Diversity of clinical, radiographic and genealogical findings in 41 families with amelogenesis imperfecta

Abstract Amelogenesis imperfecta (AI) is a group of enamel development disorders that alter the structure and chemical composition of the tissue. There is great variability in the clinical presentation; according to Witkop, AI can be categorized into 14 subtypes, which makes its diagnosis extremely complex. Objective: This study aimed to describe and determine the frequency of clinical and radiographic features and inheritance patterns found in 41 Chilean families diagnosed with diverse types of AI. Material and Methods: We analyzed the clinical records, photographs, pedigrees and radiographs of 121 individuals recruited between 2003 and 2016. All of the information was included in a database that was analyzed using the application Stata 14. Results: The 72 affected individuals had average age of 16 years, and no sex association with the presence of AI was found. The most frequent clinical subtypes were as follows: 43% hypomature, 25% hypoplastic, 21% hypomature/hypoplastic, 7% hypocalcified and 4% hypocalcified/hypoplastic. The number of severely affected teeth was 22, which occurred in the patients with hypocalcified and hypocalcified/hypoplasic AI who presented the highest number of damaged teeth. Caries and periodontal disease were found in 47 and 32% of the patients, respectively. Malocclusions were observed in 43% of the individuals with AI, with open bite being the most frequent. Radiographically, the thickness of the enamel decreased in 51% of the patients, and 80% showed decreased radiopacity of the enamel compared to that of dentin. Autosomal dominant inheritance pattern was found in 37% of the families with hypoplastic AI, and autosomal recessive pattern was present in 56% of the other clinical subtypes, but more frequently in those affected with hypomature and hypocalcified AI. Conclusion: Of the five clinical subtypes, autosomal recessive hypomature, autosomal dominant hypoplastic and autosomal recessive hypomature/hypoplastic AI were the most prevalent subtypes in this group.

Efecto de miconazol sobre el recuento de levaduras en candidiasis asociada a estomatitis protésica / Effect of miconazole on the yeast count in candidiasis associated with denture stomatitis

RESUMEN: Introducción: Estomatitis Subprotésica, proceso inflamatorio crónico de la mucosa adyacente a prótesis removible. 71,4% de los sujetos con esta condición es portador de Candida y la severidad se relaciona con la presencia de esta levadura. Para su tratamiento se indica antimicóticos tópicos de la familia de polienos o de azoles. El propósito del estudio fue determinar el recuento de levaduras del género Candida en adultos mayores con candidiasis oral, antes y después de ser tratados con miconazol. Materiales y métodos: Se consignaron antecedentes sistémicos y locales en 32 adultos mayores con estomatitis subprotésica. Se determinó recuento de levaduras del género Candida en saliva, antes y después del tratamiento tópico con Miconazol 2%. Se aceptaron diferencias estadísticamente significativas con un error alfa igual o menor a 0.05%. Resultados: Los recuentos de levaduras del inicio del estudio disminuyeron significativamente a los días 8 y 15 después del tratamiento (mediana 6.800, 163, 60, respectivamente). 56,2% de los individuos presentó persistencia de levaduras después del tratamiento; 21,8% de ellos con recuentos superiores a 400 UFC/ml de saliva. Conclusiones: En el 56,2% de los individuos del estudio se observó persistencia de levaduras del género Candida luego de 2 semanas de tratamiento con miconazol al 2%.

ABSTRACT: Introduction: Denture stomatitis is a chronic inflammatory process of the mucosa adjacent to removable prosthesis. 71.4% of the subjects with this condition are carriers of Candida and the severity is related to the presence of this yeast. Topical antimycotics belonging to the polyene or azole family are indicated for its treatment. Efficacy of miconazole is reported to be from 80% to 100%, although resistance is described in isolates of Candida. The purpose of the study was to determine the count of Candida in older adults with oral candidiasis, before and after being treated with miconazole. Methodology: Systemic and local antecedents were recorded in 32 elderly adults with denture stomatitis. Differences in number of the colony forming units of Candida yeast, were determined before and after topical treatment with Miconazole 2%. Statistical significances were set at a value of p < 0.05. Results: Yeast counts at the start of the study significantly decreased 8 and 15 days after treatment (median 6,800, 163, 60, respectively). 56.2% of the subjects presented persistence of yeasts after treatment; 21.8% of them with counts higher than 400 CFU / ml saliva. Conclusion: In 56.2% of the study subjects, persistence of Candida yeasts was observed after 2 weeks of treatment with 2% miconazole.

