OBJECTIVE:To evaluate 3D changes in the condyle (CO) and glenoid fossa (GF) in growing patients with Class II malocclusion treated with the Twin Block (TB) appliance, using cone-beam computed tomography (CBCT) to compare pre-treatment (T0), end-of-treatment (T1: 12 months), and post-removal (T2: 12 months) time points, in order to assess post-treatment skeletal stability. MATERIAL AND METHODS:It was a retrospective longitudinal pilot study. Patients were recruited between August 2015 and 2022 and followed up until 2023. Twelve patients (11.92±1.08 years; cervical vertebral stages CS3-CS4) were evaluated with CBCT at T0, T1, and T2. Complete 3D models at T0, T1, and T2 were superimposed in Dolphin Imaging software. Partial 3D models of the CO and GF were segmented in ITK-SNAP software. A coordinate system (x-, y-, and z-axes) was created for each complete 3D model at T0 using Geomagic Qualify software, followed by the alignment of the partial models of the CO and GF to the complete models. For each CO and GF, a 3D centroid was generated, and its displacement was evaluated across the T0-T1, T0-T2, and T1-T2 intervals. The non-parametric Wilcoxon and Friedman tests were used with a 95% confidence level. RESULTS:Significant posterior displacement of the CO was observed during the T0-T1 interval (right: 1.33mm; left: 1.54mm), T1-T2 (right: 1.01mm) and T0-T2 (right: 2.34mm; left: 2.16mm). Superior displacement of the CO was also significant during the three intervals. The GF showed significant posterior displacement at T0-T1 and T0-T2. The P-values were adjusted using the Bonferroni correction; 95% confidence intervals are reported in the results tables. RESULTS:These preliminary findings suggest that TB therapy induces adaptive remodelling of both the CO and GF, with the CO changes exceeding those of the GF. The CO was displaced posteriorly and superiorly, whereas the GF was displaced posteriorly and inferiorly. However, the absence of a control group precludes a definitive distinction between treatment effects and normal craniofacial growth. Future controlled studies with larger samples are necessary to confirm these observations.

Background:Molar incisor hypomineralisation (MIH) is a developmental enamel defect that predominantly affects first permanent molars and frequently involves incisors. However, evidence on MIH prevalence and clinical presentation in jungle regions is limited. Aim:To determine the distribution and clinical patterns of MIH among schoolchildren in the Central Jungle region of Peru. Materials and Methods:This cross-sectional study included 1500 schoolchildren aged 6-12 years from two public schools in Peru's Central Jungle region, recruited through stratified random sampling. Two calibrated examiners diagnosed MIH using European Academy of Paediatric Dentistry (EAPD) criteria (inter-examiner κ = [0.87]; intra-examiner κ = [0.89]). Categorical variables were analysed using Pearson's chi-squared and Fisher's exact tests (α = 0.05, 95% CI). Results:MIH prevalence was 18.8% (95% CI: [17.0-20.0]). First permanent molars were predominantly affected (upper: 84.8%, 285/336; lower: 90.9%, 288/317) compared to incisors. Pattern I distribution occurred in 78.7% of cases, while patterns II/III (21.3%) showed significant male predominance (p = 0.008). Molars exhibited significantly greater severity (p = 0.001) with white-cream opacities (28.5%) and predominantly Type III lesions, presenting higher post-eruptive breakdown and atypical caries rates. Incisors displayed mainly mild Type I demarcated opacities. Upper lateral incisors demonstrated left-sided predominance (p = 0.016). Conclusion:MIH prevalence was 18.8% among schoolchildren in Peru's Central Jungle region. First permanent molars were predominantly affected (upper: 84.8%; lower: 90.9%) compared to incisors. Pattern I distribution occurred in 78.7% of cases, while patterns II/III (21.3%) showed significant male predominance. Molars exhibited greater clinical severity with white-cream opacities, Type III lesions, and higher rates of post-eruptive breakdown and atypical caries, whereas incisors presented mainly mild demarcated opacities.

