Eficacia frente al sangrado gingival de una pasta dental con o-cymen-5-ol / Effectiveness of a toothpaste with o-cymen-5-ol against gingival bleeding

INTRODUCCIÓN: La gingivitis, si no se trata, puede provocar una periodontitis irreversible. Uno de los compuestos destinados a combatirla es el o-cymen-5-ol. OBJETIVO: El objetivo principal de este estudio fue demostrar la respuesta clínica de un dentífrico con o-cymen-5-ol al 0,1% más zinc, aplicado durante 7 días consecutivos al menos 2 veces/día, en pacientes con un índice de sangrado del surco gingival ≥ 25%. Como objetivo secundario se evaluó la tolerancia del producto. MÉTODOS: Estudio prospectivo, aleatorizado, doble ciego y controlado, para evaluar la eficacia de una pasta dental o-cymen-5-ol frente a un dentífrico con triclosán al 0,3% más zinc. Tras la visita basal, los datos se evaluaron a las 38 h., 48 h., 4 días y 7 días. Se emplearon modelos lineales de efectos mixtos, que fueron ajustados a los datos del ensayo para evaluar la respuesta del producto a lo largo del tiempo Resultados: Se incluyó a un total de 49 pacientes. El porcentaje medio de sangrado basal en ambos grupos fue homogéneo. Respecto al inicio del tratamiento, ambos grupos experimentaron una reducción significativa del índice de sangrado a las 38 horas. Esta reducción continuó ampliándose significativamente hasta un 67,5% y un 71,8%, respectivamente, a los 7 días del inicio del tratamiento. CONCLUSIONES: La pasta dental con o-cy-men-5-ol al 0,1% más zinc mejora el índice de sangrado gingival de forma significativa, ya a las 38 horas de aplicación, en individuos con un índice basal ≥25%, de forma similar a una pasta dental con triclosán al 0,3% más zinc

INTRODUCTION: Gingivitis, if not treated, can cause irreversible periodontitis. One of the compounds used to fight it is o-cymen-5-ol. OBJECTIVE: The main objective of this study was to demonstrate the clinical response of a toothpaste with o-cymen-5-ol at 0.1% plus zinc, applied during 7 consecutive days at least twice a day, in patients with a bleeding rate of the gingival sulcus ≥ 25%. As a secondary objective, the tolerance of the product is evaluated. METHODS: A prospective, randomised, double blind and controlled study, to evaluate the effectiveness of a toothpaste with o-cymen-5-ol compared to a toothpaste with triclosan at 0.3% plus zinc. After the baseline visit, the data were evaluated at 38 h, 48 h, 4 days and 7 days. Linear models of mixed effects were used, which were adjusted to the trial data in order to evaluate the response of the product in a study over time. RESULTS: A total of 49 patients were included. The average baseline percentage in both groups was homogeneous. With respect to the start of the treatment, both groups experienced a significant reduction in the bleeding rate at 38 h. This continuous reduction increased significantly up to 67.5% and 71.8%, respectively, at 7 days from the start of the treatment. CONCLUSIONS: Toothpaste with o-cymen-5-ol at 0.1% plus zinc improves the gingival bleeding rate significantly, with just 38 hours of application, in individuals with a baseline rate ≥ 25%, similarly to toothpaste with triclosan at 0.3% plus zinc

Gingivitis como primer síntoma de leucemia aguda mieloblástica / Gingivitis as a first symptom of acute myeloblastic leukemia

Las enfermedades hematológicas, entre ellas la leucemia aguda, pueden manifestarse al diagnóstico con afectación a nivel oral. Las leucemias agudas suponen casi el 10 % de todas las neoplasias. En adultos es más frecuente la leucemia aguda mieloide. Los síntomas son secundarios a las citopenias, así como a la infiltración de diferentes órganos. Debido a que se trata de neoplasias agresivas, el diagnóstico precoz es clave para instaurar el tratamiento lo antes posible, por lo que debemos considerar estas patologías en el diagnóstico diferencial ante la presencia de cuadros febriles de larga evolución o de signos de alarma de las mismas

