Pablo Acuña-Mardones

Background: Children living in underserved and rural areas experience significant barriers to healthcare access due to geographic isolation, health workforce shortages, and systemic inequities. Digital and remote health interventions such as telehealth, telemental health (TMH), and mobile health (mHealth) offer promising strategies to improve pediatric health outcomes in these contexts. However, the extent of their effectiveness remains insufficiently examined through high‐quality evidence. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and structured using the PROPS framework. Five databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library) were searched for randomized controlled trials (RCTs) published until May 2025. Eligible studies targeted children (0–17 years) in underserved or rural settings and evaluated digital or remote interventions versus standard care. Data were extracted on study design, population, intervention modality, outcomes, and implementation characteristics. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Eleven RCTs were included, covering interventions for obesity, asthma, ADHD, diabetes, oral health, and neonatal care. Telehealth interventions improved behavioral and biometric outcomes (e.g., BMI z ‐score, and adherence), particularly in the United States. TMH showed high fidelity and effectiveness for ADHD management. mHealth interventions in low‐ and middle‐income countries enhanced referral rates, service coverage, and caregiver engagement. Most studies were rated low risk of bias, though few incorporated economic or equity analyses. Conclusions: Digital health interventions are effective and feasible for improving pediatric outcomes in underserved settings. Future research should emphasize long‐term impact, cost‐effectiveness, and equitable access to ensure sustainable and inclusive digital healthcare delivery.

La educación en ingeniería enfrenta el desafío de actualizar sus estrategias pedagógicas para integrar tecnologías emergentes y fomentar el aprendizaje activo. En este contexto, la realidad virtual (VR) y los entornos inmersivos ofrecen nuevas oportunidades para innovar en la enseñanza. Este artículo presenta el resultado de la aplicación de un modelo que integra tres enfoques metodológicos, Maker, Agile y Aprendizaje Basado en Proyectos (ABP), para el desarrollo de experiencias inmersivas educativas, en un Laboratorio de Proyectos de Innovación con Base Tecnológica. La iniciativa involucró a estudiantes de diversas carreras, incluyendo Ingeniería Civil Industrial, Ingeniería Civil Industrial con menciones en Informática, Mecánica y Bioprocesos, Ingeniería Civil Eléctrica y Animación Digital. A través del trabajo interdisciplinario, los participantes desarrollaron soluciones educativas inmersivas, utilizando herramientas como Blender, Unreal Engine, Unity y otras, para la modelación y programación de entornos interactivos. Se trabajó en la definición del proceso y la estructura de la metodología. Se desarrollaron proyectos para validar la aplicación del modelo. Los proyectos desarrollados incluyeron: Metaverso Docente: Propuesta de Diseño de un Metaverso de Docencia Como Plataforma Piloto Para Realizar Actividades de Enseñanza-Aprendizaje en Ingeniería (DID23 - 0048). Planta Cervecera Virtual: Modelado de Planta Cervecera (DID23 – 0053). Simulación de procesos productivos para la enseñanza de ingeniería de bioprocesos. Sistema Solar Interactivo: Viaje Educativo por el Sistema Solar (EXT23 – 0017). Representación dinámica de cuerpos celestes para la enseñanza de física e ingeniería. El trabajar con este modelo nos llevó a tener dos líneas de resultados, primero la aplicación del modelo por parte de los estudiantes en el proceso de generación del producto y la fabricación de un mínimo producto viable, que será usado como parte de cursos de las distintas carreras de nuestra Universidad. El siguiente paso es expandir el uso de este modelo y aplicarlo en cursos formales de ingeniería, tal como diseño integral de productos y evaluar su impacto con métricas específicas. La replicabilidad del modelo sugiere un alto potencial para transformar la enseñanza en ingeniería, promoviendo la creatividad, la innovación y la formación de profesionales preparados para los desafíos tecnológicos actuales.