Early childhood caries (ECC) is a highly prevalent oral disease among children worldwide, arising from multiple contributing factors. This study aimed to investigate the sociodemographic and clinical factors associated with ECC in preschool children attending a hospital in Ica, Peru. This observational cross-sectional study involved 186 children evaluated during two dental health campaigns organised by a hospital in Ica, Peru. Oral examinations were conducted by two trained paediatric dentists, while haemoglobin levels were measured by two nurses. Mothers or caregivers completed questionnaires to provide relevant sociodemographic and behavioural data. Multiple logistic regression analyses were conducted to identify variables significantly associated with ECC (p < 0.05). The maximum likelihood method was used to assess the contribution of demographic, clinical and other factors—such as oral hygiene and cariogenic diet—using odds ratios (ORs) and regression coefficients to indicate the magnitude and direction of their effects. The prevalence of ECC was 76.88

Objective:To estimate the social cost of nasal sequelae in patients with cleft lip and palate (CL/P) treated in a Peruvian university dental clinic. Methods:This is a cross-sectional study. The sample consisted of thirty patients over 18 years of age with nasal sequelae due to CL/P. This study conducted a partial economic analysis from a social perspective, by using the following questionnaires: ENAHO-Peru to assess sociodemographic variables, the Instituto de Salud del Niño - San Borja care guidelines and its tariff schedule to estimate health care costs, the Rhinoplasty Outcome Evaluation (ROE) scale to assess quality of life about the nasal sequela, and the "willingness to pay" (WTP) technique to calculate the monetary cost of the sequela from the patients' perspective. Costs in soles, where the exchange rate was: 1 USD = S/3.878. Results:A total of 30 CL/P patients, who agreed to participate, were evaluated. Most of the patients were male (70.0%), aged 18-39 years (73.0%), single (93.4%), students (73.4%), and had secondary education (50.0%). Additionally, most were attended with Seguro Integral de Salud (46.7%), most had no daily income (50.0%), and the average quality of life score was 8.1. The highest direct cost reported was dental treatment (S/5756.89 ± S/359.22) and hospitalization (S/5013.60 ± S/880.15), statistically significant (p<0.05). The highest indirect cost was reported for absenteeism with a mean of 5288.6 ± 1280.23 (p<0.05). Regarding direct, indirect, and intangible costs in the treatment of nasal sequelae due to CL/P, the lowest median (S/6000.00) was found in intangible costs, with significant differences (p<0.05). Conclusion:About half of the social cost (12,000 Peruvian soles = 3094 US dollars) was assumed by the patients, a prohibitive cost considering that most of them come from low socio-economic backgrounds.

BACKGROUND:Functional appliances, such as Twin Block and Herbst, produce dental and skeletal effects to correct Class II division 1 malocclusion. Although widely studied, there are no prospective randomized studies in the literature evaluating the effects of these appliances on the condyle (CO) and glenoid fossa (GF). OBJECTIVE:To evaluate the differences in the CO and GF after treatment using Twin Block (TB) and Herbst (HB) functional appliances for skeletal Class II malocclusions. TRIAL DESIGN:A single-center, two-arm, parallel-group randomized controlled trial. MATERIALS AND METHODS:The sample consisted of 24 patients (12 in the TB group, 11.9 ± 1 year; 12 in the HB group, 12.5 ± 1.8 years) with Class II division 1 malocclusion. Cone beam computed tomography (CBCT) scans were recorded before (T0) and after (T1) treatment (12 months). Superimpositions were performed on Dolphin Imaging software, and partial 3D models of CO and GF were segmented in ITK-SNAP software. A coordinate system (X, Y, and Z axes) was created using Geomagic Qualify software in each 3D T0 model. CO and GF models were aligned in the 3D T0 and T1 models. A 3D centroid point was generated between T0 and T1 in each CO and GF. RESULTS:The TB group showed posterior growth in the right CO (1.3 mm), left CO (1.3 mm), right GF (0.8 mm), and left GF (0.4 mm). The HB group showed posterior growth in the right CO (1.4 mm), left CO (1.7 mm), right GF (0.1 mm), and left GF (0.1 mm). LIMITATIONS:As the operator and patients were aware of the type of functional appliance, blinding could be performed only to assess and measure the CBCT exams. CONCLUSIONS:In both groups, CO and GF grew posteriorly; CO grew vertically in the superior direction, and GF in the inferior direction. The effects on CO and GF were similar when using TB or HB. TRIAL REGISTRATION:ClinicalTrials.gov (ID: NCT02411812). It was registered before commencement.

