Miguel Simancas-Pallares

Validez y consistencia interna del Inventario Maslach para burnout en estudiantes de Odontología de Cartagena, Colombia

OBJECTIVE To determine the internal consistency and content validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) in dental students from Cartagena, Colombia. MATERIALS AND METHODS Scale validation study in 886 dental students from Cartagena, Colombia. Factor structure was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was measured using the Cronbachs alpha coefficient. Analyses were performed using the Stata v.13.2 for Windows (Statacorp., USA) and Mplus v.7.31 for Windows (Muthén & Muthén, USA) software. RESULTS Internal consistency was α=.806. The factor structure showed three that accounted for the 56.6% of the variance. CFA revealed: χ2=926.036; df=85; RMSEA=.106 (90%CI, .100-.112); CFI=.947; TLI=.934. CONCLUSIONS The MBI showed an adequate internal consistency and a factor structure being consistent with the original proposed structure with a poor fit, which does not reflect adequate content validity in this sample.

Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study

Aim To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. Patients and Methods We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. Results 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4–98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). Conclusions Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.

Focal Osteoporotic Bone Marrow Defects on Dental Implant Treated Patients: A 5-Year Period Prevalence Study

Los implantes dentales se consideran el tratamiento mas eficaz para la ausencia dentaria. Sin embargo, hay algunas condiciones oseas que pueden afectar el proceso de osteointegracion, lo que afecta a las tasas de exito clinico y radiografico. Una de estas condiciones podrian ser los defectos focales osteoporoticos de la medula osea (DFOMO). El objetivo de este estudio fue describir la prevalencia en un periodo de 5 anos de los DFOMO en pacientes tratados con implantes dentales. Se realizo un estudio descriptivo y retrospectivo, con una revision sistematica de los datos clinicos y radiologicos de pacientes tratados en una unidad de implantes dentales desde enero de 2010 hasta diciembre de 2014. Cuando se encontro algun caso de DFOMO, se aplico un cuestionario detallado sobre la ficha en busca de caracteristicas demograficas, medicas y dentales (clinicas y radiograficas). Tambien se realizo un analisis histologico de la submuestra. Se estimo la prevalencia del periodo (PP), el calculo de proporciones e intervalos de confianza con un 95 %. El analisis estadistico se realizo con el programa Stata v. 13.2 para Windows (Stata Corp, TX., EE.UU.). La prevalencia del periodo para los 5 anos de DFOMO fue 9,52 % (IC del 95 %: 6,87 % a 13,5 %). Encontrado 42 defectos en 34 pacientes. Dentro de los pacientes con DFOMO, la edad promedio fue de 55,4±11,9 anos, y 67,64 % fueron mujeres. El 97 % de los defectos se encuentraran en la mandibula. El 79,41 % fue unilateral y 69,04 % con lesiones individuales de perdidas dentarias; el 71,42 % afecto la zona de los molares y 59,52 % se encontro en el lado derecho del maxilar. El analisis histologico revelo celulas inflamatorias, calcificaciones distroficas, material hemorragico y celulas grasas, en todos los casos. La prevalencia de DFOMO fue baja, por lo que debe considerarse como una enfermedad poco frecuente pero que muestra una tendencia creciente y exponencial en el tiempo. Sin datos epidemiologicos previos, estos resultados deben ser considerados para tener precaucion durante los examenes imagenologicos y la planificacion del tratamiento, con el fin de evitar complicaciones quirurgicas o protesicas. Los factores locales como tratamientos endodonticos previos deben ser considerados para dilucidar las razones de su aparicion.

