Objetivo: Comparar el conocimiento sobre el uso de las carillas dentales en estudiantes de pregrado de distintas facultades universitarias de Lima, Perú. Materiales y métodos: 434 estudiantes de pregrado de distintas facultades universitarias de Lima - Perú (Ciencias Sociales, Comerciales y Derecho (n=166); Ingeniería, Industria y Construcción (n=137); y Ciencias de la Salud (n=131) fueron encuestados a través de un cuestionario validado para comparar sus conocimientos sobre el uso de carillas dentales, enviadas a través de plataformas digitales en el periodo de setiembre - octubre del año 2020. El análisis univariado fue realizado a través de la estadística descriptiva (frecuencia absoluta y relativa) de las variables cualitativas y las medidas de tendencia central y de dispersión (mediana y rango intercuartílico) de la variable cuantitativa ‘‘edad’’. El análisis bivariado fue realizado mediante el test de ANOVA de una vía, utilizando la media y ±desviación estándar de las variables ‘‘puntuación’’ y ‘‘facultad universitaria’’ (α≤0.05). Resultados: No se encontraron diferencias significativas al comparar el conocimiento sobre el uso de las carillas dentales entre los estudiantes de pregrado de las facultades universitarias de Ciencias Sociales, Comerciales y Derecho (13.35±2.27); Ingeniería, Industria y Construcción (13.16±2.55) y Ciencias de la Salud (13.40±3.09) de Lima, Perú. (p= 0.723) Conclusiones: No se halló diferencias en el conocimiento sobre el uso de carillas dentales entre las facultades universitarias. Como profesionales de la salud debemos reforzar y actualizar la información clínica brindada a través de los distintos medios de información dado que existe aún desconocimiento y se necesita una mayor concientización sobre este tratamiento. / Objective: Compare the knowledge about the use of dental veneers in undergraduate students from different university faculties in Lima, Peru Materials and methods: 434 undergraduate students from different university faculties of Lima - Peru (Social, Commercial and Law Sciences (n = 166); Engineering, Industry and Construction (n = 137); and Health Sciences (n = 131) were surveyed through of a validated questionnaire to compare their knowledge about the use of dental veneers, sent through digital platforms in the period September - October 2020. The univariate analysis was performed through descriptive statistics (absolute and relative frequency) of the qualitative variables and the measures of central tendency and dispersion (median and interquartile range) of the quantitative variable ''age'', the variables ''score'' and ''university faculty'' (α≤0.05). Results: No significant differences were found when comparing knowledge about the use of dental veneers among undergraduate students of the university faculties of Social, Business and Law Sciences (13.35 ± 2.27); Engineering, Industry and Construction (13.16 ± 2.55) and Health Sciences (13.40 ± 3.09) from Lima, Peru. (p = 0.723) Conclusions: There were no differences between the knowledge about the use of dental veneers between the university faculties. As health professionals we must reinforce and update the clinical information provided through the different information media since there is still a lack of knowledge and a greater awareness of this treatment is needed. / Tesis

O objetivo desse estudo foi comparar duas técnicas cirúrgicas para recobrimento radicular e avaliar qual delas ofereceu o melhor resultado estético e menor morbidade. Foram selecionados 20 participantes adultos, não fumantes, que apresentaram retrações gengivais múltiplas bilaterais, classe I ou II de Miller, localizadas em caninos, primeiros e segundos pré-molares. As duas técnicas utilizaram a MDA como enxerto. Porém, em um quadrante foi realizado um retalho parcial com incisões relaxantes unidas através de uma incisão intrasucular, a MDA foi posicionada a 1 mm apical a junção amelocementária (JAC) e o retalho posicionado a 1 mm coronal a JAC. No quadrante oposto foi realizada uma técnica minimamente invasiva de envelope supra periosteal que não utiliza incisões relaxantes, preserva as papilas, além de evitar eventuais cicatrizes. Os parâmetros clínicos (profundidade clínica de sondagem, nível clínico de inserção, índice de sangramento a sondagem, altura e largura da retração gengival e altura e espessura de gengiva queratinizada) foram avaliados 2 semanas após a terapia periodontal básica e após 6 meses aos procedimentos cirúrgicos. No exame inicial todos os parâmetros foram similares, tanto para grupo teste como para grupo controle. Não houve diferença estatisticamente significante favorecendo nenhuma das técnicas, porém o grupo controle teve números sutilmente melhores do que o grupo teste. Apesar de ambos procedimentos cirúrgicos terem proporcionado melhora significativa em todos os parâmetros analisados, com exceção da PCS, a técnica controle obteve melhores resultados, porém sem diferenças estatisticamente significantes. / Aim: The aim of this study is to compare two surgical techniques using acelular dermal matrix (ADM)for the treatment of gingival recessions. Material and Methods: Twenty patients with bilteral class I and II multiple gingival recession were selected for a Split mouth study design. At one side a modified extended coronally advanced flap (MECAF) was used. At the contralateral a supra periosteal flap (TUN) was performed. Both sides were associated with ADM, so that the technique was the only variable. The clinical parameter evaluated were: probing pocket depth (PD), relative clinical attachment level (RCAL), gingival index (GI), gingival recession height (GR), width of keratinized tissue (KT), keratinized tissu thickness (TKT), and gingival recession area (GRA). Post-operative pain was evaluated with a visual analog scale (VAS) weekly on the first month post operative. Clinical examination was performed at baseline and 6 months post operative. Results: At baseline, no differences at any of the parameters examined could be detected between groups. Both groups were effective to reduce GR, but no difference was detected between them (ΔGR: MECAF= 2.28 &plusmn 1.01; TUN= 1.93 &plusmn 1.36mm). The % of root coverage was numerically superior favoring (MECAF = 61.24 &plusmn 23.42%; TUN= 56.07 &plusmn 22.02%), without significant differences between groups. PD Did not changed significantly after treatment and a clincial attachment gain associated with reduction of gingival recession was noted. Post operative pain was more frequent on MECAF, but no significant difference between groups could be noticed. Conclusions: Both treatments were effective on reducing gingival recession and might be valuable for the treatment of multiple gingival recessions. No significant differences could be shown despite a numerical advantage favored MECAF.

