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Item Conocimiento sobre protocolo de traumatismo dentoalveolar en docentes de establecimientos educacionales de la región Metropolitana(Facultad de Ciencias Médicas de Mayabeque, 2023-04-27) Moya, Patricia; Campos, Daniela; Hidalgo, Catherina; Vidal, CarolinaIntroducción: El traumatismo dentoalveolar es una lesión frecuente en la infancia y un problema de salud pública. Un resultado favorable dependerá del conocimiento previo sobre su manejo. Objetivo: Describir el nivel de conocimientos sobre traumatismos dentoalveolar en docentes de establecimientos educacionales de la Región Metropolitana, que incluye las provincias de Chacabuco, Cordillera, Maipo, Melipilla, Santiago y Talagante, durante el año 2020. Métodos: Estudio transversal en una muestra de 384 docentes de establecimientos educacionales en la Región Metropolitana, elegidos de forma aleatoria. Se midió el conocimiento sobre manejo de traumatismo dentoalveolar mediante cuestionario de tres dimensiones. La primera registra datos personales y experiencias previas en traumatismo dentoalveolar; la segunda mide conocimiento general, lugar de atención, manejo del tiempo, acondicionamiento, transporte y tipos de dentición. El puntaje clasifica en buen nivel (16 – 20), regular (8 a 15.9), deficiente (0 – 7.9). La tercera dimensión valora la actitud frente al trauma de avulsión y fractura dentaria mediante dos casos hipotéticos y cuatro enunciados. Se describió nivel de conocimientos en tablas y gráficos. Estudio aprobado por Comité de Ética Científico. Resultados: En la muestra fue mayoritaria de mujeres en el 89.3 %, edad media 37.1 ± 8.8 años, principalmente de educación preescolar, 11.6 ± 8.8 años experiencia laboral. El nivel de conocimiento fue deficiente en 56.8 %, sin diferencias por sexo, edad, experiencia laboral y lugar de trabajo. Un tercio califica con actitud adecuada frente al trauma de avulsión dentaria, valor que aumenta al enfrentar una fractura dentaria para un 67.7 %. Conclusión: Este estudio muestra un conocimiento deficiente sobre traumatismo dento alveolar en docentes, lo que puede condicionar un mal pronóstico del diente.Item Programa Población en Control con Enfoque de Riesgo Odontológico (CERO) en la Red de Atención Primaria, Chile, 2017-2020(Universidad de Tarapacá, 2023-03-11) Moya, Patricia; Vidal, Carolina; Córdova, Maité; Lisperguer, CamilaObjetivo: Describir indicadores del Programa “Población en Control con Enfoque de Riesgo Odontológico (CERO)” en los menores de 7 años atendidos en la Red de Atención Primaria de Salud, en Chile, años 2017-2020. Materiales y métodos: Diseño de estudio ecológico, se utilizó como fuente de información los datos de atención de menores de 7 años por el programa CERO en el Registro Estadístico Mensual (REM) del Ministerio de Salud de Chile entre los años 2017 y 2020. Se midieron los indicadores: tasa de ingreso al programa con el total de ingresos por año en el numerador y la población beneficiaria en el denominador por 1000 para cada año de estudio; la frecuencia de niños libres de caries dental (índice cariado, extraído y obturado, ceo-d = 0), proporción de niños con riesgo alto según pauta de evaluación de riesgo por sexo y edad y el índice actividades preventivas versus recuperativas. Se realizó un análisis descriptivo de estos indicadores y calculo de la variación porcentual para la prevalencia de niños libres de caries desde la implementación del programa en STATA 14.0. Resultados: Se registraron un total de 1.270.695 ingresos de menores de 7 años al programa CERO en el periodo de estudio, siendo mayor la tasa de ingreso en el año 2018 con 482,6 por cada 1000 beneficiarios. En el menor de 1 año, el 98% esta libre de caries dental, valor que disminuye a medida que aumenta la edad. Aproximadamente un 42% clasifica con alto riesgo según pauta, siendo levemente mayor en los niños y aumenta considerablemente con la edad. Las actividades preventivas son siempre mayores que las registrada como recuperativas en todo el periodo estudiado. Conclusión: Si bien el estudio considera la descripción de algunos indicadores del programa CERO a nivel país a sólo 4 años de su implementación, incluido un año pandémico, no se observan importantes mejoras en la salud oral de los menores de 7 años, por lo que se sugiere continuar la vigilancia de este programa.Item Rest seat preparation for removable partial dentures: does professional dental practice reflect undergraduate teaching?