Background:To date, there is no consensus on the factors that influence on indication for prophylactic extraction of the third molar, however it is a common indication in orthodontics. Aim: To determine the factors associated with indication of prophylactic extraction of the lower third molar in orthodontic practice.Material and Methods:This cross-sectional analytical study used an online survey to obtain responses from 100 professionals with clinical practice in orthodontics. The Survey Monkey software was used to enter a valid and reliable questionnaire of 11 questions to obtain demographic and clinical information of the professional, as well as some patient conditions that could be considered in a possible indication for prophylactic extraction. The questionnaire was sent through social networks and instant messaging applications. Chi Square test was used to evaluate associated factors and binomial logistic regression to identify risk or protective factors.Results:Factors significantly associated with indication of prophylactic extraction of the lower third molar were experience in orthodontics (p-value = 0.060; OR=0.325), characteristics of impaction (p-value = 0.012; OR=3.689), prevention of pericoronitis (p-value = 0.014; OR=3.769) and help stability of treatment results (p-value = 0.002; OR=6.074).Conclusions:The risk factors to indication for prophylactic extraction of the lower third molar were impaction of the third molar, prevention of pericoronitis and helping the stability of the results after treatment. Furthermore, experience in orthodontics was identified as a protective factor for this indication. Key words:Orthodontics, risk factors, third molar, tooth extraction.

BACKGROUND:The conicity of the root canals of primary teeth is an important measure for endodontic therapies. However, determining this conicity depends on the methods employed, which requires further investigation. AIM:The aim of this study was to determine the conicity of the root canals of the upper and lower primary second molars using nanotomography (nCT). DESIGN:An in vitro study was performed using nine primary second molars, both upper and lower, subjected to nCT. Comparisons between the diameters of root canals were performed between the thirds (cervical-D0, middle-D5, and apical-D7). The conicity (%) was determined for each root canal from cervical to apical. Data were statistically analyzed with a significance level of 5%. RESULTS:The conicity ranged from 2% to 8% for the upper primary second molars. Significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in the mesio- and distobuccal roots (p < .05), but not in the palatal roots (p > .05). For the lower primary second molars, the conicity ranged from 2% to 17%, as well as significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in all roots (distal, mesiobuccal, and mesiolingual; p < .05). CONCLUSION:The conicity of the upper primary second molars was different from that of the lower ones, which showed a greater variability.

PurposeTo estimate the taper of root canals of deciduous maxillary and mandibular canines by nano computed tomography (nano-CT).MethodsThis in vitro study involved CT scan analysis of nine maxillary and five mandibular primary canines. The images of each tooth were reconstructed using OnDemand3D software. Thereon, diameter and taper analyses were performed on the free FreeCAD 0.18 software for the three-dimensional (3D) computer-aided design model. Statistical analysis was conducted using Stata v14.0 software, adopting a significance level of 5%.Results3D image reconstruction was performed, considering the diameters obtained along the entire length of the tooth root, and the conical model was built with a height of 10 mm. The diameters of the maxillary canine at points D0 (0 mm), D5 (5 mm), D7 (7 mm), and D10 (10 mm) were 1.62, 1.07, 0.78, and 0.49 mm, respectively, with a significant difference between the four points (p = 0.0001). Regarding maxillary canine root taper values in the cervical, middle, and apical regions, the values were 12%, 14%, and 10%, respectively. For mandibular canines, the mean diameter values obtained at points D0, D5, D7, and D10 were 1.51, 0.83, 0.64, and 0.45 mm, respectively, with significant differences among the four points (p = 0.005). The inferior canine root tapers in the cervical, middle, and apical regions were 14%, 10%, and 6%, respectively.ConclusionThe detailed knowledge of the root morphology of maxillary and mandibular deciduous canines, as it has been shown in vitro using nano-CT, is critical to achieve accurate and efficient endodontic treatments.