Características salivales y estado sistémico de sujetos con xerostomía / Salivary characteristics and systemic status of subjects with xerostomia

RESUMEN: Xerostomía o sensación de boca es una afección que afecta severamente la calidad de vida de quienes la padecen. Si bien se relaciona con la reducción del flujo salival (hiposalivación), existe evidencia contradictoria y se sugiere evaluar características cualitativas salivales y estado sistémico de los afectados para comprender su etiología y mejorar terapias asociadas. El objetivo de este estudio fue comparar pH y concentración de proteínas en saliva y estado sistémico entre sujetos xerostómicos con y sin hiposialia. Se midió pH, concentración de proteínas salivales y se consignaron antecedentes sistémicos y uso de fármacos en 27 individuos xerostómicos, que fueron divididos en hiposiálicos y no hiposiálicos. Se compararon las variables mencionadas usando test no paramétrico de Mann-Whitney y test Chi-Cuadrado. Se aceptaron diferencias estadísticamente significativas con error alfa igual o menor a 5 %. Sujetos xerostómicos con hiposialia presentaron mayor prevalencia de Artritis Reumatoide y Síndrome de Sjögren en comparación con xerostómicos sin hiposialia. No se encontraron diferencias estadísticamente significativas en relación a pH, concentración de proteínas y uso de medicamentos, variables que no influirían en el padecimiento de xerostomía, independiente de la existencia de hiposialia. Sujetos con xerostomía e hiposialia presentan mayor frecuencia de Artritis Reumatoide y Síndrome de Sjögren.

ABSTRACT: Xerostomia or mouth feeling is a condition that severely affects the quality of life of thosewho suffer from it. Although it is related to the reduction of salivary flow (hyposalivation),there is contradictory evidence and it is suggested to evaluate qualitative salivarycharacteristics and systemic state of those affected in order to understand its etiology and improve associated terapies. The objective of this study was to compare saliva, pH and protein concentration and systemic status among xerostomic subjects with and without hyposialia. Were measured PH and protein concentration and were recorded systemic antecedents and drug use in 27 xerostomic individuals, who were divided into hyposalic and nonhyposalic individuals. The mentioned variables were compared using non-parametric Mann-Whitney test and Chi-Square test. Statistically significant differences were accepted with alpha error equal to or less than 0.05%. Xerostomic subjects with hyposialia presented higher prevalence of Rheumatoid Arthritis and Sjögren's Syndrome compared to xerostomics without hyposialia. No statistically significant differences were found in relation to pH, protein concentration and drug use, variables that would not influence xerostomia, independent of hyposialia. Subjects with xerostomia with hyposialia present a higher frequency of Rheumatoid Arthritis and Sjögren's Syndrome.

Reporte preliminar sobre el efecto de un sustituto salival a base de manzanilla (Matricaria chamomilla) y linaza (Linum usitatissimum) en el alivio de la xerostomía en adultos mayores / Preliminary report on the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) based saliva substitute formulated for the relief of xerostomia in the elderly

Introducción: La xerostomía es una condición crónica que afecta a un alto porcentaje de adultos mayores, que deben ser tratados paliativamente mediante el uso de sustitutos salivales; sin embargo estos productos no se encuentran disponibles en el mercado nacional. Objetivos Evaluar la eficacia de un nuevo sustituto salival a base de manzanilla y semillas de linaza en la disminución de la sintomatología asociada a xerostomía en individuos adultos mayores. Metodología Se incluyeron 34 voluntarios adultos mayores con xerostomía de diverso origen. Un nuevo sustituto salival a base de manzanilla y semillas de linaza y un sustituto convencional a base de carboximetilcelulosa fueron testados en un ensayo clínico aleatorizado, cruzado, con período de blanqueamiento. Resultados El 100 por ciento de los sujetos presentó sensación de boca seca, el 58,8 por ciento sensación de saliva espesa, el 52,9 por ciento necesitaba beber líquidos para deglutir los alimentos y tenía sensación de dificultad para tragar. La sensación de ardor lingual se registró en el 23,5 por ciento de los individuos. Las enfermedades más frecuentes en la muestra analizada fueron la hipertensión arterial y la artritis. Los resultados del ensayo clínico indican que el sustituto salival a base de manzanilla y semillas de linaza disminuye significativamente la sensación de boca seca y la sensación de saliva espesa (test de Wilcoxon p < 0,05). Conclusión El nuevo sustituto salival a base de manzanilla y semillas de linaza es efectivo en el alivio de la sintomatología asociada a xerostomía en adultos mayores, por lo que puede contribuir a mejorar la calidad de vida de la población afectada por esta condición.