Hematologic disorders, including acute leukemia, may present oral manifestations as initial evidence of the disease. Acute leukemia represents almost 10% of all types of neoplasia. Acute myeloid leukemia is more frequent in adults. Symptoms are secondary to cytopenias and to infiltration of different organs. Since these are aggressive malignancies, early diagnosis is key to establishing a treatment as soon as possible. We should thus consider these disorders in differential diagnosis when we detect the presence of long-standing fever or other warning signs

Evaluación propia en mujeres gestantes al respecto de opiniones, hábitos y estado de su salud oral en una población del sur de Galicia / Self-assessment of opinions, habits and oral health status by pregnant women in the south of Galicia, Spain

Se ha constatado en el embarazo la asociación entre problemas de salud oral y complicaciones obstétricas. Por ello, el objetivo principal de este trabajo es evaluar en embarazadas la percepción de salud oral, hábitos y creencias relativas. Se diseñó un cuestionario para obtener información de las embarazadas que acudían a la consulta de Obstetricia del Hospital Comarcal Valdeorras y Odontología de atención primaria del Centro de Salud Valle Inclán (n=96). Se encontró que la percepción propia de muchas gestantes era padecer algún problema en la cavidad oral. Además, se reflejó que las gestantes tenían hábitos relativos a salud oral adecuados; en adición, creían que su embarazo iba a traer implícitamente problemas a su boca. Las gestantes son capaces de comprender la relación entre su salud oral, su salud sistémica y la de su futuro hijo. Se detectaron una serie de hábitos y creencias en las que sería conveniente incidir para reducir problemas sanitarios

An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems

Enfermedades Periimplantarias II: diagnóstico / Peri-implant diseases II: diagnosis

La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una alta tasa de éxito. No obstante, el número de implantes que se colocan continua incrementándose y con ello también la prevalencia de enfermedades periimplantarias como son la mucositis periimplantaria y la periimplantitis, lo que puede dar lugar a un fracaso de los implantes. La capacidad del clínico para detectar y diagnosticar estas enfermedades periimplantarias son fundamentales para saber cuándo es necesario el tratamiento. Para ello existen diferentes métodos diagnósticos disponibles como la movilidad del implante, la profundidad de sondaje, el sangrado al sondaje o la evaluación radiográfica. Fundamentalmente se identificará clínicamente la mucositis periimplantaria con el sangrado al sondaje junto con la ausencia de reabsorción ósea y la periimplantitis con una profundidad de sondaje profunda acompañada siempre de pérdida ósea marginal (AU)

The use of dental implants as a way to replace missing teeth is proven to be a treatment with a high success rate. However, the number of implants placed continues to increase as well as the prevalence of peri-implant diseases such as peri-implant mucositis and peri-implantitis, which can lead to implant failure. The ability of the clinicians to detect and diagnose these peri-implant diseases is essential to know when the treatment is necessary. There are several diagnostic methods available as implant mobility, probing depth, bleeding on probing and radiographic evaluation. Basically, peri-implant mucositis can be identified with bleeding on probing with no bone resorption and periimplantitis with a deep probing depth always accompanied by marginal bone loss (AU)

Clinical indicators of periodontal disease in patients with coronary heart disease: A 10 years longitudinal study

Objectives: There is evidence about a possible relationship existing between periodontal diseases and coronary heart disease. The aim of the present longitudinal study was to investigate the changes in periodontal evolution after etiological periodontal treatment, comparing a healthy control group with another having coronary heart disease. Study Design: The study included initially 55 patients of which 44 finished it. They were placed into two groups: Healthy Control Group (HCG) n =9, and Coronary Heart Disease Group (CHDG) n=35. The gingival level (GL), probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were measured to compare the periodontal status in both groups. The patients were examined and etiological periodontal treatment was performed and they were then examined at the end of 1 and 10 years. Statistical method: A one way-ANOVA and a MR-ANOVA were established; significance p<0.05. Results: No significant differences between both groups were detected on the first visit (p>0.5). However, at the second visit the CHDG presented a significantly higher PD (p<0.05) and PI (p<0.01). CHDG patients gradually increase PD through time and in comparison to the control group (p<0.041). CHDG patients present a significantly higher CAL loss (p<0.0385) and a significant increase in PI (p<0.0041) at the end of one year, while on the third visit no significant differences were detected in any of these indices. Likewise, a similar fact can be observed on evaluating BOP at the end of ten years causal treatment, a smaller decrease in the cardiac group was observed in regards to the initial values (p<0.001).Conclusion: Patients with coronary heart disease showed a worse evolution of periodontal indices than healthy ones, when referring to probing depth, plaque index and bleeding on probing index (AU)