Background:To evaluate the effect of staining beverages on the color stability, translucency and gloss of two provisional restorative materials.Material and Methods:Sixty discs (8 mm x 2 mm) were manufactured for Duralay and Protemp 4. The discs were randomly divided according to the beverages: tea, coffee, wine, Coca-Cola and "Chicha morada" (n=12). The discs were polished and initial recordings of color and translucency were made with a spectrophotometer, and the gloss was measured with a glossmeter. The discs were immersed for 5 days in each of the beverages at 37◦C, and the color, translucency and gloss were recorded again. The differences between the initial and final records were calculated to obtain the values of ΔE, ΔTP, ΔGU. For the analysis, the two-way MANOVA model was chosen, and the significance level was set at 5%.Results:A significant interaction was observed between the type of material and the staining beverages on the changes observed in the values of ΔE, ΔTP, ΔGU (p<0.05). ΔE values for Duralay and Protemp 4 were affected by coffee (7.48±1.53) and wine (11.02±1.07), respectively. The greatest change in ΔTP for Duralay were generated by tea (-1.79±0.62), and coffee (-5.65±0.66) for Protemp 4. Gloss was affected mainly by coffee for both materials (Duralay = -6.44±1.17 , Protemp 4 = -8.28±1.09).Conclusions:The type of material and the pigment drinks act together to influence changes in color, translucency and gloss. The methacrylate-based resin was more stable than the bis-acrylic resin to changes in color, translucency and gloss. Key words:Color, translucency, gloss, staining solutions, interim restorations.

Background: Dental anxiety is a source of problems in the dental treatment that can lead to dental avoidance. Objective: Determine and compare the factors associated with dental anxiety in Peruvian parents. Material and Methods: An observational, descriptive and cross-sectional study was carried out. The sample consisted of children from 3 to 6 years old and their companions, who attended the Instituto Nacional de Salud del Niño in Lima, Peru. The Corah anxiety scale, the dental fear questionnaire and the Frankl scale were used to assess anxiety, parental dental fear, and children's collaboration. The following variables were also evaluated: negative dental experience, treated tooth and treatment of the children. Chi-square statistical tests, Mann-Whitney U and the binary logistic regression model were used. Results: The sample consisted of 325 children and their companions. An association was found between gender (OR = 2.456; 95% CI: 1.037 - 5.818), child collaboration (OR = 0.044; 95% CI: 0.044 - 0.543) and maternal anxiety (p<0.05). Furthermore, there was an association between dental fear (OR = 3.569; 95% CI: 1.136 - 11.218), child collaboration (OR = 0.023; 95% CI: 0.003 - 0.172) and paternal anxiety (p<0.05). Conclusion: The factor associated with maternal dental anxiety was the sex of the child, and on the father’s side, it was the dental fear experienced by them. Moreover, the component affiliated with both parents was the child's collaboration.

Early childhood caries (ECC) are an oral health problem worldwide in children under 6 years of age. This disease of rapid development has a multifactorial etiology, and one of the possible risk factors is developmental defects of enamel (DDE), such as hypoplasia and opacities. The aim of this systematic review was to evaluate the association between DDE and ECC in children under 6 years of age. An electronic search was conducted until March 2022 using Medline (PubMed), Scopus, Science-Direct, LILACS, Web of Science, Cochrane Library, EBSCO-Host, EMBASE, and Google Scholar and complemented with a manual search, with no restrictions on language or date of publication. Longitudinal studies of children under 6 years of age with primary dentition were included. A total of 1158 studies were found, of which 651 records were reviewed by title and abstract, and 24 articles were selected for full-text evaluation. Finally, nine studies that met the selection criteria were included in the qualitative synthesis. Study quality and certainty were assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Three cohort studies of good quality were included in the meta-analysis. A risk associated with DDE (RR = 1.94; 95% CI: 1.52-2.49) and a risk associated with enamel hypoplasia (RR = 5.45; 95% CI: 1.84-16.14) were found. The results for diffuse opacity (RR = 1.21; 95% CI: 0.18-8.15) and demarcated opacity (RR = 1.26; 95% CI: 0.43-3.65) were not significant. GRADE analysis presented low and very low certainty of evidence. It was concluded that there is an association between DDE and ECC. However, the results should be interpreted with caution because of the limitations of the study. The protocol for this study has been registered in PROSPERO under identification number CRD42021238919.

