Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis.

OBJECTIVE: To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP). MATERIALS AND METHODS: A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed. RESULTS: The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005). CONCLUSION: In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies. CLINICAL RELEVANCE: Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.

Dispositivos intraorales utilizados para el tratamiento de la apnea obstructiva del sueño en pacientes edéntulos. Revisión de la literatura y bases de patentes / Intraoral Devices for OSA Treatment in Edentulous Patients. Literature and Patents Datebase Review

Introducción: la apnea obstructiva del sueño (AOS) se considera un problema de salud pública que afecta en gran medida a hombres y mujeres entre 50 y 70 años de edad, donde en ocasiones son, además, pacientes edéntulos, lo cual dificulta su tratamiento. Objetivo: identificar los aparatos intraorales existentes para tratar la AOS leve y moderada en pacientes edéntulos. Metodología: se buscó literatura sobre el tema en bases de datos y de patentes. Resultados: se encontraron cinco artículos y dos patentes. El objetivo terapéutico de todos los dispositivos es aumentar la vía aérea superior entre la bsise de la lengua y la pared posterior de la faringe, mediante el avance mandibular. Dentro de las principales desventajas que presentan estos dispositivos están falta de retención, dificultad para mantener la dimensión vertical, problemas musculares y trastornos en la articulación temporomandibular. Conclusión: existen pocos dispositivos intraorales efectivos en la literatura para el tratamiento de la AOS en pacientes edéntulos. Esto hace necesario diseñar futuras investigaciones en esta área.

Introduction: The Obstructive Sleep Apnea (OSA) is considerad a problem of World Public Health that greatly affects men and women between ¿0 and 70 years oíd, where some of them are edentulous patients which treatment difficulty. Objective: lo identiíy the existing devices for mild and modérate OSA treatment ¿n edentulous patients. Method: A comprehensiva review was conducted in the literatura and patent databases. Results: 5 articles and 2 patents were round. The main therapy objective ¿n all devices is to increase the upper airway space between the tongue base and the posterior pharyngeal wall trough mandibular advancement. Several problems with use of these devices inelude lack retention, difficult for maintain the vertical dimensión, muscular discomfort and Temporomandibular Disorders. Conclusión: There are limited effective ¿ntraoral devices in literatura for OSA treatment in edentulous patients. It is necessary to design futura investigations in this area.

Estado gingival de dientes temporales con y sin restauración de coronas de acero en niños de 3 a 9 años / Gingival Condition around the Temporary Teeth with and without Steel Crown Restorations in 3-to-9 Year-Old Children

Antecedentes: Con las coronas de acero es posible conservar los dientes temporales hasta su exfoliación fisiológica; sin embargo, en la literatura existe controversia con respecto al comportamiento del tejido gingival de los dientes restaurados con coronas de acero. Propósito: /Analizar el estado gingival de dientes temporales con restauración de coronas de acero y sin esta en niños de 3 a 9 años de edad atendidos en las clínicas odontológicas de la Pontificia Universidad Javeriana, en Bogotá, entre 2013 y 2014. Métodos: Se realizó un estudio descriptivo de corte transversal. Se observaron 110 dientes temporales restaurados con corona de acero y sus antagonistas sin corona de acero. Se analizaron los índices gingival y de biopelíeula, la adaptación clínica de las coronas de acero y la presencia o ausencia de exceso de cemento en todas las superficies de los dientes. Resultados: No hubo diferencias estadísticamente significativas entre la adaptación de las coronas de acero y el estado gingival. El único indicador relevante fixe la superficie vestibular (p = 0,018). Por otra parte, el estado gingival y la biopelíeula presentaron una baja correlación (¡9 %). Conclusiones: El índice gingival de dientes restaurados con coronas de acero y sin estas presentó una correlación positiva entre la inflamación gingival y la edad de la población pediátrica, aun cuando la retención de biopelíeula no fue significativa.

Bideground: Ihc use of steel crowns enables to preserve the temporary teeth until their physiological changeover; however, in the literature there is a controversy regarding the behavior of the gingival tissue around teeth restored with steel crowns. Purpose: To analyze the gingival condition around the temporary teeth that have been restored with and without steel crowns in children from 3 to 9 years old who attended to the dental clinic at the Pontificia Universidad de Colombia in Bogotá between 2013 and 2014. Methods: A cross-sectional descriptive study was carried out and 110 temporary teeth restored with steel crown were observed and compared to the teeth restored without it. Biofilm and gingival indexes were analyzed as well as the steel crown clinical adaptation and the presence of cement excess in any of the dental surfaces. Results: No significant statistical difference was found bccwccn the steel crown adaptation and the gingival condition. 'Ihc only relevant indicator was the vestibular surface (p = 0.018). On the other hand, both the biofilm and the gingival condition showed a poor correlation (19%). Conclusions: Ihc gingival index in teeth restored with and without steel crown showed a positive correlation between gingival inflammation and the children populación age, even chough the biofilm retention was not significant.

Biomarkers in saliva for the detection of oral squamous cell carcinoma and their potential use for early diagnosis: a systematic review.

Objective To determine the capacity of salivary biomarkers in the early diagnosis of oral squamous cell carcinoma. Study design A systematic review of the literature was performed based on the English titles listed in the PubMed, EBSCO, Cochrane, Science Direct, ISI web Science and SciELO databases using the following search descriptors: Oral cancer, diagnosis, biomarkers, saliva and oral squamous cell carcinoma. Abstracts and full-text articles were assessed independently by two reviewers. International checklists for assessment of methodological quality were used. Levels of evidence and grades of recommendation through the Scottish Intercollegiate Guidelines Network (SIGN) template were recognized. The units of analysis were identified through a reference matrix. Results Through the research strategy and after application of different filters and considering choosing criteria, six studies were obtained for analysis. Salivary biomarkers for oral cancer most frequently found were mRNA and proteins for IL-8, CD44, MMP-1 and MMP-3. New peptide-biomarkers such as Cyfra 21-1 and ZNF510 were found. ZNF 510 was the only biomarker which increased in the population with tumour stage T1 + T2 and T3 + T4. Only one study showed a sensitivity and specificity of 96% when the biomarker ZNF 510 is employed to discriminate early and late tumour stages. Conclusions There is no sufficient scientific evidence to support the capacity of the identified salivary biomarkers for the early diagnosis of oral cancer (sub-clinical stages of the pathogenic period before cancer phenotypes are manifested). Salivary biomarkers, however, may be employed to discriminate between healthy and cancer patients.