(American Journal of Multidisciplinary Research & Development, 2021-02) Fernández, Enrique; Padilla, Paula; Jazanovich, Diego; Albers, Daniela; Acosta, Hernán; Benavides, Carolina; Sarabia, AlexanderStatement of problem. Dental publications worldwide have reported discrepancies between how removable partial dentures are taught at undergraduate level and how these clinical procedures are performed extramurally, particularly regarding rest seat preparation. Considerable gaps have already been documented between undergraduate teaching and actual implementation in dental practice. Purpose. The aims of this study are to evaluate the presence of mouth preparation (cingulum and/or occlusal rest seats) before fabrication of cast removable partial dentures and explore causes that may contribute to and result in discrepancies between what is taught at undergraduate level and what is later on practiced by qualified dentists. The tested null hypothesis was that there is no difference between the frequency of working casts with and without rest seat preparations evaluated by dental laboratories in our study. Material and Methods. 103 laboratories were identified through an internet search strategy. Each laboratory was subsequently telephoned to determine if they provided cast metal removable partial dentures. Only 36 laboratories were shortlisted and out of these only 24 agreed to take part in our study. Three establishments did not fulfil our inclusion criteria leaving an overall 21 dental laboratories to participate in this study. Laboratory staff were calibrated to inspect, detect, and record the presence or absence of cingulum and/or occlusal rest seats in working casts before fabrication of metal frameworks for removable partial dentures over a one-month period. All 21 calibrated laboratories were given a proforma spreadsheet to record the presence or absence of at least one rest seat preparation per model before fabrication of metal frameworks.Statistical analysis was performed with StataCorp softwareby using the binomial probability test of 1 sample. Results. A total of 1,512 working casts were inspected and 630 (41.70%)displayed rest seat preparations(P< 0.001). The remainder 58.30% of casts examined (882) had no rest seat preparations. Only two laboratories recorded over 80% of casts with rest seat preparations and eight laboratories recorded rest seat preparations in 20% of working casts, or less. Conclusions. Lack of rest seat preparation highlights a rather large proportion of dentists performing inadequate mouth preparation before removable partial denture fabrication. Interacting factors might include shortcomings in undergraduate curricular design for removable partial prosthodontics and a contemporary socioeconomic and cultural burden on the dental profession. These implications for dental education beg the question of how to implement and deliver curricular content emphasizing duty of care and ethics for future generations of competent dental practitioners. CLINICAL IMPLICATIONS The results from this study confirm a vast majority of dental practitioners do not perform suitable pre-prosthetic mouth preparation with regard to rest seats.This has a direct clinical impact on removable partial prostheses hindering successful oral rehabilitation, which is most likely to result in further damage to remaining hard and soft dental tissues.Item “Nadie está preparado para escuchar lo que vi” : atención de salud mental de refugiados y solicitantes de asilo en Chile(Instituto de Salud Colectiva, Universidad Nacional de Lanús, 2020-01) Carreño, Alejandra; Blukacz, Alice; Cabieses, Baltica; Jazanovich, DiegoThis article analyzes the results of a descriptive, qualitative study carried out in 2018 on the mental healthcare needs of Latin American refugees and asylum seekers in Chile, through the perspectives of refugees and asylum applicants (n=8), healthcare professionals responsible for delivery of care (n=4), and members of civil society organisations involved in this area (n=2). Our findings indicate that despite Chile’s commitment to international treaties in this regard, little has been achieved in safeguarding the right to access to mental health care, understood as part of the universal right to health care access. This article documents barriers to mental health care access for migrants applying for asylum and refugee status. Post-migration stress factors may also increase the risk of emotional disorders within this group of people. Mental healthcare providers and teams are often not equipped with the tools to deal with the psychological consequences arising from the situations of violence