Internet y el español / José Antonio Millán. Madrid: Fundación Retevisión, 2001

Sección: ReseñasEl pasado 4 de julio se presentó en el Circulo de Bellas Artes de Madrid el libro de José Antonio Millán Internet y el español. La presentación corrió a cargo de Juan Luis Cebrián, reciente académico de la lengua y buen conocedor de los medios de comunicación. A continuación tomó la palabra el autor. José Antonio es lingüista, ha sido editor tradicional y ahora es editor digital. Ha dirigido el equipo que creó el primer diccionario electrónico del español CD ROM del diccionario de la Real Academia de la Lengua y el proyecto del Centro Virtual Cervantes.N

Cost-effectiveness of managing cavitated primary molar caries lesions:A randomized trial in Germany

The Hall Technique (HT), Non-Restorative Cavity Control (NRCC) and conventional carious tissue removal and restoration (CR) are strategies for managing cavitated caries lesions in primary molars. A randomized controlled three-arm parallel group trial in a university clinic in Germany was used to measure the cost-effectiveness of these strategies. 142 children (HT: 40; NRCC: 44; CR: 58) were followed over a mean 2.5 years. A German healthcare perspective was chosen. The primary outcome was estimated molar survival; secondary outcomes were not needing extraction, not having pain or needing endodontic treatment/extraction, or not needing any re-intervention at all. Initial, maintenance and endodontic/restorative/extraction re-treatment costs were derived from fee items of the statutory insurance. Cumulative cost-effectiveness and cost-effectiveness acceptability were estimated from bootstrapped samples. HT molars survived longer (estimated mean; 95% CI: 29.7; 26.6–30.5 months) than NRCC (25.3; 21.2–28.7 months) and CR molars (24.1; 22.0–26.2 months). HT was also less costly (66; 62–71 Euro) than NRCC (296; 274–318 Euro) and CR (83; 73–92 Euro). HT was more cost-effective than NRCC and CR in >96% of samples, and had acceptable cost-effectiveness regardless of a payer’s willingness-to-pay. This superior cost-effectiveness was confirmed for secondary health outcomes. Cost-advantages were even more pronounced when costs were calculated per year of tooth retention (mean annual costs were HT: 29, NRCC: 154, CR: 61 Euro). HT was more cost-effective than CR or NRCC for managing cavitated caries lesions in primary molars, yielding better dental health outcomes at lower costs. If choosing between these three strategies for managing cavitated caries lesions in primary molars, dentists should prefer HT over NRCC or CR. This would also save costs for the healthcare payer

Alternative caries management options for primary molars:2.5-yr outcomes of a randomised clinical trial

Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458)

Interventions for managing root caries

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of interventions for: preventing root caries (primary prevention); arresting root caries (secondary prevention); restoring root caries lesions (tertiary prevention).</p

Predicting Caries by Measuring Its Activity Using Quantitative Light-Induced Fluorescence in vivo: A 2-Year Caries Increment Analysis

The aim of this study was to analyse the predictive power of several clinical baseline parameters and the de-/remineralisation properties of in vivo etched sites measured with quantitative light-induced fluorescence (QLF) for subsequent 2-year caries increment. At baseline, in 44 children (8.23 ± 1.5 years) two areas (diameter 2 mm) of the buccal surface of a primary posterior tooth were etched with 36% phosphoric acid gel for 1 and 4 min, respectively. The etched sites were analysed immediately after etching (ΔQ1) and 24 h (ΔQ2) later by QLF. Additionally, caries status (deft/DMFT and initial caries), approximal plaque, bleeding on probing, and the patient’s current use of fluorides were recorded. In the 2-year follow-up, 29 children were re-assessed. After clinical examination, the caries increment was calculated (ΔDMFT) and correlated with the baseline clinical variables and the QLF readings. Results showed a significant positive correlation between ΔQ1 min and the ΔDMFT (r = 0.44, p = 0.02). The ΔDMFT was significantly correlated with the baseline deft (r = 0.56, p = 0.002), cavitated active caries lesions (r = 0.52, p = 0.003), and filled teeth (r = 0.53, p = 0.003). In a regression analysis the use of fluoridated salt (SC = –0.10) and fluoride gel (SC = –0.14) were negatively associated with ΔDMFT. In conclusion, these findings suggest that the demineralisation properties of the etched sites and the outcome of the 24-hour measurements with QLF are significantly associated with caries increment. Previous caries experience strongly correlated with caries increment in this group of children

Analyzing the Effects of Load Distribution Algorithms on Energy Consumption of Servers in Cloud Data Centers

Cloud computing has become an important driver for IT service provisioning in recent years. It offers additional flexibility to both customers and IT service providers, but also comes along with new challenges for providers. One of the major challenges for providers is the reduction of energy consumption since today, already more than 50% of operational costs in data centers account for energy. A possible way to reduce these costs is to efficiently distribute load within the data center. Although the effect of load distribution algorithms on energy consumption is a topic of recent research, an analysis-framework for evaluating arbitrary load distribution algorithms with regard to their effects on the energy consumption of cloud data centers is still nonexistent. Therefore, in this contribution, a concept of a simulation-based, quantitative analysis-framework for load distribution algorithms in cloud environments with respect to the energy consumption of data centers is developed and evaluated

Managing carious lesions:consensus recommendations on terminology

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Caries Epidemiology and Community Dentistry: Chances for Future Improvements in Caries Risk Groups. Outcomes of the ORCA Saturday Afternoon Symposium, Greifswald, 2014. Part 1

This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with ‘caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in ‘healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors

Cross-sectional Analysis of Emergency Dental Pediatric Patients and Proposal of Guidance for Clinical Management

Aim: This study aims primarily to investigate the characteristics of pediatric patients seeking emergency dental care and the according treatment in a specialized dental service and secondly to propose a data-based guidance for the management of dental emergencies in children. Materials and Methods: Records of the demographic and clinical characteristics of 332 children who attended specialized dental clinics seeking emergency dental care were collected. Statistical analysis was carried out. Based on the data, a proposal for management of emergency/pain patients was introduced. Results: Pain patients were high caries risk children (mean: 4.59 ± 3.65 dmft, 1.65 ± 2.73 DMFT). The main clinical diagnoses of pain patients in all different age groups were dental caries (63.6%). In general, the most frequent treatment was extraction (41.0%), and the most of these extractions needed to be performed under sedation (57.3%). Based on the analyzed data, a proposal for the management of emergency/pain patients was formulated. Conclusion: Dental caries was the main cause of emergency or pain-related dental visits among children, with tooth extraction under sedation being the common treatment. It is essential for general practitioners and specialized pedodontists to construct a treatment plan that not only manages the patient’s pain but also considers the long-term effects of the treatment on the patient’s future cooperation

The rise of dentine hypersensitivity and tooth wear in an ageing population

Our understanding of the aetiology of dentine hypersensitivity (DH) has changed dramatically over the past few decades. It is no longer an enigma, but other problems exist. The prevalence of DH in the world and in particular in the UK is increasing, predominately due to increases in tooth wear and the erosive dietary intake in the younger population. DH is increasingly reported in all age groups and is shown to provide clinical indication of an active erosive tooth wear. As the population ages and possibly retain teeth for longer, the likelihood of tooth wear and DH could increase. This paper describes the prevalence, aetiology, diagnosis and management of DH in relation to tooth wear, which work together through a surface phenomenon. The aim is to raise awareness of the conditions and to help inform a prevention strategy in an ageing population, which starts from younger age groups to reduce disease into older age