Factores de riesgo relacionados con las lesiones paraprotésicas en pacientes portadores de prótesis removibles / Risk factors related to the paraprosthetic lesions in patients with removable prosthesis

Introducción: Las lesiones paraprotésicas son alteraciones de la mucosa bucal asociadas al uso de prótesis dental, las cuales pueden provocar complicaciones graves. Objetivo: Identificar los factores de riesgo relacionados con las lesiones paraprotésicas en pacientes portadores de prótesis removibles. Métodos: Se realizó un estudio observacional y descriptivo de 180 pacientes con lesiones paraprotésicas, atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde febrero del 2019 hasta mayo del 2020. Se seleccionaron las siguientes variables: edad, sexo, factor de riesgo y tipo de lesión paraprotésica. Resultados: Predominaron los pacientes de 60 años y más, la estomatitis subprótesis (52,7 %) y factores de riesgo, tales como prótesis mucosoportada, mayor tiempo de uso, así como hábito de dormir con la prótesis. Conclusiones: La lesión paraprotésica más frecuente fue la estomatitis subprótesis debido a la persistencia de los mismos factores de riesgo, que incidieron en la población a través del tiempo.

Introduction: Paraprosthetic lesions are alterations of the oral mucosa associated with the use of dental prosthesis, which can cause serious complications. Objective: To identify the risk factors related to the paraprosthetic lesions in patients with removable prosthesis. Method: An observational and descriptive study of 180 patients with paraprosthetic lesions was carried out; they were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from February, 2019 to May, 2020. The following variables were selected: age, sex, risk factor and type of paraprosthetic lesion. Results: There was a prevalence of the 60 years and over patients, sub prosthesis stomatitis (52.7 %) and risk factors, such as mucosoported prosthesis, longer time using it, as well the habit of sleeping with the prosthesis. Conclusions: The most frequent paraprosthetic lesion was the sub prosthesis stomatitis due to the persistence of the same risk factors that impacted in the population through the time.

Presencia de bacterias en prótesis dentales durante el proceso de elaboración / Presence of bacteria in dental prostheses during the elaboration process

Existe una creciente preocupación sobre el tema de la infección cruzada en clínicas y laboratorios dentales. El laboratorio odontológico debe seguir normas de bioseguridad que garanticen a todo el equipo de salud la prevención de estas infecciones. Los técnicos que allí laboran corren el riesgo de exponer su cara a salpicaduras, así como a rocíos de sangre y saliva. Este estudio fue diseñado para saber si los laboratorios a los que recurrimos cumplen con estas normas de bioseguridad, y qué tan confiados podemos estar de la desinfección por parte de ellos, ya que las prótesis deberían estar desinfectadas correctamente antes de colocarlas en boca (AU)

There is growing concern about the issue of cross infection in dental clinics and laboratories. The dental laboratory must follow biosafety standards that guarantee the prevention of these infections to the entire health team. The technicians who work there run the risk of exposing their face to splashes and spray of blood and saliva. This study was designed to find out if the laboratories we use comply with these biosafety standards, and how confident we can be of their disinfection by them, since the prostheses should be properly disinfected before placing them in the mouth (AU)

Efectos de la prótesis dental en la función masticatoria de adultos mayores / Effects of dental prosthesis in the chewing function of the elderly

A medida que envejecemos, en la cavidad oral se producen cambios estructurales, por lo que adultos y adultos mayores requieren del uso de prótesis dental. Sin embargo, la implementación de la prótesis dental puede generar insatisfacción en relación a las diferentes funciones orofaciales. Se realizó una revisión de literatura con el propósito de determinar cómo el uso de prótesis dental afecta la función masticatoria en adultos mayores. La búsqueda consistió en artículos científicos originales en idioma español, inglés y portugués, sin límites temporales, en la base de datos PubMed y de forma manual. Se seleccionaron 45 artículos científicos tras la aplicación de filtros. El uso de prótesis dental afecta la función masticatoria en adultos y adultos mayores, siendo un factor crítico en términos de su nivel de satisfacción y calidad de vida, así como de la velocidad masticatoria, formación del bolo y preferencia de alimentos.

As we grow old, structural changes occur in the oral cavity, so elderly people require the use of dental prostheses. However, the implementation of the dental prosthesis can generate dissatisfaction in relation to the different orofacial functions. A literature review was conducted to determine how the use of dental prosthesis affects masticatory function in elderly people. The review consisted of original scientific articles in Spanish, English and Portuguese, without time limits, in the PubMed database and manually. Forty-five scientific articles were selected after the application of filters. The use of dental prosthesis affects chewing function in adults and older adults, being a critical factor in terms of their level of satisfaction and quality of life, as well as masticatory speed, bolus formation and food preference.

