural dynamics that in turn are subsumed in the processes of the general level where the political, economic and cultural dynamics intervene Conclusion. The high prevalence and experience of dental caries in children from 6 to 12 years old, at a singular level, are related to the non-strengthening of programs focused on prevention; at a particular level with labor informality, the cost overruns and economic limitations for oral care, the overload of responsibilities of the mother, the low value to the temporary dentition and ignorance of the dynamics of oral diseases and at structural level the limiting processes related to the public spending, the extreme gaps between social classes and the processes of gender violence that affect women and minors.
Prevalencia de periodontitis apical en dientes no tratados endodónticamente evaluados en CBCT
(2019-04-29) Buitrago Rojas, Sandra Milena; Castellanos Domínguez, Yeny Zulay; Moreno Monsalve, Jaime Omar
Introduction The early diagnosis of apical periodontitis is made through diagnostic images. Cone beam computed tomography (CBCT) is currently considered the radiographic technique with the best capabilities to identify this event. The objective of this study was to determine the prevalence of apical periodontitis in 1858 teeth without endodontic treatment, evaluated in 152 CBCT taken from patients who attended a dental practice in a region of Colombia. Methodology Through a cross-sectional analytical study, CBCT of permanent teeth of people of both sexes taken between 2016 and 2017 were included. The presence of apical periodontitis was evaluated using the CBCT PAI index. The association between the event and variables such as gender, age, affected tooth and number of teeth that presented the pathology by assessed tomography, was performed by Chi2 test, p de 0.05 values were considered of statistical significance. Results The prevalence of apical Periodontitis was 19.7%. 83.6% of these lesions (n = 306) were located in the CBCT PAI I ((> 0.5 mm-1mm) .The most affected teeth were 13, 24 and 23 respectively. With respect to the total number of affected teeth in evaluated tomography, it was evidenced that 19.7% of the CBCT analyzed (n = 30) had one tooth with evidence of the pathology and 19.1% (n = 29) two affected teeth. Conclusions The prevalence found (19.7%) was relatively high compared with other studies reported. In a CBCT it is possible to observe apical Periodontitis of incipient size.
Experiencias de familias en el cuidado de la salud bucal de niños de Fundown en Bucaramanga
(2019-05-06) Sáenz Torres, María Eugenia; Rincón Mendez, Alba Yaneth
Introduction: One distinctive characteristic of Down syndrome (henceforth, “DS”) is the decrease in motor ability caused by muscle hypotonic, therefore affected children cannot perform proper oral hygiene practices by themselves to maintain a healthy oral condition. In this sense, the upbringing of children with DS implies for families a greater responsibility in their care and adaptation to society, generating higher levels of stress when compared with families of children without intellectual disabilities. Objective: To describe the experiences of families in the oral health care of children with Down syndrome. Methods: A qualitative study with a phenomenological approach was conducted with eight families of children who regularly attended Fundown in Bucaramanga, Colombia during the second semester of 2017. The descriptive methodology proposed by Husserl was used. In-depth interviews, episodic interviews, participant observation and photographic records were performed. The analysis and interpretation of the information was done through manual coding. 307 fragments were extracted, 90 labels were placed and organized into a central theme, four categories and eight subcategories. Triangulation (interview, observation, photographs) and consensus of researchers were done. Results: Family experiences go beyond oral health care, as the caregivers do not separate it from other fundamental aspects of their children's lives. This is important from an integral view of the human being, his health and his care. The experiences were characterized by the preeminence of the female role, influenced by the absence/presence of the paternal role, and additionally nourished with everyday practices. Social support and opportunities are spaces that allow the experiences to be evaluated and help identify certain aspects that make them positive or negative. Conclusions: It is necessary to understand from a social point of view, what it means for families to care for children with DS; additionally ways of support that empower them and strengthen them to respond in a comprehensive and effective way to the challenging endeavor of a SD journey must be secured.
Variaciones anatómicas en primeros premolares inferiores evaluados con microtomografía en dos poblaciones de Sur América
(2018) Duarte Monsalve, Martha Lucely; Moreno Monsalve, Jaime Omar
Introduction: The objetive of endodontic treatment is shaping and cleaning of the root canal system through a mechanical and chemical cleaning, in order to eliminate organic and inorganic tissues and bacteria, allowing a perfect obturation. A mayor cause of endodontic failure is inadequate microbial control because of the inability to locate, debride, shape and filling of all canals of the canal system. Appropriate knowledge of the complexity of root canal systems is essential for successful root canal treatment.The root and canal morphology vary greatly between populations, within populations and even within the same individual, possibly attributed to race, age, sample selection and type of study among others.The endodontic treatment failure rate is highest for mandibular first premolars; this might be attributed to frequent variations in root canal morphology and inability to find and extra canals access.Objective: The purpose of this study was to describe the anatomical variations of root canal in mandibular first premolars in two South American population by reconstructing 3-dimensional models by using microcomputed tomography. Metodology: An analytical cross-sectional study was performed. One hundred mandibular first premolars were scanned by micro-computed tomography, reconstructed 3- dimensionally by using Sky Scan 1174, with voxel size of 17 microns. Variations of root canals with Vertucci classification and root canal accessory identification were assessed. Summary measures were calculated according to the nature of variables. relating country of origin with anatomical variations. Fischer exact tests and Chi2 were applied, considering a level of significance p ≤ 0,05.Results: In a proximal view, canal patterns categorized according to the classification defined by Vertucci as types I (32%), V (27%), VII (7%) y III ((5%). The accessory canals were present in 49% of the teeth, some with multiple canals that were located in the apical, medium an coronal third of the roots. Secundary canals in 32%, apical delta 9%, intercanal 8%, recurrent 6%, furcation canal 5% and lateral canal 2% . Vertucci type I was found in 62,5% of Colombians’ samples; on the other hand, Vertucci type V was observed in 56% of Brasilians’ samples. There were no statistically significant differences in the classification established by Vertucci for Colombia and Brazil, but the accessory canal showed statistically significant differences, with respect to the country of origin, for apical delta (p = 0.015) and Interconduct (p = 0.030 ). Conclusions: Vertucci type I configuration was presented in greater proportion in Colombia while in the Brazilian sample the V-type configuration and additional configuration were the most prevalent, these observations could indicate that there is a more complex configuration of root canals for this group of teeth in the population of Brazil.

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