Using past material and spiritual remains, cultural heritage examines communities’ identity formation across time. Cultural heritage requires public and private institutions to care about its restoration, maintenance, conservation, and promotion. Through a bibliometric perspective, this study has analyzed, quantified, and mapped the scientific production of the fourth industrial revolution applied to heritage studies from 2016 to 2021 in the Scopus and Web of Science databases. Biblioshiny software from RStudio was employed to categorize and evaluate the contribution of authors, countries, institutions, and journals. In addition, VOSviewer was used to visualize their collaboration networks. As a main result, we found that augmented reality and remote sensing represent the research hotspot concerning heritage studies. Those techniques have become common in archaeology, as well as museums, leading to an increase in their activity. Perhaps, more recent tools, such as machine learning and deep learning, will provide future pathways in cultural heritage from data collected in social networks. This bibliometric analysis, therefore, provides an updated perspective of the implementations of technologies from industry 4.0 in heritage science as a possible guideline for future worldwide research.

The present study evaluates the quality of Clinical Practice Guidelines (CPG) related to the management of paediatric dental emergencies applicable to the COVID-19 pandemic, through the use of the measuring instrument AGREE II (Appraisal of Guidelines for Research and Evaluation in Europe).We conducted a thorough web search of CPG among the top CPG compilers. : In addition, a thorough search was conducted among the major national and international dental organisations as well as reputable websites in order to find CPG that fulfil the inclusion criteria.An overall Five (05) out of twenty-three (23) selected CPG, were classified as “acceptable” according to AGREE II. These five guides were evaluated to determine their “Recommendation degree”. According to the quality evaluation criteria and recommendation degree of the AGREEII instrument, only one CPG (AUGE clinical guide for ambulatory dental emergencies- Chile, 2011) was considered a “Rec-ommended” CPG, but applicable only among Spanish- speaking coun-tries. It would be advisable to work on this guide, using English as an international language.High, middling, and low quality CPG were determined using the quality assessment and recommendation degrees criteria from AGREE II. Only one CPG had a score of 75% or above, earning the designation "highly recommended". Therefore, in order to ensure their quality, it is advised that both current and future CPG updates develop them using the available tools and procedures.

High-quality scientific evidence requires approaches to evaluate the research methodologies. Thus, degrees of recommendation for medical procedures or health interventions have been established.1,2 Internal validity assessment (for methodology and bias), external validity assessment (for reproducibility in the target population), and analysis of impact ought to be performed. Clinical practice guidelines are documents intended to provide recommendations for making decisions about medical procedures.3 Nevertheless, some clinical practice guidelines are not properly structured and lack updated scientific evidence. Therefore, clinical practice guideline quality control ensures that potential biases in their elaboration have been marked and recommendations have been internally and externally validated. The Appraisal for Guidelines, Research and Evaluation in Europe evaluates the methodological rigor (a key factor for clinical practice guideline quality) and the transparency with which the clinical practice guidelines are elaborated. The two most used measurement scales, the Grading of Recommendations, Assessment, Development, and Evaluation scale (GRADE) and the Scottish Intercollegiate Guidelines Network (SIGN) scale, were designed to assess and categorize systematic reviews and clinical practice guidelines regarding therapeutic procedures. The SIGN scale also focuses on the reduction of systematic errors or bias risk.4 The pyramid for levels of scientific evidence classifies research according to its relevance, but not all the evidence placed at the same level have the same quality. Murad et al.5 proposed an alternative depiction of this pyramid with wavy lines dividing the quality levels (following the GRADE approach) (Fig. 1, above). This study aimed to present a new didactic proposal of the level of scientific evidence pyramid according to the SIGN scale, by depicting each level of scientific evidence that leads to recommendation degree (Fig. 1, below). This study was approved by the Institutional Committee of Ethics in Research, IMT “DAC” National University of San Marcos (CIEI-2020-003).Fig. 1.: New pyramid proposal according to SIGN. (Above) Pyramid proposed according to GRADE. (Used with permission from [email protected].) (Below) New proposal for a pyramid of evidence levels according to SIGN.The SIGN approach is different from others that only evaluate the methodological design. This causes overestimation in the categorization of the level of scientific evidence and recommendation degrees. Another limitation is the need to complement the bias risk assessment with additional instruments. For treatment studies, the SIGN proposal categorizes the level of scientific evidence with numbers (from 1 to 4) to generate the recommendation degree, identified with letters (from A to D) (Fig. 1, below). The levels of scientific evidence categorized as “1++” and “1+” generate a “type A” recommendation degree. The levels of scientific evidence categorized as “1−” and “2−” are considered “not recommended” due to high bias risk. The level of scientific evidence categorized as “2++” generates a “type B” recommendation degree. The level of scientific evidence categorized as “2+” generates a “type C” recommendation degree. The levels of scientific evidence categorized as “3” and “4” generate a “type D” recommendation degree. This new pyramid proposal responds better to the levels of scientific evidence for clinical application. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

