Prevalencia de patología infantil dental y de la mucosa en un servicio de urgencias hospitalario / Prevalence of dental and mucosal lesions among the pediatric population who attended the emergency department of a general hospital

Fundamento: La elevada prevalencia de la patología oral infantil incentiva a conocer sus manifestaciones y el carácter urgente de las mismas, objetivo del presente estudio. Metodología: Estudio transversal que incluyó pacientes de edad <14 años que acudieron a un servicio de urgencias durante un año. Se analizó la relación entre las variables recogidas y la patología oral. Resultados: Se incluyeron 55 pacientes, 45,5% niñas, edad media 4,11 años (10 días a 13 años). Globalmente, predominó la patología mucosa (74,5%) frente a la dentaria, y el origen infeccioso (54,6%) frente al traumático (14,5%). La patología dentaria (50% odontalgia y 35,7% infecciones) se asoció significativamente a edad >6 años (66,7 vs 10%), dolor (40,7 vs 10,7%) y ausencia de fiebre (37,9 vs 11,5%). La patología mucosa (61% infecciones: 53,7% víricas y 31,7% por herpangina) se asoció significativamente a edad ≤6 años (60 vs 6,7%;) y fiebre (76,9 vs 17,2%). Se observaron seis lesiones traumáticas sobre la mucosa y dos en los dientes; significativamente más pacientes acudieron a urgencias antes de 24 horas (mediana =1 hora) que en caso de infección (100 vs 51,7%). La edad ≤6 años se asoció significativamente a fiebre, patología mucosa, infección de la mucosa y herpangina, y la >6 años se asoció a dolor, tratamiento antibiótico previo y al alta y pauta previa de AINE. Conclusión: La patología oral infantil atendida en el servicio de urgencias analizado fue de la mucosa y origen infeccioso, predominando la dentaria en >6 años y la mucosa en ≤6 años, sin diferencia por sexo.(AU)

Background: The high prevalence of oral pathology in children encourages to gain further understanding on their manifestations and urgent nature, objective of the present study. Methodology: Crosssectional study that included patients aged <14 years of age who attended an emergency department over a oneyear period. The relationship between the variables collected and oral pathology was analyzed. Results: Fifty-five patients were included, 45.5% girls, mean age 4.11 years (10 days to 13 years). Overall, mucosal pathology (74.5%) prevailed over dental ones, and lesions of infectious origin (54.6%) over the traumatic ones (14.5%). Dental pathology (50% toothache and 35.7% infections) was significantly associated with being >6 years (66.7 vs 10%), pain (40.7 vs 10.7%) and absence of fever (37.9 vs 11.5%). Mucosal pathology (61% infections: 53.7% viral and 31.7% due to herpangina) was significantly associated with being ≤6 years (60 vs 6.7%) and having fever (76.9 vs 17.2%). Six traumatic lesions on the mucosa and two on the teeth were observed; significantly more patients attended the emergency room within 24 hours (median =1 hour) than in the case of infection (100 vs 51.7%). Being ≤6 years was significantly associated with fever, mucosal pathology, mucosal infection, and herpangina, and being >6 years was associated with pain, previous antibiotic treatment and at discharge, and previous NSAID regimen. Conclusions: The analyzed pediatric oral pathologies treated in the emergency department are of mucosal and infectious origin. Dental disease prevail in children >6 years of age and mucosal lesions in those ≤6 years; no sex differences are observed.

Rubinstein-Taybi syndrome: principal oral and dental disorders and literature update

Introduction: Oral and dental (OD) disorders in children with Rubinstein-Taybi syndrome (RTS) are frequent but not well-known by dentists and pediatricians due to the syndrome being extremely rare. Objective: To describe the OD findings observed in a 5-year-old girl with RTS and to update the literature. Clinical case: The patient presented the following OD manifestations: prominent lower lip, narrow mouth opening, narrow and arched palate, history of angular cheilitis, micrognathia, poor lingual motility, plaque and tartar, bleeding from gingival areas due to poor dental prophylaxis, and malocclusion in the form of an anterior open bite. These OD manifestations are seen in more than 40-60% of patients with RTS. Conclusions: Professionals who treat children with RTS should become aware of the advisability of referring them to the pediatric dentist from 1 year of age and performing check-ups every 6 months. Dental management is often difficult so collaboration with anesthesiologists is recommended in order to carry out a safe and effective treatment (AU)

Does anti-inflammatory drugs modify the severe odontogenic infection prognosis? A 10-year's experience

