Iris Espinoza

Clinical Attachment Loss in Chilean Adult Population: First Chilean National Dental Examination Survey

BACKGROUND Data from national surveys regarding the periodontal status of the adult population in Latin America are scarce. The aim of this study assesses the prevalence and extension of clinical attachment loss (AL) in the adult population of Chile. Age, sex, and sociodemographic and behavioral differences in the prevalence of clinical AL are also examined. METHODS A stratified, multistage probability design formula was used to separate the adult Chilean population into two age cohorts. The first group consisted of 1,092 young adults (age range: 35 to 44 years), and the second group consisted of 469 adult seniors (age range: 65 to 74 years). All subjects were examined to measure clinical AL. The research also included an evaluation, conducted through oral interviews, of social and health aspects of the subjects. Clinical AL was measured in all teeth surfaces, excluding third molars. Results were analyzed using a multivariable model and logistic regression. RESULTS A total of 93.45% of the young adults had ≥ 1 site with clinical AL >3 mm compared with 97.58% of the adult seniors, with an average of 6.51 and 15.81 missing teeth, respectively (P <0.05). The number of sites with severe clinical AL (>6 mm) was 38.65% in young adults and 69.35% in senior adults (P <0.05). Clinical AL was significantly higher in males than in females (P <0.05). The multivariate analyses identified that the main risk indicators for clinical AL >6 mm in ≥ 1 site were: age (65 to 74 years), sex (male) low education level (<or=12 years of education), and smoking (P <0.05). CONCLUSION The adult population in Chile shows a high prevalence and extension of clinical AL with age, sex, education level, and smoking as the main risk indicators of severe clinical AL in this population.

Validación del cuestionario de calidad de vida (WHOQOL-BREF) en adultos mayores chilenos

Background: The WHOQOL-BREF is a generic questionnaire to measure quality of life created by the Study Group on Quality of Life of the World Health Organization. Aim: To adapt and evaluate the psychometric properties of the Spanish version of the WHOQOL-BREF instrument in a group of Chilean older subjects living in Metropolitan Santiago. Material and Methods: A linguistic-cultural adaptation of the Spanish version of the WHOQOL-BREF was performed and tested in a pilot study. Subsequently, the modified scale was applied to a group of 1186 older women aged 72 ± 8 years and 334 men aged 72 ± 7 years. The psychometric properties such as internal consistency, item-total correlation of responses, and construct validity were evaluated. A confirmatory factor analysis was done to check if the dimensions described in the original version, were evaluated. Analyses were performed with STA-TA statistical software 10.0 and LISREL 8.50. Results: Confirmatory factor analysis confirmed that the dimensionsphysical health, psychological, social relationships and environment, described by the authors in their original description, were maintained. The instrument had a good internal consistency with a Cronbach alpha of 0.88 for the total scale and rangingfrom 0.70 to 0.79 in each of the dimensions. Conclusions: The evaluated version of the WHOQOL-BREF has an acceptable reliability and validity, and suggests that it is suitable for the assessment of Quality of Life in elderly people in Chile.

Correlation between single photon emission computed tomography, AgNOR count, and histomorphologic features in patients with active mandibular condylar hyperplasia.

PURPOSE To analyze the association between nuclear medicine examination (single photon emission computed tomography [SPECT]), histology, and Argyrophilic Nuclear Organizer Region (AgNOR) count in patients with active condylar hyperplasia who have undergone condylectomy. PATIENTS AND METHODS Eight patients with a diagnosis of active condylar hyperplasia and evidence of facial asymmetry, with progressive deformation in time and on SPECT studies, were evaluated. The relationship between the rate of technetium Tc 99 intake, cartilage layer thickness, and cellular activity measured by recounting nucleolar organizers with AgNOR was evaluated. RESULTS The 4 pathologic layers of condylar hyperplasia (fibrous, mesenchymal, and hypertrophic chondrocyte layers and ossification layer) showed great variability and different thicknesses among the cases analyzed. As age increased, the histologic layer thickness decreased (r = -0.73, P = .04). The age of the patients was inversely related to the number of AgNOR dots (r = -0.65, P = .08). The thickness of both mesenchymal and hypertrophic chondrocyte layers was related to cartilage island depth (r = 0.81, P = .02). CONCLUSIONS Younger patients with condylar hyperplasia had a thicker condylar layer and more cellular activity measured by AgNOR count. The histologic features of this group of patients could not be associated with their SPECT findings.