O objetivo desse estudo foi comparar duas técnicas cirúrgicas para recobrimento radicular e avaliar qual delas ofereceu o melhor resultado estético e menor morbidade. Foram selecionados 20 participantes adultos, não fumantes, que apresentaram retrações gengivais múltiplas bilaterais, classe I ou II de Miller, localizadas em caninos, primeiros e segundos pré-molares. As duas técnicas utilizaram a MDA como enxerto. Porém, em um quadrante foi realizado um retalho parcial com incisões relaxantes unidas através de uma incisão intrasucular, a MDA foi posicionada a 1 mm apical a junção amelocementária (JAC) e o retalho posicionado a 1 mm coronal a JAC. No quadrante oposto foi realizada uma técnica minimamente invasiva de envelope supra periosteal que não utiliza incisões relaxantes, preserva as papilas, além de evitar eventuais cicatrizes. Os parâmetros clínicos (profundidade clínica de sondagem, nível clínico de inserção, índice de sangramento a sondagem, altura e largura da retração gengival e altura e espessura de gengiva queratinizada) foram avaliados 2 semanas após a terapia periodontal básica e após 6 meses aos procedimentos cirúrgicos. No exame inicial todos os parâmetros foram similares, tanto para grupo teste como para grupo controle. Não houve diferença estatisticamente significante favorecendo nenhuma das técnicas, porém o grupo controle teve números sutilmente melhores do que o grupo teste. Apesar de ambos procedimentos cirúrgicos terem proporcionado melhora significativa em todos os parâmetros analisados, com exceção da PCS, a técnica controle obteve melhores resultados, porém sem diferenças estatisticamente significantes. / Aim: The aim of this study is to compare two surgical techniques using acelular dermal matrix (ADM)for the treatment of gingival recessions. Material and Methods: Twenty patients with bilteral class I and II multiple gingival recession were selected for a Split mouth study design. At one side a modified extended coronally advanced flap (MECAF) was used. At the contralateral a supra periosteal flap (TUN) was performed. Both sides were associated with ADM, so that the technique was the only variable. The clinical parameter evaluated were: probing pocket depth (PD), relative clinical attachment level (RCAL), gingival index (GI), gingival recession height (GR), width of keratinized tissue (KT), keratinized tissu thickness (TKT), and gingival recession area (GRA). Post-operative pain was evaluated with a visual analog scale (VAS) weekly on the first month post operative. Clinical examination was performed at baseline and 6 months post operative. Results: At baseline, no differences at any of the parameters examined could be detected between groups. Both groups were effective to reduce GR, but no difference was detected between them (ΔGR: MECAF= 2.28 &plusmn 1.01; TUN= 1.93 &plusmn 1.36mm). The % of root coverage was numerically superior favoring (MECAF = 61.24 &plusmn 23.42%; TUN= 56.07 &plusmn 22.02%), without significant differences between groups. PD Did not changed significantly after treatment and a clincial attachment gain associated with reduction of gingival recession was noted. Post operative pain was more frequent on MECAF, but no significant difference between groups could be noticed. Conclusions: Both treatments were effective on reducing gingival recession and might be valuable for the treatment of multiple gingival recessions. No significant differences could be shown despite a numerical advantage favored MECAF.