BACKGROUND: Numerous biochemical datas support the noxious role of anti-inflammatory drugs on immune response. Those observations are often put forward for unfavorable evolution of odontogenic infection but has never been really proven in clinic. The aim of this study is to try to clarify this role based on the collection of the clinical course of odontogenic infections over a 10-year analysis period. MATERIAL AND METHODS: The investigators implemented a prospective observational study. The sample was composed of patients managed between January 2004 and December 2014 for severe odontogenic infection based on three criteria: hospital admission, intravenous antibiotic therapy, tooth extraction and collections drainage under general anesthesia. Clinical and pharmacological data were collected at admission, during hospitalization until discharged home. The population was first separated into two groups patients with or without anti-inflammatory drugs on admission, then on four groups (non-steroidal anti-inflammatory drugs, corticosteroids drugs, both and none on admission). Analysis were performed each time by univariate analysis, multivariate analysis and propensity score matching. RESULTS: Six hundred and fifty-three patients were included in the study, 329 (50%) patients report orally anti-inflammatory treatment before presenting to hospital, 50 (7.6%) received corticosteroids, 242 (37%) received NSAIDs and 37 (5.6%) both. Evolution is worsening for patients under anti-inflammatory drugs in term of hospitalization in ICU (p = 0.016), number of surgeries (p = 0.003), risk of tracheotomy (p = 0.036), duration of hospitalization (p = 0.005) and spaces involved by the infection (p < 0.001). When separating patients into 4 groups, dysphonia and odynophagia are more frequent for patients under corticosteroid and NSAID (35.14%, p < 0.001), mediastinal erythema is more frequent for patients under corticosteroid (16%, p = 0.004), fever is more frequent for patients under NSAID (35.5%, p = 0.032), pain is higher for patients under corticosteroids (p = 0.024). But, in order to reduce bias, linked to factors of gravity, a regression weighted by propensity scores was performed and any group of patients is different from the others. CONCLUSIONS: Patients under anti-inflammatory drugs have more severe dental infection on admission and their complex evolution seems to be linked to the severity of infection on admission

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Deep neck infection of dental origin. A case report / Infección cervical profunda de origen dental. Descripción de un caso

INTRODUCCIÓN Y OBJETIVO: Al menos el 36% de las infecciones cervicales profundas pueden tener un origen dental. Descripción del caso: Mujer de 44 años que consultó por disfonía de una semana de evolución. La rinofibrolaringoscopia reveló edema aritenoideo izquierdo y parálisis de la hemilaringe izquierda y cuello normal. Se realizó una tomografía axial computarizada, encontrando absceso parafaríngeo izquierdo. Se realizó tratamiento antibiótico sistémico y quirúrgico con cervicotomía y drenaje del absceso en cuyo cultivo se aisló Prevotella buccae. Comentarios: El resultado del cultivo ayudó a establecer el origen dental de la infección. En la historia dental, se encontró una historia de pericoronitis asociada con 3.8. CONCLUSIONES: el diagnóstico del origen dental de una infección cervical profunda se establece mediante la historia dental, el examen oral, la radiología oral y el cultivo microbiológico

INTRODUCTION AND OBJECTIVE: At least 36% of deep cervical infections may have a dental origin. CASE DESCRIPTION: A 44-year-old woman who consulted for dysphonia of a week of evolution. Rhinofibrolaryngoscopy revealed left arytenoid edema and paralysis of the left hemilarynx and normal neck. A computerized axial tomography was performed, finding left parapharyngeal abscess. Systemic and surgical antibiotic treatment was performed with cervicotomy and drainage of the abscess in whose culture Prevotella buccae was isolated. COMMENTS: The result of the culture helped establish the dental origin of the infection. In the dental history, a history of pericoronitis associated with 3.8 was found. CONCLUSIONS: The diagnosis of the dental origin of a deep cervical infection is established by dental history, oral examination, oral radiology and microbiological culture

Atrofia extrema vertical y horizontal combinada en sectores posteriores mandibulares. Uso de implantes cortos y expansión de cresta en dos fases con implantes transicionales / Extreme Vertical And Horizontal Atrophy In Mandibular Posterior Sectors. Use Of Short Implants And Split Crest In Two Phases With Transitional Implants. Clinical Case