and persecution associated with forced migration. Our study discusses the need to strengthen the link between mental health care – as a fundamental human right – and the right to international protection.Item Detection of approximal caries lesions in adults: a cross-sectional study(Operative Dentistry, 2019) Urzúa, Iván; Cabello, Rodrigo; Marín, Paulina; Ruiz, Begoña; Jazanovich, Diego; Mautz, Claudia; Lira, Mauricio; Sánchez, Jenny; Rodríguez, Gonzalo; Osorio, Sylvia; Ortiz, María EugeniaDetection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.Item Patient experience and non-surgical periodontal therapy in a postgraduate periodontal training program: A qualitative study(Sociedad de Periodoncia de Chile, Sociedad de Implantología Oral de Chile, Sociedad de Prótesis y Rehabilitación Oral de Chile, Sociedad Chilena de Odontopediatría y Sociedad de Ortodoncia de Chile, 2022-04) Prieto, Diego; Vásquez, Pamela; Ortega, Miguel Ángel; Cáceres, Felipe; Meléndez, Catalina; Nally, Mauricio; Jazanovich, DiegoObjective: To explore patient experience for non-surgical periodontal therapy using phenomenography. Methods: This qualitative study was performed in a postgraduate specialist training program in periodontics. Patients reported their experiences through in-depth interviews in order to recognize the impact of non-surgical periodontal therapy on their quality of life and their satisfaction. A homogeneous sampling procedure was used, establishing redundancy after the fifteenth interview. Interviews were audio recorded, transcribed and analyzed by three researchers who codified the answers into categories to determine the emerging topics. Results: The core emerging themes were: (i) lack of information about periodontal disease; (ii) experience during treatment; (iii) treatment implications; and (iv) clinician–patient relationship. Conclusions: Patients seem to have limited knowledge about periodontal diseases. Reasons for attendance mainly include bleeding gums, tooth mobility, and aesthetic problems. Therapy can generate pain, fear, and is considered invasive, whereas dentine hypersensitivity may occur post-operatively. Despite this, patients would be willing to undergo treatment again and were generally satisfied with the level of care and treatment received.Item Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region(BioMed Central, 2023-03-09) Monsalves, María José; Espinoza, Iris; Moya, Patricia; Aubert, Josefina; Duran, Doris; Arteaga, Oscar; Kaufman, Jay S; Bangdiwala, ShrikantObjective To estimate the association between Social Determinants of Health (structural and intermediate) and caries indicators in Chile’s Metropolitan Region preschool children. Methods A multilevel cross-sectional study of Social Determinants of Health (SDH) and caries in hildren aged 1 to 6 years in Chile’s Metropolitan Region was conducted in 2014–2015, with three levels: district, school and child. Caries were assessed by the dmft-index and the prevalence of untreated caries. The structural eterminants analyzed were Community Human Development Index (CHDI), urban/rural location, school type, caregiver’s education and family income. Poisson multilevel regression models were fit. Results The sample size was 2,275 children from 40 schools in 13 districts. While the highest CHDI district had an untreated caries prevalence of 17.1% (12.3–22.7%), in the most disadvantaged district it was 53.9% (95% CI 46.0– 61.6%). As family income increased, the probability of untreated caries prevalence decreased (PR = 0.9 95% CI 0.8–1.0). Rural districts had an average dmft-index of 7.3 (95% CI 7.2–7.4), while in urban districts, it was 4.4 (95% CI 4.3–4.5). Higher probabilities of untreated caries prevalence (PR = 3.0 95% CI 2.3–3.9) were observed in rural children. Greater probabilities of untreated caries prevalence (PR = 1.3 95% CI 1.1–1.6) and prevalence of caries experience (PR = 1.3 95% CI 1.1–1.5) were observed in children whose caregivers had a secondary educational level. Conclusions A strong association was observed between the social determinants of health, specifically the structural ones, and the caries indicators studied in children of the Metropolitan Region of Chile. There were notable differences in caries between districts according to social advantage. Rurality and caregiver’s education were the most consistent predictors.Item Situación de salud bucal de párvulos chilenos en un contexto comunitario(Universidad de Chile, 2021) Maldonado, Catalina; Pavkovic, Carolina; Moya, Patricia; Caro, Juan CarlosObjetivo: Determinar