Prevalencia de gingivitis y factores asociados en niños chilenos de cuatro años / Prevalence of gingivitis and associated factors in 4 year-old chilean children

Objetivos: Determinar la prevalencia y distribución de gingivitis y su relación con factores socioeconómicos, biológicos y locales en niños chilenos de 4 años. Metodología: Se realizó un estudio transversal en preescolares de 4 años que acuden al Hospital de Calbuco, Región de Los Lagos, Chile. La muestra consistió en 102 niños/niñas de 4 años. Un examinador, previamente calibrado, realizó examen odontológico, determinando presencia de placa bacteriana visible, caries dental y sangramiento gingival. Resultados: Los resultados demostraron una prevalencia del 93,1% gingivitis, siendo los sextantes IV y VI los más afectados, con un 90 y 92% de prevalencia respectivamente. Al realizar el análisis de la correlación de gingivitis con otros factores, resultó una correlación positiva con caries y con el nivel de placa bacteriana, por sextante. No hubo correlaciones significativas con género, mal oclusión, frecuencia de cepillado y responsable del cepillado. Conclusión: La alta prevalencia encontrada, los sextantes más afectadas y la escasa relación con datos de la anamnesis del niño/niña, deben ser consideradas en la educación que se le entrega al adulto responsable del cepillado, particularmente en la población de nivel socioeconómico bajo, quienes son más susceptible a las enfermedades bucales (AU)

Objective: To determine the prevalence and distribution of gingivitis and its relation with socioeconomic, biological and local factors in Chilean children of 4 years-old. Methodology: A cross-sectional study was performed in pre-school children of 4 years old attended in Calbuco Hospital, Los Lagos Region, Chile. The sample consisted of 102 children of 4 years-old. An examiner, previously calibrated, realized clinical examination determining presence of visible plaque, dental decay and gingival bleeding. Results: The prevalence of gingivitis was 93.1%, being the sextants IV and IV the most affected, with a 90% and92% of prevalence respectively. To performance the analysis of the correlation of gingivitis with other factors, a positive correlation was found with caries and plaque level, by sextant. There weren’t significant correlations with genre, malocclusion, frequency of brushing and responsible of the brushing. Conclusion: The high prevalence founded, the sextants more affected and the little relation with data of the anamnesis of children, must be considered in the education that is given to the caregivers, particularly in the population of low socioeconomic level, who are more susceptible to oral diseases (AU)

Malformación vascular intraósea en el maxilar que se presenta en forma de sangrado gingival / Intra-osseous vascular malformation in the maxilla

Las malformaciones arterio-venosas intraóseas (MAVs) en la región maxilofacial son entidades clínicas poco frecuentes. Ofrecen una amplia gama de presentación clínica y no siempre se diagnostican sin sorpresa. El tratamiento de estas lesiones siempre ha representado un reto para el cirujano debido a su intensa vascularización y a la elevada incidencia de recurrencia. Se presenta el caso de una malformación arterio-venosa intraósea en el maxilar superior que se manifiesta como sangrado gingival, cuyos exámenes radiológicos de rutina no fueron concluyentes. Se llevó a cabo la excisión quirúrgica y el empaquetado del hueso con cera, y se realizó el seguimiento del paciente durante 1 año sin que se produjera recurrencia. Las malformaciones vasculares deben tenerse en consideración en el diagnóstico diferencial del sangrado gingival con radiografías dentales no concluyentes(AU)