OBJECTIVE:To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P).DESIGN:Quasi-experimental study.METHODS:A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed.RESULTS:Improvements in infant's OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores (P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL (P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment (P < .0001).CONCLUSIONS:Primary surgical post-treatment resulted in significant improvement of the infant's OHRQoL with CL/P.

OBJECTIVE:This study aimed to correlate the cervical vertebrae maturation (CVM) stages with the bone fusion stages of the midpalatal suture (MPS).MATERIALS AND METHODS:The sample consisted of 351 cone-beam computed tomographies (CBCTs) of patients divided into two groups: 10-15 years old and 16-20 years old. Both CVM and MPS stages were correlated using Spearman's correlation analysis. To assess the diagnostic performance of the CVM stages in identifying the bone fusion stages of the MPS, the likelihood ratio (LHR) test was applied.RESULTS:In the whole sample, a low positive correlation was found between CVM and MPS bone fusion level (P<0.001; Rho=0.395). In the younger age group, the correlation was moderate in the male (P<0.001; Rho=0.616) and low in the female (P<0.001; Rho=0.394) patients. In the 16-20 years age group, there was no correlation between CVM and MPS fusion. A moderate increase in the probability of determining CS1 for stage A (38%) and CS2 for stage B (42.2%) of MPS ossification was found among the 10-15 year old female patients.CONCLUSION:A low and moderate positive correlation was found between CVM and MPS level of bone fusion in female and male patients respectively, but the diagnostic performance of the CVM stages in the identification of MPS bone fusion stages did not have a high correlation. Therefore, the CVM stages indicated no conclusive probability of determining the MPS bone fusion stage.

OBJECTIVE:To evaluate the cephalometric characteristics of skulls with and without artificial deformation in a pre-Columbian civilization of the Peruvian Andes (Chavin civilization 900 B.C. to 200 B.C.). MATERIALS AND METHODS:The study was observational, analytical, retrospective, and comparative in design. The image analysis unit was radiological with cephalometric measurement. The sample consisted of occipito-frontal dry skulls of the Chavín culture (n = 40) with and without artifical deformation, which underwent cephalometric radiography for analysis. RESULTS:The measurements of skull base size, anterior cranial base size, posterior cranial base size, posterior cranial base size, and cranial deflection were greater in the deformed than the non-deformed skulls (95.1 ± 6.6 vs. 92.3 ± 6.2 mm, 61.5 ± 3.6 vs. 61.4 ± 3.6 mm, 39.8 ± 3.4 vs. 38.1 ± 3.5 mm, 136 ± 26.9 vs. 135.0 ± 5.6 mm, and 35.7 ± 31.8 vs. 28.2 ± 14.6 mm, respectively). Significant differences were only found in the posterior cranial base size measurements between deformed and nondeformed skulls (P = 0.008). When comparing the characteristics of the skulls, significant differences were only found between the position of the posterior nasal spine and the maxilla size of the deformed versus the non-deformed skulls (P < 0.05). CONCLUSIONS:It is concluded that there are differences in the size, position, and inclination of the craniofacial structures between the artificially deformed skulls and the skulls that have not been artificially deformed by the old Chavin civilization.