Autopercepção das condições alimentares de idosos usuários de prótese dentária / Autoperception of food conditions of elderly dental prosthetic users

RESUMO Objetivo Avaliar a autopercepção das condições alimentares de idosos usuários de prótese dentária, verificando sua interferência na alimentação. Método Participaram 60 idosos com idade entre 60 e 88 anos, usuários de prótese dentária total ou parcial, que frequentam assiduamente o Centro de Convivência Nair Ventorin Gurgacz - FAG em Cascavel, Paraná. Todos os indivíduos responderam a um questionário de identificação e ao protocolo Índice de Determinação da Saúde Bucal Geriátrica (GOHAI). Resultados Os idosos do estudo, maioria mulheres e usuários de prótese removível bimaxilar com mais de 30 anos, classificam sua alimentação como "boa" e não possuem preferência por consistência alimentar, embora frequentemente sintam dor ao mastigar os alimentos. A média pontuada no protocolo GOHAI foi classificada como "ruim" e o maior prejuízo dos idosos ocorreu no domínio físico, que engloba questões relacionadas à mastigação, deglutição e fala. Não foram constatadas relações entre o tempo de utilização da prótese dentária com a idade e os escores do GOHAI. Conclusão Embora os idosos raramente tenham queixa sobre o modo de se alimentar, referindo desconforto ou constrangimento, apresentam uma média abaixo do esperado no protocolo, indicando que, ainda que não relatem, muitas modificações podem estar acontecendo, gradativamente, e que soam como naturais, gerando prejuízos à qualidade de vida em alimentação do idoso.

ABSTRACT Purpose To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding. Methods The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI). Results The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores. Conclusion The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.

Prosthetically adverse implant position: an aesthetic surgical-prosthetic solution: case report

Clinical case of a 43-year-old female patient treated at the clinic of Universidad Nacional Mayor de San Marcos, Peru, in 2015 for aesthetic problems in the activation of a unitary implant placed at a distal and vestibular direction from the ideal position. the clinical examination revealed the vestibularization of the implant at the level of the upper right central incisor with the healing abutment visible above the gingival line and high gingival smile. connective tissue grafts and ovoid pontics were carried out in order to improve the characteristics of the peri-implant tissue. this clinical case evidenced an improvement of the soft tissue profile and patient satisfaction regarding her smile. the management of a vestibularized implant may be solved through the management of ovoid pontics and connective tissue grafts.

Novas tendências de combate ao biofilme de Candida em próteses dentárias / New trends to combat Candida biofilm in dental prosthetics

Apesar de a espécie Candida albicans ser efetivamente o microrganismo mais frequentemente associado a estomatite protética, as espécies de Candida não albicans já foram isoladas nas superfícies de dentaduras e da mucosa oral de indivíduos com essa lesão eritematosa. A virulência das espécies de Candida e a capacidade de adesão a polímeros acrílicos são condições prévias para a colonização e o desenvolvimento de biofilmes em superfícies de dentaduras. Estudos recentes focam na tentativa de modificação das resinas acrílicas para diminuir a adesão de cepas patogênicas e formadoras de biofilme do gênero Candida spp. Dentro desse aspecto, esta revisão sistematiza o atual panorama epidemiológico da estomatite protética associada ao uso de próteses dentárias, bem como as atuais e novas opções de combate ao biofilme fúngico especializado na adesão desse tipo de biomaterial. (AU)

Although the Candida albicans species is effectively the microorganism most frequently associated with prosthetic stomatitis, Candida non-albicans species have already been isolated from the denture and oral mucosal surfaces of individuals with this erythematous lesion. The virulence of Candida species and the ability to adhesion to acrylic polymers are preconditions for the colonization and development of biofilms on denture surfaces. Recent studies focus on the attempt to modify the acrylic resins to reduce the adhesion of pathogenic and biofilm forming strains of the genus Candida spp. In this aspect, this review systematizes the current epidemiological panorama of prosthetic stomatitis associated with the use of dental prostheses, as well as new options for combating the fungal biofilm specialized in the adhesion of this type of biomaterial. (AU)

A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1, 534 cases

Abstract Despite the large number of published studies about oral candidiasis and associated risk factors, reports of large single-center retrospective studies on the prevalence of oral candidiasis, risk factors, and the oral candidiasis types diagnosed more frequently in oral diagnostic reference centers are scarce. The objective of the present study was to retrospectively survey the demographic and clinical profiles of 1,534 patients diagnosed with candidiasis and treated at the Center for Diagnosis of Oral Diseases (CDOD), Pelotas Dental School, Federal University of Pelotas between 1997 and 2014. Using a retrospective, cross-sectional, epidemiological design, data on race, gender, age, systemic diseases, oral candidiasis type and location, symptoms, and harmful habits such as smoking and alcohol consumption were collected. The statistical analysis was performed using STATA version 13.1. Risk factors for chronic atrophic candidiasis (CAC) were evaluated using Poisson regression with robust variance (p ≤ 0.05). The majority of patients with oral candidiasis seen at the CDOD over the 18-year period of analysis were Caucasian women, aged 51-60 years, nonsmokers, and nondrinkers, with no systemic disease, and who wore some form of dental prostheses. CAC was the single most common clinical type of candidiasis detected, and the most frequently affected oral site was the palate. These data from a large single-center in Brazil agree with previous evidence about the clinical and demographic profiles of patients with oral candidiasis.