Objetivo: Evaluar la asociación entre el impacto psicosocial de la estética dental con la discriminación auto percibida en pacientes ambulatorios de un hospital público en Lima. Materiales y Métodos: Un total de 207 pacientes ambulatorios fueron encuestados en este estudio, de edades comprendidas entre los 18 y 30 años. Para la evaluación del impacto psicosocial de la estética dental se utilizó el Cuestionario del Impacto Psicosocial de la Estética dental (PIDAQ). Asimismo, para la discriminación auto percibida se utilizó un pequeño cuestionario extraído de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2017. Además, se evaluaron otras variables como la edad, sexo, educación, ingreso económico, etnicidad y razón de discriminación. Se utilizó la regresión de Poisson con estimador robusto de varianza tanto como para la asociación de las variables, así como para el cálculo de las razones de prevalencia crudas y ajustadas. El nivel de confianza fue al 95% y el nivel de significancia se estableció como p < 0.05. Resultados: Los encuestados si se auto percibieron como discriminadas según el impacto psicosocial de su estética dental, observándose una asociación estadísticamente significativa positiva (RP 1.02 IC 95% 1.01 – 1.03). Conclusiones: Se observó que el impacto psicosocial de la estética dental se encuentra asociado con la discriminación auto percibida. Además, los pacientes que se auto perciben como discriminados en su mayoría son mujeres en promedio de veintitrés años, mestizos, con un ingreso económico medio bajo. / Aim: To evaluate the association between the psychosocial impact of dental aesthetics with self-perceived discrimination in outpatients of a public hospital in Lima. Materials and Methods: A total of 207 outpatients were evaluated, between 18 and 30 years old. The psychosocial impact of dental aesthetics was evaluated with the Psychosocial Impact of Dental Aesthetics questionnaire (PIDAQ). Likewise, for self-perceived discrimination, questions were selected from the Peruvian National Household Survey on Living Conditions and Poverty 2017. In addition, other variables such as age, sex, education, income, ethnicity and reason for discrimination were evaluated. The Poisson regression with robust estimator of variance was used for the association of the variables, as well as for the calculation of the crude and adjusted prevalence ratios. The confidence level was 95% and the level of significance was established as p <0.05. Results: Those surveyed perceived themselves as discriminated according to the psychosocial impact of their dental aesthetics, observing a positive significant association between both variables (PR 1.02, 95% CI 1.01 –1.03). Conclusions: The psychosocial impact of dental aesthetics was found to be associated with self-perceived discrimination. In addition, those who self-perceived themselves discriminated were mostly women, of twenty-three years old on average, mestizos, with a low average economic income. / Tesis

Objetivo: Determinar la asociación del impacto psicosocial de la estética dental entre hombres y mujeres universitarios de Lima – Perú. Materiales y Métodos: Estudio de tipo observacional, analítico y transversal con un total de 619 alumnos universitarios de Lima - Perú con edades entre los 18 y 25 años. Para la evaluación del impacto psicosocial de la estética dental se utilizó el Cuestionario del Impacto Psicosocial de la Estética dental (PIDAQ). Además, se evaluaron otras variables como sexo, edad, facultades universitarias, nivel educativo de los padres, institución de educación, ciclo académico e índice de masculinidad en el hogar. Para la comparación de las características de los estudiantes universitarios y su impacto psicosocial por dimensiones se utilizó la prueba de U de Mann-Whitney, ANOVA, Kruskal-Wallis y T-Student para pruebas no pareadas, y para correlacionar se utilizó el Coeficiente de correlación de Spearman. Finalmente, se utilizó la regresión de Poisson con estimador robusto de varianza para el cálculo de asociación mediante razones de tasa de incidencia crudas y ajustadas a todas las covariables, con intervalos de confianza al 95%. Resultados: El 41% de la muestra fueron hombres con un promedio de 36,48 puntos en el PIDAQ total y una correlación positiva con el índice de masculinidad en el hogar (Spearman 0.194). Asimismo, se encontró una asociación positiva, entre el sexo masculino, índice de masculinidad en el hogar y todas las dimensiones del impacto psicosocial. (IRR 1.10 IC 95% 1.01 – 1.20). Conclusiones: Se evidenció que el impacto psicosocial de la estética dental tiene una asociación positiva en los jóvenes universitarios con el sexo masculino y el índice de masculinidad en el hogar. / Objective: To determine the association of the psychosocial impact of dental aesthetics among university men and women from Lima – Peru. Materials and Methods: Observational, analytical and cross-sectional study with a total of 619 university students in Lima, Peru between the ages of 18 and 25 years. The Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ) was used to evaluate the psychosocial impact of dental esthetics. In addition, other variables such as sex, age, university faculties, educational level of the parents, educational institution, academic cycle and masculinity index in the home were evaluated. For the comparison of the characteristics of university students and their psychosocial impact by dimensions, the Mann-Whitney U test, ANOVA, Kruskal-Wallis and T-Student for unpaired tests were used, and Spearman's correlation coefficient was used for correlations. Finally, Poisson regression with robust variance estimator was used to calculate association using crude and adjusted incidence rate ratios for all covariates, with 95% confidence intervals. Results: 41% of the sample were men with an average of 36.48 points on the total PIDAQ and a positive correlation with the masculinity index in the home (Spearman 0.194). Likewise, a positive association was found between male sex, masculinity index in the home and all dimensions of psychosocial impact. (IRR 1.10 IC 95% 1.01 - 1.20). Conclusions: It was evidenced that the psychosocial impact of dental aesthetics has a positive association in young university students with the male sex and the masculinity index at home. / Tesis

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.