Neurocysticercosis (NCC) is endemic in many parts of the world, carrying significant neurological morbidity that varies according to whether lesions are located inside the cerebral parenchyma or in extraparenchymal spaces. The latter, in particular subarachnoid NCC, is assumed to be more severe, but no controlled studies comparing mortality between types of NCC exist. The aim of this study was to compare all-cause mortality between patients with intraparenchymal NCC and those with subarachnoid NCC. Vital status and sociodemographic characteristics were evaluated in patients with intraparenchymal viable, intraparenchymal calcified, and subarachnoid NCC attending a neurological referral hospital in Lima, Perú. Survival analyses using Kaplan-Meier curves and Cox proportional regression models were carried out to compare mortality rates between groups. From 840 NCC patients followed by a median time of 82.3 months, 42 (5.0%) died, six (1.8%) in the intraparenchymal viable group, four (1.3%) in the calcified group, and 32 (16.6%) in the subarachnoid group (P < 0.001). Older age and lower education were significantly associated with mortality. The age-adjusted hazard ratio for death in the subarachnoid group was 13.6 (95% CI: 5.6-33.0, P < 0.001) compared with the intraparenchymal viable group and 10.7 (95% CI: 3.7-30.8, P < 0.001) when compared with the calcified group. We concluded that subarachnoid disease is associated with a much higher mortality in NCC.

Objective > To determine the ossification level of the midpalatal suture (MPS) in children, adolescents and adults from a Peruvian sample; according to the method proposed by Angelieri et al. with cone-beam computed tomographies (CBCTs). Material and methods > The sample consisted of 315 CBCTs of 168 females and 147 males. The total sample was divided into 3 groups according to age and sex: children (n = 77), adolescents (n = 113) and adults (n = 125). The images were mainly assessed in the axial plane using the Real Scan 2.0 software. The different periods of ossification of the MPS at the level of the vertical half of the palate was defined according to the five stages of Angieleri method (from A to E). The Student t-Test, Chi-square test, Kruskal-Wallis test and Spearman's Rho test were applied. Results > Chi(2) test results showed that the stages of MPS ossification depended on the age of the patient by age ranges (P < 0.005). Multiple comparison tests affirmed that male and female subjects in the children group had fewer ossification stages than the adolescent and adult groups (P < 0.001). Meanwhile, there were no statistically significant differences between the two older age groups. Finally, there was a moderate positive correlation between the stages of ossification of the MPS and the age in the male group (Rho = 0.511). Conclusions > The onset of MPS ossification was significantly related to subjects up to 12 years of age and more frequently in stages B and C in both sexes. There was no difference in MPS ossification in adolescents and adult subjects.

The aim was to assess the effect of XP-endo Finisher (XPF) on multispecies biofilm removal, in comparison with passive ultrasonic irrigation (PUI) and conventional syringe irrigation (CSI), by scanning electron microscope (SEM). Fifty mandibular first premolars were instrumented, longitudinally sectioned. The split halves were incubated for 4 days with a broth obtained from three bacteria strains: Enterococcus faecalis, Eikenella corrodens and Streptococcus anginosus. Subsequently, the re-approximated split halves were irrigated with 4% sodium hypochlorite (NaOCl) or water using CSI, and the final irrigation protocols were CSI with 4% NaOCl (CSI+4%NaOCl), PUI+4%NaOCl, XPF+4%NaOCl and CSI+water. The analysis of biofilm removal was performed using SEM images. There were no differences between PUI and XPF (P > 0.05), and both groups promoted higher biofilm removal than CSI+4%NaOCl and CSI+water groups (P < 0.05). It can be concluded the multispecies biofilm removal was significantly improved using XPF and PUI when compared to CSI.