El objetivo del presente trabajo es la presentación de un caso clínico en el que mostramos dos técnicas quirúrgicas para resolver la atrofia ósea en sentido horizontal. En la implantología actual nos enfrentamos cada vez con más frecuencia a casos con extremas reabsorciones óseas que nos obligan a implementar distintas técnicas quirúrgicas para lograr el éxito de nuestros tratamientos con implantes dentales. La coexistencia de atrofias verticales y horizontales complica la resolución de estos casos con éxito, aunque cada vez con mayor frecuencia nos enfrentamos a este tipo de situaciones más complicadas debido a que los pacientes demandan el tratamiento implantológico incluso en casos muy severos. Por ello, no es infrecuente tener que utilizar técnicas como la expansión de cresta o los implantes cortos de forma combinada en algunas situaciones. En el siguiente caso clínico mostramos una paciente con reabsorción extrema mandibular en ambos sectores posteriores con los dos tipos de reabsorción descritos anteriormente: las zonas posteriores con reabsorción extrema vertical y un abordaje con implantes cortos y una zona anterior con reabsorción extrema horizontal tratada con Split en dos fases mediante implantes expansores transicionales

The objective of this work is the presentation of a clinical case in which we show two surgical techniques to solve the horizontal bone atrophy. In the advanced implant dentistry, different surgical techniques would be required for the successfull treatment of patients presenting severe alveolar ridge atrophy. The presence of vertical and horizontal atrophies increases drastically the difficulty of the clinical case where several surgical techniques will be needed. Therefore, it is not uncommon to performe techniques like the alveolar ridge expansion and short implants in the same mandible or maxilla. The following clinical case presented an advanced horizontal and vertical alveolar atrophy in the right and left posterior regions of the mandible. The treatment plan included the use of short implants to treat the vertical atrophy and the two-stage alveolar ridge split to treat the horizontal atrophy

Prevalencia de caries dental en escolares de educación infantil de una zona de salud con nivel socioeconómico bajo / Prevalence of dental caries in children enrolled in preschool education from a low socioeconomic status area

Introducción: la caries dental es una enfermedad crónica, con elevada prevalencia en preescolares españoles. La falta de higiene, la alimentación inadecuada y las algias dentarias son problemas de salud frecuentes en nuestra zona básica de salud según los resultados del análisis de situación de salud. El objetivo de este trabajo es estudiar la prevalencia de caries dental en niños de tres a cinco años en nuestra zona básica de salud mediante un estudio descriptivo transversal. Material y métodos: se realiza la inspección bucodental por dentista y la recogida de datos por higienista dental en escolares de primer, segundo y tercer curso de Educación Infantil. La variable principal estudiada es la presencia de caries. Los datos son registrados en fichas individuales y volcados en una base de datos elaborada en el programa SPSS, donde se realiza el análisis descriptivo de los mismos. Resultados: de 150 niños escolarizados en educación infantil en la zona, se revisan 121 que acuden a clase el día que se realiza la revisión (80,7%). En primer curso un 46% de los niños presentan caries, en segundo un 40,5% y en tercero encontramos un 77,3% de niños con caries en dientes temporales y un 20,8% en definitivos. Conclusiones: las cifras de caries en nuestra zona básica de salud son altas, muy superiores a los datos nacionales. Es necesario aumentar las actividades preventivas en la primera infancia, en especial en las zonas de menor nivel social como la nuestra

Introduction: dental caries is a chronic disease with a high prevalence in Spanish young children. A poor oral hygiene, inadequate dietary habits and toothaches are frequent problems in our health district based on a previous situation analysis of health. Our objective was to perform a cross-sectional descriptive study to assess the prevalence of dental caries in children aged 3 to 5 years in our health district. Materials and methods: a dentist performed an oral and dental evaluation while a dental hygienist collected data in children enrolled in years 1, 2 and 3 of preschool. The primary outcome was the presence of caries. The data were collected in individual forms and subsequently entered in a database created with the software SPSS, which we also used to perform the descriptive analysis of the data. Results: of the 150 children enrolled in preschool in our health district, we assessed 121 that attended school on the day that we carried out the checkups (80.7%). We found caries in deciduous teeth in 46% of children enrolled in year 1, 40.5% of children in year 2 and 77.3% of children in year 3, and in permanent teeth in 20.8% of children in year 3. Conclusions: the prevalence of caries was much higher in our health district compared to the previously reported nationwide prevalence. We need to increase the preventive interventions targeted to early childhood, especially in disadvantaged areas like our health district

Abordaje de las infecciones odontogénicas por el Médico de Familia / Approach to odontogenic infections by the family doctor