Background/Objectives: The extraction of impacted mandibular third molars (M3Ms) carries significant risks, especially regarding the inferior alveolar nerve (IAN). This study aimed to evaluate the effectiveness of a 3D-planned inward fragmentation technique (3Dp-IFT) to improve surgical outcomes, reduce complications, and preserve bone structure in cases involving complex M3M impactions. Methods: Twenty-three patients aged between 18 and 36 years requiring M3M removal were included. Preoperative planning involved the use of cone–beam computed tomography (CBCT) for precise localization of the furcation area, followed by the creation of a 3D navigation template using PlastyCAD software version 1.7. The surgical procedure was performed under local anesthesia, with meticulous endoscopic assistance to ensure accurate access and minimize trauma. Postoperative outcomes, such as bone loss, pain, swelling, and mouth opening range, were carefully measured. The data were systematically organized and analyzed descriptively using Microsoft Excel. Results: No disturbances to the IAN or lingual nerve were observed. The mean buccal bone loss was 2.2 mm, with a standard deviation of 1.2 mm. Postoperative pain and swelling were generally low, with significant reductions within the first week. The use of the 3D navigation template significantly improved surgical access, enhancing safety and minimizing complications. Conclusions: The 3Dp-IFT technique represents a significant advancement in the minimally invasive removal of M3M by allowing precise access to critical anatomical areas while minimizing bone loss and postoperative complications. This approach is particularly beneficial for complex cases involving M3M near the IAN, thereby improving surgical safety and patient outcomes.

The aim of this study was to determine the morphogeometric patterns of the interforaminal region from cone beam computed tomography (CBCT) scans of individuals with total mandibular edentulism. CBCT images were obtained from 40 patients with total edentulism who are older (12 men and 28 women; average age of 69.5 ± 9.4 years) and who wore a non-implant-supported, lower, removable, total prosthesis. We conducted a two-dimensional (2D) morphogeometric analysis of the Digital Imaging and Communication in Medicine (DICOM) files from the CBCT scans, and five equidistant cross sections were planned. For the three-dimensional (3D) morphogeometric analysis, standard triangular language (STL) files were obtained after segmentation of the interforaminal mandibular region, and four anatomical landmarks and their respective curves were digitized. The patterns among the shapes were determined using principal component analysis (PCA) on MorphoJ software (version 1.07a). The results of the 2D morphogeometric analyses for PCA of the interforaminal mandibular paramedian region were PC1 or elongated drop shape, 54.78%; PC2 or wineskin shape, 17.65%; PC3 or pear shape, 11.77%; and PC4 or eggplant shape, 5.71%, and those for PCA of the symphyseal region were PC1 or elongated drop shape, 62.13%; PC2 or ovoid shape, 11.64%; PC3 or triangular shape, 9.71%; and PC4 or tuber shape, 4.96%. The results of the 3D morphogeometric analyses for the interforaminal hemimandibular region were PC1, 59.83%; PC2, 10.39%; PC3, 7.67%; and PC4, 5.09%. This study provides relevant information for future clinical guidelines on prosthetics and implants, in addition to proposing the use of new technologies that support diagnosis and treatment in patients with edentulism.

Objectives. To develop and implement a “semi‐presential” technology platform to support urgent and priority dental care for the elderly in the context of the COVID‐19 pandemic among the Chilean population. Methods. A dental mobile clinic was implemented along with the development of a technological platform designed to support emergency and priority dental procedures, including teleconsultation with specialists. Under strict biosafety protocols, dental care was provided in five Chilean regions between February and May 2021. Sociodemographic, medical, and dental data were recorded. Results. A total of 135 patients over sixty years old, with a mean age of 72 years, were treated, 48 males and 87 females were attended between February and May 2021 in five different regions of Chile. 53.3% required immediate or urgent treatment, and 24.4% were derived to specialists from whom 60.6% needed immediate or urgent treatment. 74.3% of teleconsultations were derived to an oral pathology specialist. Conclusion. It was shown that a “semi‐presential” technology platform implemented in a mobile dental clinic can help elderly people who are impeded to look for traditional dental assistance during a pandemic.

The purpose of this study is to assess the use of grade V titanium mini transitional implants (MTIs) immediately loaded by a temporary overdenture. For this, a histomorphometric analysis of the bone area fraction occupancy (BAFO) was performed by backscattered scanning electron microscopy (BS-SEM). Four female patients were submitted to surgery in which two MTIs were installed and immediately loaded with a temporary acrylic prosthesis. During the same surgery, two regular diameter implants were placed inside the bone and maintained without mechanical load. After 8 months, the MTIs were extracted using a trephine and processed for ultrastructural bone analysis by BS-SEM, and the regular-diameter implants were loaded with an overdenture device. A total of 243 BAFOs of MTIs were analyzed, of which 94 were mainly filled with cortical bone, while 149 were mainly filled with trabecular bone. Bone tissue analysis considering the total BAFOs with calcified tissues showed 72.13% lamellar bone, 26.04% woven bone, and 1.82% chondroid bone without significant differences between the samples. This study revealed that grade V titanium used in immediately loaded MTI was successfully osseointegrated by a mature and vascularized bone tissue as assessed from the BAFO.