Intraosseous arterio-venous malformations (AVM) in the maxillofacial region are rare clinical entities. They have a wide range of clinical presentation and are not always diagnosed without a surprise. Treatment of these lesions has always been a challenge to the surgeon due to extreme vascularity and the high recurrence rate. The case presented is that of an intraosseous arterio-venous malformation in the maxilla that started as gingival bleeding and routine radiographic examinations were inconclusive. Surgical excision and bone wax packing was performed there were no recurrences during 1-year of follow-up. Vascular malformations may be considered in differential diagnosis of gingival bleeding with inconclusive dental radiographs(AU)

Correlation of CD4 cell count with gingival bleeding index in HIV positive individuals

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Objectives: To correlate CD4 cell count with gingival bleeding index in HIV positive individuals.Methods: Fifty-one serologically confirmed HIV positive individuals were included in the study. Plaque index andbleeding index was recorded by a single examiner. CD4 cell count was obtained within 30 days from the day of examination. CD4 cell counts and gingival bleeding index was correlated using Spearman’s correlation test. p < 0.01 was considered as statistically significant.Results: Mean plaque score, mean gingival bleeding index score and mean CD4 cell count was 1.40, 0.96 and 249.86cells/mm3 respectively. It was noticed that gingival bleeding was enhanced in individuals with increased immunosuppression. However, no significant positive correlation was seen between mean CD4 cell count and gingival bleeding (p = 0.14).Conclusion: Though CD4 cells are an important indicator for clinical aggravation of HIV infection, periodontaldisease as measured by bleeding index is not directly associated to the cell count (AU)

Indicadores tempranos de gravedad en el dengue / Early indicators of severity in dengue virus infection

Objetivo. Identificar los marcadores clínicos de gravedad en el dengue, diferentes a hemorragias mayores. Diseño. Estudio de corte transversal. Población y métodos. Pacientes con diagnóstico de dengue que ingresaron durante el período 1993-1998 en hospitales de Santander (Colombia). Al ingreso, o durante su estancia, se clasificaron los casos de dengue hemorrágico (DH) o dengue clásico (DC). Se registraron los hallazgos clínicos, diferentes a hemorragias mayores, encontrados en urgencias y durante la primera evaluación hospitalaria. Se evaluó la asociación entre estos hallazgos y el desenlace de DH. Resultados. Se incluyó a 891 pacientes (DC: 420, DH: 471). Hubo asociación entre DH y un registro en el ingreso de vómito (odds ratio [OR]: 1,89; intervalo de confianza del 95 % [IC 95%]: 1,37-2,6; p = 0,0001); hemorragia gingival (OR: 1,55; IC 95%: 1,11-2,18; p = 0,01); epistaxis (OR: 1,78; IC 95%: 1,28-2,48; p 5 0,001); hepatomegalia (OR: 2,56; IC 95%: 1,61-4,07; p < 0,0001); hematuria microscópica (OR: 2,33; IC 95%: 1,36-4; p = 0,002), y exantema (OR: 1,36; IC 95%: 1,04-1,77; p = 0,02). Los valores de hematócrito tomados en urgencias y en el primer día de hospitalización fueron significativamente más elevados en el grupo con DH (p < 0,001, en ambas observaciones). En un análisis multivariado, el hematócrito de urgencias de los pacientes con DH superó al de aquellos con DC, independientemente de las otras variables estudiadas (diferencia: 3,65; IC 95%: 2,81-4,49). Conclusión. Se evidencia una asociación entre los hallazgos clínicos tempranos diferentes a hemorragias mayores y DH. Estos resultados deben evaluarse en un estudio de cohortes (AU)