Prevalencia de Caries y Pérdida de Dientes en Población de 65 a 74 Años de Santiago, Chile

Resumen Objetivo Medir prevalencia de caries y perdida de dientes en adultos mayores de nivel socio-economico bajo y medio-bajo en Santiago, Chile. Metodos Muestreo probabilistico estratificado, con criterio proporcional; muestra de 109 personas (74 mujeres; 35 hombres) de 65-74 anos edad. Datos recogidos mediante cuestionario en entrevista personal. Todos los pacientes fueron examinados, previo consentimiento informado, por un dentista calibrado. El estudio fue realizado entre marzo y diciembre de 2008. Datos analizados usando chi-cuadrado y ANOVA. Resultados CPOD promedio fue 24,9 (IC: 23,83; 25,96); 100% de individuos tenian historia de caries; 45,9% tenian lesiones no tratadas. El promedio de lesiones no tratadas fue 0,9 por individuo. El 38,5% de los sujetos usaban protesis removible y 15 personas (13,76%) eran edentulas. Conclusiones Magnitud de la brecha e importancia del entorno social en la generacion del dano de la salud oral, obliga a enfrentar el problema desde una perspectiva amplia de determinantes sociales de la salud al momento de establecer politicas publicas.

Evaluation of the efficacy of two mouthrinses formulated for the relief of xerostomia of diverse origin in adult subjects

OBJECTIVE To evaluate the efficacy of two new mouthrinses in the reduction of xerostomía-associated symptomatology. BACKGROUND Xerostomia is a common chronic health condition that affects a great number of adults and significantly deteriorates quality of life, such that treatment is necessary. MATERIALS AND METHODS Sixty-seven adult subjects of both sexes presenting xerostomia of diverse origin were selected. Mouthrinses were tested using a double-blind, randomized, cross-over clinical trial with an intervining wash out period. RESULTS The 100% of subjects presented sensation of dry mouth, and 86% stated sensation of thick saliva. Burning tongue sensation, need to drink liquids to swallow and the sensation of swallowing difficulty were recorded in more than 50% of the patients. The most frequent pathologies in the sample were depression, arthritis, and arterial hypertension. Results of the clinical tests showed that mouthrinse 1 relieves sensation of dry mouth, need to drink liquids, and swallowing difficulty. In contrast, mouthrinse 2 relieves only latter two symptoms. Both rinses were more effective in relieving xerostomía-associated symptomatology in patients taking 3 or more medicines simultaneously. CONCLUSION Both mouthrinses were effective in relieving various xerostomia symptoms, could be distributed at a low cost, thereby improving the quality of life of population affected.

The Challenge of Evaluating the Oral Health Status of Older Persons in Latin America

Knowledge Transfer Statement: This article provides an overview of the oral health status of older people from Latin American countries and the emergence of recent gerodontology research initiatives within the region.

Oral health of the Latin American elders: What we know and what we should do-Position paper of the Latin American Oral Geriatric Group of the International Association for Dental Research

OBJECTIVE The purpose of this review was to gather information and discuss oral health status of older people in the Latin American and Caribbean region (LAC). BACKGROUND Scarce data are available to portrait the oral situation of older people in the region. MATERIAL AND METHODS This review paper is the result of a meeting of the IADRs Latin American Geriatric Oral Research Group held in Porto Alegre, Brazil, in November of 2016, part of the activities of an IADR Regional Development Programme (RDP). A group of researchers from 8 countries of LAC held a discussion using 5 questions related to the oral health situation of older Latin Americans, the most appropriate strategies to face the problem and the challenges for the future, with an open discussion format. In a second step, a group of 6 experts refined the answers and reviewed the existent literature. RESULTS The review of the evidence revealed that only a few LAC countries have information, which suggests the need for multinational efforts to understand the oral health status and programmes in place. Of the few studies available, it is possible to observe poor oral health as a common feature of older adults in the region. CONCLUSION There is a need for the development of national surveys and standardised tools for the assessment of oral health in older adults. Also, intense advocacy to modify and influence public health policies in the different countries of the LAC is strongly recommended.