Development, validity and reliability of the Orofacial Esthetic Scale — Spanish version

PURPOSE To develop a Spanish version of the Orofacial Esthetic Scale (OES-Sp) and to determine its psychometric properties in dental patients. METHODS We performed a validation study for OES development and validation into Spanish. In the development phase, eight individuals participated in the translation process (cross-cultural adaptation) following the PROMIS methodology. In the validation phase, 331 dental patients (age mean±sd: 42.9±12.3years, 59 % female) from the HealthPartners dental clinics in Minnesota, USA responded to a survey of Spanish speaking patients (n=540, response rate: 61 %). We first explored dimensionality by means of exploratory factor analysis and scree plot, and then we computed reliability measures with the Cronbachs alpha statistic. Finally, we assessed convergent validity by computing Pearson/Spearman rank correlations between OES-Sp and Oral Health Impact Profile (OHIP)-based orofacial appearance measures. All statistical procedures were performed using Stata v.13 for Windows (StataCorp). RESULTS Exploratory factor analysis provided evidence that a single factor represents the Spanish OES version. Score reliability was high with Cronbachs alpha statistic of 0.95 (lower limit of the 95 % CI: 0.94). Score validity was sufficient indicated by Pearson and Spearman rank correlations between -0.53 and -0.69 (all 95 % confidence intervals: less than ± 0.10). CONCLUSIONS OES is a valuable instrument to measure the orofacial appearance construct for Spanish-speaking populations. OES was concluded to be unidimensional with excellent score reliability and sufficient convergent score validity when compared with other Orofacial Appearance measures. Our results suggest that OES could be used in Spanish-speaking patients, an important and growing population around the globe.

Trastornos mentales comunes y factores asociados en estudiantes de Odontología en Cartagena, Colombia

INTRODUCTION Psychological morbidity assessments are of interest since mental health is part of a persons overall health and early detection promotes emotional well-being. AIM To determine the association between common mental disorders and related factors in dental students from Cartagena, Colombia. METHODS We conducted a cross-sectional study in 858 dental students from Cartagena, Colombia; who answered a structured anonymous self-report questionnaire to assess the presence of common mental disorders (CMD) (General Health Questionnaire-12), problematic alcohol consumption (CAGE), sociodemographic and other related variables. Data were analyzed using descriptive statistics and bivariate analysis was conducted later using χ2 tests. The strength of association was obtained with prevalence ratios (PR) and 95% confidence intervals (95%CI). Finally adjusted PRs, and 95%CIs were obtained using a log-binomial regression model. Statistical analysis was performed using Stata v.13.2 for Windows (Stata Corp.; TX, USA). RESULTS The average age was 20.8±3.01 years of age, and more than half were females. CMD overall prevalence was 30.3% (95%CI, 27.3-33.5). The regression model suggested as associated factors: sex (PR, 1.54; 95%CI, 1.21-1.96), recent economic changes (PR, 1.70; 95%CI, 1.37-2.12), family conflicts [PR, 2.29; 95%CI, 1.89-2.77), abandonment (PR, 1.58; 95%CI, 1.23-2.03), history of abuse (PR, 2.05; 95%CI, 1.27-3.31), and problematic alcohol consumption (PR, 1.35; 95%CI, 1.02-1.78). CONCLUSIONS CMD prevalence was high. Being female, family conflicts, history of abuse and problematic alcohol consumption are considered as risk factors for CMD development and should be carefully assessed to predict emotional well-being.

Grafting and Dental Implantation in Patients With Jawbone Cavitation: Case Series and 3-Year Follow-Up.

Purpose: Jawbone cavitation (BC) is not uncommon and is considered to be related to some cases of unexpected implant displacement into deep jawbone space. Here, a series of cases with BC is described, in which the lesions were accidentally found and successfully treated by bone grafting and dental implantation. Methods: Thirty-four partially edentulous patients who were found to have BC during dental implant surgeries were included in this study. Alloplast bone substitute (&bgr;–tricalcium phosphate) grafting with immediate or staged locking-taper implant placement was performed. Bone filling and implants on BC were followed up to 36 months, and they were evaluated clinically and radiographically to verify treatment outcome. Results: A total of 41 BCs were found at premolar and molar regions, which involved one or more teeth breadth. Nearly most of the lesions occurred in the mandible (95.1%, 39/41). Histologically, they were compatible with focal osteoporotic marrow defects. Fifty-two locking-taper implants and final restorations were delivered on 38 BCs. One implant failed due to loss of integration. The overall cumulative 3-year implant survival rate was 98.1%. Conclusion: By carefully examining and managing the surgical bed, the current treatment modality was shown to yield a satisfactory outcome for restoration of edentulous ridge with underneath BC.