Objective. To identify clinical markers of severity in dengue, different from those of major hemorrhage. Design. Cross-sectional study. Population and methods. Patients with a diagnosis of dengue infection admitted to hospitals in Santander (Colombia) during the years 1993 to 1998 were studied. On admittance or during hospitalization, patients were classified as cases of dengue hemorrhagic fever (DHF) or dengue fever (DF). Clinical findings differing from those of major hemorrhage were recorded in the emergency room and during the first assessment at hospitalization. The association between these findings and the outcome of DHF were evaluated using univariate and multivariate analyses. Results. 891 patients (DF: 420; DHF: 471) were included in the study. Associations were found between DHF and the following signs and symptoms: vomiting (OR: 1.89; 95% CI: 1.37-2.6; p = 0.0001); gingival hemorrhage (OR: 1.55; 95% CI: 1.11-2.18; p = 0.01); epistaxis (OR: 1.78; 95% CI: 1.28-2.48; p = 0.001); hepatomegaly (OR: 2.56; 95% CI: 1.61-4.07; p < 0.0001); microscopic hematuria (OR: 2.33; 95% CI: 1.36-4; p = 0.002); and rash (OR: 1.36; 95% CI: 1.04-1.77; p = 0.02). The hematocrit in the emergency room and on the first day of hospitalization was significantly higher in the group with DHF (p < 0.001, in both observations). On multivariate analysis, the hematocrit from DHF patients obtained in the emergency room was higher than that from DF, independently of the other relevant variables (difference: 3.65; 95% CI: 2.81-4.49). Conclusion. Under the study conditions, there was an association between early clinical findings and DHF. These results must be evaluated in a cohort study (AU)

Enfermedad periodontal necrosante: una manifestación de trastornos sistémicos / Necrotizing periodontal disease: a manifestation of systemic disorders

La enfermedad periodontal necrosante (EPN) es una infección caracterizada por la necrosis y decapitación de las papilas interdentarias, que se manifiesta, además, con hemorragia gingival y dolor. Prevotella intermedia y algunas espiroquetas se han asociado a las lesiones gingivales. Entre los factores predisponentes más relevantes destacan: el estrés, la inmunodepresión, especialmente en los pacientes con infección por el virus de la inmunodeficiencia humana (VIH), el tabaco, déficit alimentarios y la existencia de gingivitis. En los últimos años, el diagnóstico de la EPN ha tomado mayor importancia, no sólo por su contribución a la pérdida de inserción periodontal, sino porque se la ha calificado como un marcador del deterioro inmunológico en pacientes con infección por el VIH

Necrotizing periodontal disease (NPD) is an infection characterized by gingival necrosis presenting as «punched-out» papillae, with gingival bleeding, and pain. Prevotella intermedia and spirochetes have been associated with the gingival lesions. Predisposing factors may include emotional stress, immunosuppression, especially secondary to human immunodeficiency virus (HIV) infection, cigarette smoking, poor diet and pre-existing gingivitis. During the last few years, diagnosis of NPD has became more important not only because of its contribution to the appearance of clinical attachment loss and gingival sequelae, but also because it has been revealed as a marker for immune deterioration in HIV-seropositive patients

Escorbuto: púrpura folicular como signo guía / Scurvy: follicular purpura as a diagnostic sign

El escorbuto es un cuadro clínico caracterizado por debilidad general, anemia, gingivitis y hemorragias cutáneas, secundario a una carencia de ácido ascórbico en la dieta. Actualmente, esta enfermedad constituye una rareza clínica, aunque todavía puede observarse en casos de desnutrición asociada a alcoholismo o a carencias dietéticas, especialmente en la infancia y la senectud. Presentamos el caso de un varón de 45 años que consultó por edemas en extremidades inferiores con púrpura folicular que se acompañaba de astenia, poliartralgias y gingivorragia. Tras la instauración de tratamiento con vitamina C 1 g/día el paciente presentó una rápida mejoría sintomática. El diagnóstico del escorbuto se basa en la sintomatología, la historia dietética y la rápida resolución del cuadro con la instauración de suplementos de vitamina C

Scurvy is a set of clinical manifestations characterized by general weakness, anemia, gingivitis and cutaneous bleeding, caused by a lack of ascorbic acid in the diet. This pathology is currently a clinical rarity, although it can still be seen in cases of malnutrition associated with alcoholism or with dietary deficiencies, especially in childhood and old age. We present the case of a 45-year-old male who consulted his physician because of lower limb edema with follicular purpura, accompanied by asthenia, polyarthralgia and bleeding gums. After treatment with 1 g/day of vitamin C was initiated, the patient's symptoms quickly improved. The diagnosis of scurvy was based on the patient's clinical symptoms, dietary history and the rapid resolution of the symptoms when vitamin C supplements were initiated

Aplasia medular inducida por antitiroideos de síntesis / Aplastic anemia induced by antithyroid drugs

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