Systematic review of Latin American national oral health surveys in adults

BACKGROUND Oral diseases represent a main public health problem worldwide. There is scarce information about oral health indicators in adults in middle-income countries in Latin America and Africa. OBJECTIVES To identify and describe national health surveys with national representative samples that included oral health assessment for adults in Latin America. METHODS A systematic review was conducted in scientific and regional bibliographic databases (PubMed, SciELO, Wos and Embase); this was complemented with searchings in grey literature (Google Scholar, Open Grey and government health organization websites), from August 2016 to May 2017 (from 2000 to date). Studies conducted, supervised or funded by Ministries of Health or National Health Institutes were included. Data extracted included country, year, methods, interview and dental examination. Two researchers independently performed search and data extraction. Results were discussed as a group. RESULTS Only 5 countries in Latin America have developed national health surveys evaluating the dental status in adults, with overall national representative samples during 2000-2015: Brazil, Colombia, Panama, Chile and Uruguay. Main differences were observed in the type of dental indicators selected, measure of dental services access and the professional who performed the dental examination. While some dental surveys were specifically designed as oral health surveys (Brazil, Colombia, Panama and Uruguay) and the examination was performed by dentists, other surveys represent a module within a general health survey (Chile) and the examination was performed by nurses. CONCLUSIONS There are a small number of Latin American countries that report research about dental status with national representation samples. Most of these studies have been conducted as national oral health surveys, and fieldwork was carried out by dentists. The development of oral health research in this part of the world should be promoted as these surveys provide relevant information to monitor oral health and evaluate the effectiveness of health programmes.

Distribution of biopsied non plaque-induced gingival lesions in a Chilean population according to the classification of periodontal diseases

BackgroundMany gingival lesions are not induced by plaque. The aim of this study was to analyze the frequency of biopsied non-plaque-induced gingival lesions (NPIGL) in a Chilean population.MethodsOne thousand twelve cases of biopsied gingival lesions with confirmed anatomopathologic diagnosis were included, from the records of the Oral Pathology Referral Institute (OPRI), Faculty of Dentistry, University of Chile, between years 1990 and 2009.ResultsThe most frequent non plaque-induced gingival lesions categories from biopsied cases included hyperplastic lesions, malignancies and benign neoplasms. The most frequent diagnoses in each category were fibrous hyperplasia (35.47%), squamous cell carcinoma (3.85%) and giant cell fibroma (2.08%), respectively. From all lesions, only 8.3% fitted in the specified categories of the current classification of periodontal diseases.ConclusionsThe most frequent biopsied NPIGL were hyperplastic lesions and neoplasms. These categories represent relevant lesions to be included in a future periodontal classification system to improve the care needs of the patients, as well as early diagnosis and treatment.

Orofacial granulomatosis and diet therapy: a review of the literature and two clinical cases

Orofacial granulomatosis is a nonspecific term that contains a wide variety of granulomatous entities, which share a clinical and histopathological presentation. It manifests as persistent or recurrent orofacial swelling, amongst other findings. Idiopathic orofacial granulomatosis, characterized by an absence of systemic granulomatous disease, is a diagnosis of exclusion. The main differential diagnosis is Crohns disease. Its pathogenesis is unknown, however, it seems to be immune-mediated. Patch-test sensitivity to multiple allergens is well documented. Currently, therapeutic options consider restrictive diets, topical, intralesional, and systemic agents. First-line therapy is currently a matter of debate. We present a review of the value of diet therapy in this syndrome, along with two illustrative cases.Orofacial granulomatosis is a nonspecific term that contains a wide variety of granulomatous entities, which share a clinical and histopathological presentation. It manifests as persistent or recurrent orofacial swelling, amongst other findings. Idiopathic orofacial granulomatosis, characterized by an absence of systemic granulomatous disease, is a diagnosis of exclusion. The main differential diagnosis is Crohns disease. Its pathogenesis is unknown, however, it seems to be immune-mediated. Patch-test sensitivity to multiple allergens is well documented. Currently, therapeutic options consider restrictive diets, topical, intralesional, and systemic agents. First-line therapy is currently a matter of debate. We present a review of the value of diet therapy in this syndrome, along with two illustrative cases.