Las infecciones odontogénicas son muy frecuentes y representan el 10 % de las prescripciones antibióticas en España. Para el médico de familia es importante conocer los distintos cuadros clínicos para elegir adecuadamente el tratamiento, así como hacer hincapié en la prevención de los mismos. Para ello es necesario identificar la microflora oral y cómo se comporta. No debemos preguntarnos qué antibiótico dar. La cuestión es si necesitamos prescribirlos o no cuando nos enfrentamos a las infecciones odontogénicas vistas en nuestra práctica diaria. Además, debemos conocer los más indicados, tanto para el tratamiento como para la profilaxis

Odontogenic infections are very frequent and account for 10% of all antibiotic prescriptions in Spain. It is important for the family doctor to know their different clinical pictures in order to choose the treatment properly, as well as to emphasize prevention. Hence it is necessary to know the oral microflora and how it behaves. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics to deal with the most common odontogenic infections seen in our practice. In addition, we must know the most suitable ones, both for the treatment and for the prophylaxis

Actualización en el manejo odontológico del paciente con patología hepática / Update on dental handling of the patient with liver disease

La enfermedad o disfunción hepática puede deberse a numerosas causas como infecciones adquiridas, patologías congénitas o el abuso de drogas. Cuando esta disfunción y el daño hepático se prolongan a lo largo del tiempo, puede desembocar en una cirrosis hepática, cuadro irreversible y de graves repercusiones para el enfermo. Las dos patologías hepáticas más frecuentes y principales causas de la cirrosis son la hepatitis o inflamación hepática, la cual se puede deber a numerosos factores siendo el más frecuente las infecciones por virus, y la enfermedad hepática alcohólica, provocada por el abuso de alcohol continuado durante un largo período de tiempo. El manejo odontológico de un paciente con alteraciones hepáticas supone un verdadero reto, ya que el hígado juega un papel vital en numerosas funciones metabólicas, como la secreción de bilis o la excreción de bilirrubina procedente del metabolismo de la hemoglobina. Un fallo en la función hepática puede suponer alteraciones en el metabolismo de aminoácidos, amoníaco, proteínas, hidratos de carbono y triglicéridos. Un paciente con patología hepática tendrá un metabolismo alterado de numerosos fármacos empleados habitualmente por el dentista, tendrá un mayor riesgo de hemorragia debido a anomalías en la síntesis de diferentes factores de coagulación, siendo además un paciente con mayor riesgo de infecciones. La gran repercusión de la enfermedad hepática, así como el notable desconocimiento de muchos profesionales odontólogos en su manejo, justifican este artículo donde se talla tanto las generalidades más importantes de esta entidad como sus principales manifestaciones orales y consideraciones en el manejo odontológico

Liver disease or dysfunction may be due to numerous causes such as acquired infections, congenital pathologies or drug abuse. When this dysfunction and liver damage are prolonged overtime, it can lead to hepatic cirrhosis, an irreversible condition and serious repercussions for the patient. The two most frequent liver diseases and major causes of cirrhosis are hepatitis or hepatic inflammation, which may be due to numerous factors being the most frequent virus infections, and alcoholic liver disease, caused by alcohol abuse continued during A long period of time. The dental management of a patient with liver disorders is a real challenge, since the liver plays a vital role in many metabolic functions, such as bile secretion or excretion of bilirubin from hemoglobin metabolism. A failure in liver function can lead to alterations in the metabolismof amino acids, ammonia, proteins, carbohydrates and triglycerides. A patient with liver disease will have an altered metabolism of numerous drugs commonly used by the dentist, will have a greater risk of hemorrhage due to abnormalities in the synthesis of different coagulation factors, being also a patient with a higher risk of infections. The great repercussion of liver disease, as well as the remarkable lack of knowledge of many dental professionals in its management, justify this article where it is detailed both the most important generalities of this entity as its main oral manifestations and considerations in dental management

Coloración dental por índigo carmín. Excipientes: la asignatura pendiente / Indigo carmine related tooth discolouration. Excipients: a pending subject

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Dental developmental alterations in patients with dilacerated teeth

Background: The aim of this study was to record and analyze all DDAs associated to dilacerated teeth in patients attending the clinics of the Postgraduate Division, Facultad de Odontología, UNAM in Mexico City. Material and Methods: Orthopantomograms from all patients seeking for stomatological attention in our institution were reviewed and those cases of dilaceration were separated. Age, gender, diagnosis, location, involved teeth and associated DDAs were recorded and analyzed. Results: From 6,340 patients, 99 (1.6%) harbored 125 dilacerated teeth. Of them, 45 (45.5%) showed one or more DDAs. The most frequently detected DDAs were hypodontia, enamel pearls, taurodontism and microdontia. Conclusions: 45.5% is a very high proportion of DDAs in patients with dilacerated roots. Findings from this study strongly suggest that patients with dilacerated teeth should be carefully screened since many of them could present other DDAs. Simultaneous occurrence of dilaceration and DDAs suggests synchronic developmental defects during dental growth