Validez de constructo y consistencia interna de tres estructuras factoriales y dos sistemas de puntuación del Cuestionario General de Salud–12

INTRODUCTION The analysis of the psychometric properties of an instrument is important for the control of measurement bias. OBJECTIVE To compare the construct validity and internal consistency of three factorial structures of the General Health Questionnaire-12. MATERIALS AND METHODS We conducted a validation study in a nested sample of 483 dentistry students from Cartagena, Colombia. The instrument was applied along with questions about personal factors. The construct validity of the following structures was evaluated: one-dimensional, one-dimensional with correction of response bias, and the two and three-factor structure, and these scoring systems: Likert scale (0-1-2-3) and dichotomous (0-0-1-1) scoring method. Validity was determined by confirmatory factorial analysis, and the internal consistency with Cronbachs alpha coefficient for the Likert scale and the Kuder-Richardson Formula 20 for the dichotomous scoring using the Stata™, v. 13.2 (Stata Corp, USA) and Mplus™, v.7.11 (Muthen and Muthen, USA) software. RESULTS Adjustment indexes revealed that the best model was the one-dimensional one with correction of response bias based on a dichotomous scoring (degrees of freedom=36; chi square=52.432; root mean square error of approximation=0.03; 90% CI: 0.008-0.048; comparative fit index=0.982; Tucker-Lewis index=0.966). The internal consistency was 0.70. CONCLUSIONS The adjustment of the model in this study allowed for the control of measurement bias and guaranteed external validity of results when using the General Health Questionnaire-12 to evaluate mental conditions in this population. The psychometric properties of the scales should be critically evaluated before results analysis.Contribución de los autores: Miguel Simancas-Pallares: concepción de la idea y análisis de la información Katherine Arrieta: concepción de la idea Todos los autores participaron en la recolección de la información y la estructuración del manuscrito. Validez de constructo y consistencia interna de tres estructuras factoriales y dos sistemas de puntuación del cuestionario de salud general de 12 ítems

Validez de constructo y consistencia interna de tres estructuras factoriales y dos sistemas de puntuación del cuestionario de salud general de 12 ítems

INTRODUCTION The analysis of the psychometric properties of an instrument is important for the control of measurement bias. OBJECTIVE To compare the construct validity and internal consistency of three factorial structures of the General Health Questionnaire-12. MATERIALS AND METHODS We conducted a validation study in a nested sample of 483 dentistry students from Cartagena, Colombia. The instrument was applied along with questions about personal factors. The construct validity of the following structures was evaluated: one-dimensional, one-dimensional with correction of response bias, and the two and three-factor structure, and these scoring systems: Likert scale (0-1-2-3) and dichotomous (0-0-1-1) scoring method. Validity was determined by confirmatory factorial analysis, and the internal consistency with Cronbachs alpha coefficient for the Likert scale and the Kuder-Richardson Formula 20 for the dichotomous scoring using the Stata™, v. 13.2 (Stata Corp, USA) and Mplus™, v.7.11 (Muthen and Muthen, USA) software. RESULTS Adjustment indexes revealed that the best model was the one-dimensional one with correction of response bias based on a dichotomous scoring (degrees of freedom=36; chi square=52.432; root mean square error of approximation=0.03; 90% CI: 0.008-0.048; comparative fit index=0.982; Tucker-Lewis index=0.966). The internal consistency was 0.70. CONCLUSIONS The adjustment of the model in this study allowed for the control of measurement bias and guaranteed external validity of results when using the General Health Questionnaire-12 to evaluate mental conditions in this population. The psychometric properties of the scales should be critically evaluated before results analysis.Contribución de los autores: Miguel Simancas-Pallares: concepción de la idea y análisis de la información Katherine Arrieta: concepción de la idea Todos los autores participaron en la recolección de la información y la estructuración del manuscrito. Validez de constructo y consistencia interna de tres estructuras factoriales y dos sistemas de puntuación del cuestionario de salud general de 12 ítems