Introduction: Xerostomia is a common chronic health condition that affects a great number of elderly people. Palliative treatment, such as salivary substitutes should be used, but these products are not accessible in the Chilean market. Objectives To evaluate the efficacy of a new Chamomile and linseed based saliva substitute in the reduction of xerostomía-associated symptomatology in elderly people. Methodology Forty elderly subjects presenting with xerostomia of various origins were selected. Chamomile and linseed based saliva substitute and a carboxymethylcellulose based conventional artificial saliva were tested using a double-blind, randomized, cross-over clinical trial with an intervining wash out period. Results All (100 percent) of subjects had a sensation of dry mouth, and 58.8 percent mentioned a sensation of thick saliva, 52.9 percent needed to drink liquids to swallow, and with a sensation of swallowing difficulty. Burning tongue sensation was recorded in 23.5 percent of the patients. The most frequent pathologies in the sample were arterial hypertension and arthritis. Results of the clinical tests showed that Chamomile and linseed based saliva substitute significantly relieves the sensation of dry mouth and the sensation of thick saliva (Wilcoxon test P < .05). Conclusion New chamomile and linseed based saliva substitute was effective in relieving xerostomia symptoms in elderly people, and could improve the quality of life of population affected by this condition.

Caracterización cinética de la respuesta de secreción salival producida por ácido cítrico: diferencias con pilocarpina / Kinetic assessment of salivary secretory response to citric acid, as compared with pilocarpine

Background: Induction of salivation is becoming increasingly popular in the assessment of salivary gland status. Various mechanical or pharmacological procedures are empirically used to produce salivation. Oral stimulation by citric acid (AC) is by far the most used sialagogue procedure. Aim: To characterize the salivary secretory response to AC solutions applied to the dorsolateral tongue surfaces. Subjects and methods: Young healthy women from the upper levels of a medical career (n=19) participated as volunteers. Salivary volume and UV-absorbing organic material in saliva from single subjects were measured after various protocols of topical stimulation by AC. Results: After a single stimulation by 1-8 percent AC the salivary flow rate peaked before 30 seconds and recovered the basal level earlier than 2 minutes. Repetitive stimulations at 30-sec intervals kept the flow rate at a maximum. After suspending these stimulations, basal flow rate was recovered before 2 minutes. Repetitive AC-stimulations at 8-min intervals produced a series of identical and independent secretory responses. The concentration of organic material in saliva remained unaltered after the various modes of stimulation. Thus, the profile of organic material secretion was always a direct expression of changes in salivary flow rate. In contrast to AC, the oral administration of the cholinergic agonist pilocarpine (PIL) produced a two-wave salivary response that as a whole lasted for about 30 minutes. In this case the volume and the amount of organic material were at least 10-fold the ones secreted in response to AC. Conclusions: AC provoked a rapid and short-lived salivary response that differs markedly from the one produced by other secretagogues, like pilocarpine

Sistemas adhesivos para amalgama / Adhesive systems for amalgam

La amalgama dental presenta dos desventajas principales, cuales son, la falta de adhesión a las estructuras dentarias y la consecuente microfiltración marginal. Con la finalidad de subsanar este problema, algunos investigadores han demostrado que la amalgama fresca puede ser adherida a esmalte y dentina a través de resinas adhesivas convencionales o a través de algunos productos especialmente formulados para este objetivo, algunos de los cuales se describen en este trabajo desde el punto de vista de sus características y mecanismo de unión como también cuales serían las indicaciones y limitaciones que tendría el uso de estos materiales en la técnica de amalgamas adhesivas