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A retrospective analysis of oral and maxillofacial pathology in a pediatric population from Rio de Janeiro-Brazil over a 75-year period

BACKGROUND: The aim of this study was to analyze the distribution of oral and maxillofacial lesions affecting children and adolescents patients from a single oral pathology laboratory from Rio de Janeiro, Brazil. MATERIAL AND METHODS: Oral and maxillofacial lesions biopsied in patients younger than 19-years were retrieved from the oral pathology files of the Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro over a 75-year period (1942-2017). The clinical data and the diagnoses of each case were included in a Microsoft Excel(R) database, being classified into 13 categories according to the etiology. A descriptive analysis of the variables age, gender and final diagnosis was made. RESULTS: From 19.095 lesions diagnosed in this period, 2408 (12.61%) were from patients aged 0 to19 years, with a higher incidence in females in the second decade. Salivary gland pathology was the most common group of lesions (24.30%), followed by reactive lesions (16.82%) and odontogenic cysts (14.66%). Mucocele was the most common lesion (21.72%), followed by dentigerous cyst (6.48%) and fibrous hyperplasia (6.44%). Malignant lesions were observed in 1.12% of all cases with Burkitt lymphoma as the most frequent. CONCLUSIONS: Our results were similar to previous studies and knowledge of these data may contribute to the understanding of oral lesions that most commonly affects children

Salud Dental en pacientes con Lepra / No disponible

La lepra conlleva una serie de efectos secundarios indeseables que condicionan la tolerancia y la calidad de vida del paciente. Así, dentro de la esfera orofacial, la boca puede ser asiento de lesiones que, pese a su accesibilidad, pueden por ignorancia pasar desapercibidas y dificultar el adecuado tratamiento de un proceso que hasta ese momento había producido pocas lesiones corporales. Para ello, realizamos una revisión bibliográfica para estudiar el daño dental que esta grave enfermedad puede llegar a causar en la cavidad oral, comparando distintas poblaciones hansenianas

Leprosy involves a series of undesirable side effects, which determine the patient’s tolerance and quality of life. The mouth can be the seat of injuries, which despite their accessibility, can be unnoticed and impede the suitable treatment of a process, which up to that moment, had produced few skin injuries. We performed a bibliographic review to study the dental damage that this serious disease can cause in the oral cavity, comparing different Hansenian populations

Manejo de las infecciones odontogénicas en las consultas de atención primaria: ¿antibiótico? / Management of odontogenic infections in Primary Care: Antibiotic?

Nuestro objetivo es intentar contribuir al uso racional de los antibióticos prescritos por los médicos de familia cuando un paciente consulta por un problema odontológico. Actualmente la pregunta que nos debemos hacer es si hay que tomar antibiótico, en lugar de cuál dar. Revisamos las principales infecciones odontológicas, cuál debe ser el tratamiento adecuado y el papel de la prevención. Es necesario conocer la complejidad de la microflora de la cavidad oral, pues de ella dependerá la conveniencia de antibioterapia, la evolución hacia la curación o la progresión de algunas infecciones odontogénicas. La placa bacteriana, formada por el biofilm, se comporta como una barrera para la acción de los antimicrobianos. Es en la prevención de su formación, así como en la eliminación mecánica de esta una vez formada, en lo que el médico de familia debe insistir. Debemos transmitir a la población que los antibióticos no curan el dolor dental

Our aim is to contribute to the rational use of antibiotics prescribed by family doctors when a patient consults for a dental problem. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics in front of the most common odontogenic infections seen in our practice. We review the main dental infections, which should be their appropriate management and the role of prevention. We need to know the complexity of the oral microbiome because it’l depend on the appropriateness of the antibiotherapy, the evolution towards cure or progression of some odontogenic infections. The bacterial plaque, formed by the biofilm, behaves as a barrier to the action of antimicrobials. It’s in the prevention of its development as well as in it mechanical elimination once shaped, in what the family doctor should insist. We must transmit antibiotics don’t heal dental pain

Evolución histórica de la prevalencia del síndrome incisivo molar / Prevalence of the incisor molar hypomineralization: an historical view