la situación de salud bucal en párvulos ingresados a un programa promocional-preventivo en la comuna de Melipilla durante el año 2018. Material y métodos: Estudio transversal realizado en 860 párvulos de entre dos a cinco años de edad matriculados en 17 establecimientos educacionales de la comuna, ubicados en zona urbana y rural. La experiencia de caries dental como variable dependiente y sexo, edad y zona geográfica del establecimiento educacional (urbano-rural) como variable independiente fueron medidas en un contexto comunitario (en aula). Estudio aprobado por Comité Científico de Ética de Universidad Finis Terrae y Servicio de Salud Metropolitano Occidente. Resultados: El estudio abarcó al 88,5% de los párvulos matriculados, con promedio de edad de 3,76 ± 1,06 años. El 53,5% correspondieron a niñas. Un 34,1% (IC:95% 30,74:37,48) presentó caries dental, sin diferencias por sexo, zona geográfica, si por edad. A mayor edad, mayor daño por caries dental. Cada párvulo en promedio presentó un diente primario con caries (diente cariado:1,14 ± 2,28). El tercio de la población mas afectada por caries dental presentó en promedio tres dientes primarios con daño. Discusión: Los resultados muestran un elevado daño por caries dental cuyo inicio es temprano; esto pone de manifiesto la necesidad de avanzar en el desarrollo de políticas públicas de salud bucal destinadas a la primera infancia.Item Urgencia odontológica ambulatoria en la población de la red pública de salud en Chile, 2017-2020(Universidad de Tarapacá, 2022-09-06) Moya, Patricia; Vidal G., Carolina; Escobar E., María José; Garrido C., CamilaObjetivo: Describir la tendencia de las consultas de urgencia odontológica ambulatoria registrada en la población atendida en la red pública de salud en Chile entre los años 2017 y 2020. Materiales y métodos: Diseño de estudio ecológico. Se evaluaron las consultas de urgencia odontológica ambulatoria obtenidas del Registro Estadístico Mensual (REM) del Ministerio de Salud de Chile entre los años 2017 y 2020. Se calculó la tasa de consulta por urgencia odontológica ambulatoria (UOA) considerando el total de consultas de urgencias con Garantía explícitas en salud en el numerador y la población beneficiaria registrada por el Fondo Nacional de salud en el denominador, amplificado por 1000 para cada año de estudio. Las tasas se especificaron por sexo, grupo etario (<20 años; 20 a 64 años y 65 y más años), y zona geográfica de Chile (zona norte, centro y sur). Resultados: Se registraron un total de 27.639.889 consultas odontológicas en la red pública de atención de salud en el país, de estas, 1.345.390 corresponden a consultas por UOA. Se observó una disminución de la tasa de consulta por urgencia odontológica ambulatoria hacia el año 2020 (variación porcentual de -17,93%). La tasa de consultas es levemente mayor en mujeres, en edades entre 20 a 64 años y en la zona norte y sur del país. Conclusión: Se observa una disminución sostenida en la tasa de consultas por UOA en la red pública de salud del país, lo que podría reflejar la existencia de un mayor acceso de la población a resolver los problemas de salud bucal en el nivel primario de atención asociado al desarrollo de diferentes programas de salud bucal. Sin embargo hay que ser cautelosos con la interpretaciónItem The viral nucleocapsid protein and the human RNA-binding protein Mex3A promote translation of the Andes orthohantavirus small mRNA(Public Library of Science, 2021-09-21) Vera-Otarola, Jorge; Castillo-Vargas, Estefania; Angulo, Jenniffer; Barriga, Francisco M.; Batlle, Eduard; Lopez-Lastra, MarceloAndes orthohantavirus (ANDV) is endemic in Argentina and Chile and is the primary etiological agent of hantavirus cardiopulmonary syndrome (HCPS) in South America. ANDV is unique among other members of the Hantaviridae family of viruses because of its ability to spread from person to person. The molecular mechanisms driving ANDV protein synthesis remain poorly understood. A previous report showed that translation of the Small segment mRNA (SmRNA) of ANDV relied on both the 5’cap and the 3’untranslated region (UTR) of the SmRNA. In this new study, we further characterize the mechanism by which the 5’ and 3’end of the SmRNA interact to assure viral protein synthesis. We establish that the viral nucleocapsid protein N and the cellular protein hMex3A participate in the process. These observations indicated that both viral and cellular proteins regulate viral gene expression during ANDV infection by enabling the viral mRNA to establish a non-covalent 5’-3’end interaction.