El propósito de este trabajo es conocer la evolución de la prevalencia del Síndrome Incisivo Molar, no sólo a nivel mundial sino también en nuestro ámbito nacional. Constituye una revisión bibliográfica sobre los artículos científicos publicados en relación con dicha alteración. Tras el análisis y teniendo en cuenta el año de publicación independientemente de la zona geográfica de estudio, no se observa un aumento de la prevalencia de hIM. Los países que experimentan mayores porcentajes son Australia, Brasil y Reino unido (44%, 40,2% y 40% respectivamente). Los que presentan menor prevalencia son China y Libia (2,8% y 2,9% respectivamente). En el ámbito nacional claramente se ha observado un incremento con el tiempo en la prevalencia del hIM. Las variaciones en los resultados obtenidos pueden reflejar diferencias reales entre regiones y países. Sin embargo, podrían explicarse, al menos en una parte, por las diferentes edades de la muestra, diferentes fechas de nacimiento, criterios de diagnóstico, variabilidad en cuanto a la posible etiología, entre otros factores (AU)

The purpose of this paper is to know the evolution of the prevalence of molar-incisor hypomineralization, both on a national and international scale, comprising a bibliographical review of the scientific papers published on the subject. Following the analysis and taking into consideration the year of publication, but not the geographical area of the study, an increase in the prevalence of MIh is not observed. The countries with the highest prevalence percentages are Australia, Brazil and the united Kingdom (with 44%, 40.2% and 40%, respectively). On the other hand, the countries with the lowest prevalence percentages are China and Libya, with 2.8% and 2.9%, respectively. On a national scale, a clear increment of the prevalence of MIh has been observed over time. Disparities in the obtained results show real differences between countries and regions. On one hand, they can be explained due to the different ages within the sample, dates of birth, diagnosis criteria and possible etiologies, among other factors (AU)

Hábitos de salud bucodental en los pacientes atendidos por dolor dental en un dispositivo de urgencias / Dental care habits in patients seen for toothache in an Emergency Unit

OBJETIVO: describir los hábitos de salud bucodental de los pacientes atendidos por dolor dental en un Dispositivo de Cuidados Críticos y Urgencias. MATERIAL Y MÉTODO: estudio descriptivo transversal en una muestra de 399 (precisión del 5%, nivel de confianza de 95,5%, proporción es-perada del 50%), pacientes con dolor dental, atendidos en el Dispositivo de Cuidados Críticos y Urgencias (DCCU) de Torreblanca (Sevilla). Para la recogida de los datos se utilizó un cuestionario autoadministrado, elaborado ex profeso para este estudio, que recorría variables sociodemográficas, características y manejo del dolor, hábitos alimentarios, consumo de tabaco, café y alcohol. Para el tratamiento y análisis de los datos se calcularon índices de estadística descriptiva en función de la naturaleza de las variables. RESULTADOS: se estudiaron 399 pacientes. El 88% dijo tener el máximo dolor (entre 7 y 10). Un 92% consumía fármacos para el dolor de forma autónoma y no supervisada por un profesional. El 92,2% no acu-día al dentista de forma regular. El 45,9% era fumador y el 59,6% bebedor habitual. El 69,7% tomaba café con asiduidad y solamente el 27,3% y el 30,2% tomaba diariamente verdura y fruta, respectivamente. El 22,5% afirmó "cuidar su dentadura". Únicamente el 27,3% se cepillaba los dientes todos los días, el 7,3% utilizaba seda dental y 44,1% usaba colutorios habitualmente. CONCLUSIONES: los conocimientos de la población en relación a la salud bucodental siguen siendo insuficientes. La prevalencia de factores de riesgo para la salud bucodental es alta en la población estudiada. Los gestores de los centros asistenciales y los profesionales de salud han de trabajar en la promoción de hábitos de vida saludable y mejora de la higiene bucodental, a través de la educación para la salud y en cada intervención que realizan a sus pacientes

OBJECTIVE: to describe dental care habits of those patients seen for toothache in a Critical Care and Emergency Unit. MATERIALS AND METHOD: transversal descriptive study in a sample of 399 patients with toothache (5% accuracy, 95.5% confidence level, 50% expected proportion), who were seen at the Critical Care and Emergency Unit (CCEU) in Torreblanca (Seville). A self-administered questionnaire was used for data collection, which had been prepared specifically for this study, and included sociodemographical variables, pain characteristics and management, dietary habits, smoking, and coffee and alcohol intake. For data treatment and analysis, descriptive statistic rates were estimated based on the nature of variables. RESULTS: 399 patients were studied. 88% of these claimed to suffer the maximum pain level (between 7 and 10). 92% of them were self-administering painkillers unsupervised by any professional. 92.2% of these patients did not see their dentist on a regular basis. 45.9% of them smoked, and 59.6% were habitual drinkers. 69.7% of the patients drank coffee regularly, while only 27.3% and 30.2% ate vegetables and fruit every day, respectively. 22.5% of these patients claimed "they looked after their teeth". Only 27.3% brushed their teeth every day, 7.3% flossed their teeth and 44.1% used mouthwash regularly. CONCLUSIONS: the knowledge by the population regarding dental health is still insufficient. There is a high prevalence of risk factors for dental health among the population studied. Healthcare centre managers and healthcare professionals must work in order to promote healthy life habits, and an improvement in dental hygiene, through health education and in each intervention for their patients

Absentismo laboral por patología odontológica y médica en una industria de gran porte del sector mecánico y mueblero / Absenteeism by medical and dental pathologies in a large industry of the mechanical and furniture field

INTRODUCCIÓN: La legislación vigente brasileña establece que, en las industrias, los servicios de salud se realizan por el Servicio Especializado en Ingeniería de Seguridad y en Medicina del Trabajo (SESMT). OBJETIVO: Analizar las causas del absentismo por razones odontológicas y médicas y verificar la interferencia de factores como edad, sexo y función del trabajador, además de razones que más llevaron al empleado a ausentarse de su trabajo. MATERIAL Y MÉTODOS: La investigación es un estudio descriptivo de abordaje cuantitativo. Se examinaron los certificados odontológicos y médicos y declaraciones de comparecencia debidamente homologados de una industria del sector acrílico del municipio de Araçatuba-SP, en el periodo de enero a julio de 2011. RESULTADOS: Del total de certificados (n=1841), solo 103 (5,6%) presentaron razones odontológicas. Se observó predominancia de franja etaria de 20 a 29 años, sexo masculino y función no administrativa. Las causas odontológicas y médicas más comunes indicadas en los certificados que llevaron al funcionario a ausentarse del trabajo fueron "dientes incluidos e impactados" y "diarrea y gastroenteritis de origen infeccioso presumible", respectivamente. Sobre los factores relacionados al absentismo, se observó un índice de gravedad de 2,83, de frecuencia de 1,33 y la duración media de ausencias de 2,12. CONCLUSIONES: Se concluye que las razones odontológicas tuvieron poca importancia sobre el total de ausencias por motivos de enfermedad, además que provocaron el ausentismo del trabajador por un periodo menor. Las variables edad y función no influyeron en la ocurrencia del absentismo en el trabajo

INTRODUCTION: The current Brazilian legislation states that health services must be performed by the Specialized Service of Safety Engineering and Labor Medicine (SESMT). OBJECTIVE: To analyze the dental and medical reasons for absenteeism, checking the interference of factors such as age, gender and position of the worker, and most of the reasons that led the employee to miss work. MATERIAL AND METHODS: The research appears as a descriptive study with a quantitative approach. The dental and medical certificates and statements of attendance were analyzed, duly approved, lodged in a acrylic industry in the city of Araçatuba-SP, from January to July 2011. RESULTS: Of the total number of certificates (n = 1841), only 103 (5.6%) were for dental reasons. Predominance of the age group of 20-29 years, males and with non-administrative function. The reasons most dental and medical certificates stated that led the workers to miss working days were "inclusive and impacted teeth" and "diarrhea and gastroenteritis of presumed infectious origin", respectively. As to factors related to absenteeism, there was a severity index of 2.83, 1.33 frequency and average duration of absences of 2.12. CONCLUSIONS: It is concluded that dental reasons had little weight on total absences due to illness that caused the temporary leave of the worker for a shorter period. The age and function variables influence the occurrence of work absenteeism

Decayed, missing and filled teeth index and dental anomalies in long-term survivors leukaemic children: A prospective controlled study

Objective: The aim of this prospective controlled study is the comparison between long-term children survived leukaemia and a control group in terms of the decayed, missing or filled permanent teeth (DMFT) and dental anomalies. Study design: Fifty-two long term children survived leukaemia, aged from 8 to 15 years (27 females, 25 males; mean age 11.5 years) were evaluated for the possible effects of the anti-leukaemic therapy on dental development and compared to a control group of 52 healthy children (27 females, 25 males, mean age 11 years). All long-term children who survived were at least 24 months in continuous complete remission. The study of the dental status with a routine oral examination and panoramic radiographs was performed. The DMFT (recorded according to the WHO criteria) and dental anomalies were registered and evaluated. Results: The results of this study evidence that long-term children survived leukaemia, in comparison with the control group, have an higher risk to develop dental caries and show a greater severity of dental anomalies including V-shaped roots, dental agenesis, microdontia, enamel dysplasias. Conclusions: Paediatric patients with haemathological diseases require a special attentions in dental care in addition to the antineoplastic treatment. Therefore, oral hygiene and oral health can be maintained thanks to a close cooperation between the paediatric oncohaematologists, pediatrics dental surgeons and dental hygienists (AU)

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Mediastinitis descendente necrotizante de causa odontogénica. A propósito de un caso / Descending necrotizing mediastinitis of odontogenic origin A case REPORT

Introducción: La infección de origen dentario, constituye un motivo muy frecuente de consulta en nuestra práctica diaria. Ocasionalmente dicha infección puede extenderse a través de los espacios cervicales y llegar al mediastino, condicionando una mediastinitis necrotizante descendente (MND).Objetivo: Analizar las posibles causas odontogénicas desencadenantes, así como establecer los gérmenes implicados, sintomatología, tratamiento y evolución. Caso clínico: Paciente varón de 29 años de edad que acude al servicio de urgencias del hospital General universitario de Alicante presentando una mediastinitis descendente necrotizante derivada de una pericoronaritis aguda a nivel del 48. Conclusiones: Las causas más habituales de la MND de carácter odontogénico, son infecciones a nivel de los molares mandibulares, siendo frecuentes los casos derivados de pericoronaritis agudas de los terceros molares inferiores. Se trata de una infección polimicrobiana mixta, que refleja la naturaleza odontogénica. El tratamiento requerido consiste en medidas generales con drenaje adecuado de las colecciones purulentas (AU)

Introduction: This infection originating from the teeth is a frequent subject of consultation in daily practice. The infection may occasionally spread by way of cervical spaces and reach the mediastinum, giving rise to descending necrotising mediastinitis (DNM).Objective: Analyse the possible odontogenic causes and establish the microorganisms involved, symptoms, treatment and development. Clinical case: Male patient aged 29 attends the emergency department of General university hospital in Alicante suffering from descending necrotising mediastinitis deriving from severe pericononitis of level 48.Conclusions: The most common causes of DNM of an odontogenic nature are infectionsof the mandibular molars, cases deriving from severe pericononitis of the third lower molar being frequent. It is a mixed polymicrobial infection, which is a reflection of its odontogenic nature. The treatment required consists of general measures with adequate drainage of purulent collections (AU)

Oral manifestations in a group of adults with autism spectrum disorder

Objective: A number of studies have evaluated the oral health of patients with autism spectrum disorder (ASD), though most have involved children, and no specific oral manifestations have been described. The present study describes the buccodental disorders and describes the buccodental disorders and hygiene habits in a group of adults with ASD. Study desing: A prospective case-control study was made of a group of patients with ASD (n=30), with a mean age of 27.7±5.69 years, and of a healthy age- and gender-matched control group (n=30). An evaluation was made of the medical history, medication, oral hygiene habits and oral diseases, with determination of the CAOD, CAOS and OHI-S oral hygiene scores. Results: Most of the patients in the ASD group used two or more drugs and were assisted in brushing 2-3 times a day. The most frequent manifestations were bruxism, self-inflicted oral lesions and certain malocclusions. The CAOD and CAOS scores were significantly lower than in the controls. Conclusions: Adults with ASD and assisted dental hygiene presented fewer caries than the non-disabled population. However, bruxism, ogival palate and anterior open bite were frequent in the patients with ASD (AU)

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Management of immature teeth by dentin-pulpregeneration: A recent approach

Treatment of the young permanent tooth with a necrotic root canal system and an incompletely developed root isvery difficult and challenging. Few acceptable results have been achieved through apexification but use of longterm calcium hydroxide might alter the mechanical properties of dentin. Thus, one alternative approach is to developand restore a functional pulp-dentin complex. Procedures attempting to preserve the potentially remaining dental pulp stem cells and mesenchymal stem cells of the apical papilla can result in canal revascularization and the completion of root maturation. There are several advantages of promoting apexogenesis in immature teeth with open apices. It encourages a longer and thicker root to develop thus decreasing the propensity of long termroot fracture. So, the present article reviews the recent approach of regeneration of pulp-dentin complex in immature permanent teeth (AU)