Portación de Candida spp. en cavidad oral en diabéticos y no diabéticos / Carrying of Candida spp. in the oral cavity in diabetic and non-diabetic patients

Introducción: Candida spp. es un habitante normal de la microbiota humana, que puede originar infecciones superficiales y sistémicas de carácter oportunista. En pacientes diabéticos se incrementa el riesgo de infecciones por esta levadura, lo cual estaría determinado por la portación de Candida spp. Esta portación es variable, así se observa en cavidad oral desde 13,7 al 64 por ciento. Objetivo: establecer los porcentajes de colonización y posibles factores asociados en este grupo de alto riesgo. Método: se realizó un estudio descriptivo en un total de 172 pacientes diabéticos y no diabéticos. Las muestras de enjuague bucal se sembraron en agar Sabouraud y CHROMagar Candida. Los aislamientos se sometieron a pruebas fenotípicas y a reacción en cadena de la polimerasa múltiple para su identificación. Las variables demográficas, los hábitos de higiene oral, el uso de prótesis dental, así como los niveles de hemoglobina glucosilada se evaluaron para determinación de frecuencias y asociación por chi2 y análisis multivariado, mediante el programa SPSS versión 19.0. Resultados: el porcentaje de colonización en el total de la población diabética y no diabética (n= 172) fue de 33,7 por ciento. La distribución por especies fue de Candida albicans (63,8 por ciento), Candida glabrata (10,3 por ciento), Candida tropicalis (6,9 por ciento), Candida krusei (5,2 por ciento), Candida dubliniensis (3,4 por ciento), Candida parapsilosis (3,4 por ciento), Candida lusitaniae (1,7 por ciento), Candida guilliermondii (1,7 por ciento) y Candida spp. (no identificada, 3,4 por ciento). En sujetos no diabéticos el porcentaje de colonización fue de 27,9 por ciento y en diabéticos de 36,9 por ciento. En los sujetos del estudio se encontró que 14,9 por ciento tenía control glúcemico por los niveles de hemoglobina glucosilada, el 57,6 por ciento utilizaba prótesis dentales y el 63,9 por ciento practicaba higiene oral regular. Conclusión: Candida albicans es la especie predominante en ambos grupos, con un porcentaje significativo de las especies no albicans en estos pacientes. El uso de prótesis dental es un factor coadyuvante para la colonización por especies del género Candida(AU)

Introduction: Candida spp. is a normal inhabitant of the human microbiota, which can cause superficial and systemic infections of an opportunistic nature. In diabetic patients the risk of infections by this yeast increases, which would be determined by the carrying of Candida spp. This carrying is variable, as observed in the oral cavity from 13.7 to 64 percent. Objective: to establish the percentages of colonization and possible associated factors in this high-risk group. Method: a descriptive study was carried out in a total of 172 diabetic and non-diabetic patients. Mouthwash samples were seeded on Sabouraud agar and CHROMagar Candida. The isolates were subjected to phenotypic tests and to a multiple polymerase´s chain reaction for identification. Demographic variables, oral hygiene habits, the use of dental prostheses, as well as glycosylated hemoglobin levels were evaluated for frequency and association determination by chi2 and multivariate analysis, using the SPSS program version 19.0. Results: the percentage of colonization in the total of the diabetic and non-diabetic population (n= 172) was 33.7 percent. The distribution by species was Candida albicans (63.8 percent), Candida glabrata (10.3 percent), Candida tropicalis (6.9 percent), Candida krusei (5.2 percent), Candida dubliniensis (3.4 percent), Candida parapsilosis (3.4 percent), Candida lusitaniae (1.7 percent), Candida guilliermondii (1.7 percent), and Candida spp. (unidentified, 3.4 percent). In non-diabetic patients the percentage of colonization was 27.9 percent and in diabetics 36.9 percent. In the study´s patients, it was found that 14.9 percent had glycemic control by glycosylated hemoglobin levels, 57.6 percent used dental prostheses, and 63.9 percent practiced regular oral hygiene. Conclusion: Candida albicans was the predominant specie in both groups, with a significant percentage of the non-albicans species in these patients. The use of dental prostheses was a contributory factor for colonization by species of the genus Candida(AU)

Evaluation of dental material series from patients with dental prostheses and suspicion of delayed hypersensitivity

Abstract: BACKGROUND: Patients with oral sensitivity are common in our practice. Allergic contact dermatitis is one of the most frequent etiologies. OBJECTIVES: Evaluate oral contact dermatitis using the Brazilian standard series and complementary dental series in patients using dental prostheses, with or without oral complaints. Determine specific dental Brazilian series. METHODS: Patients using dental prostheses with or without oral complaints realized patch tests. Brazilian standard series and complementary dental series were used according to ICDRG recommendations. The results were analysed according to age, sex, race, atopic conditions and symptoms associated. RESULTS: From 54 patients tested, 34 (63%) were positive at least to one substance. Nineteen had oral complaints, such as burning mouth, itch or oral erythema. There was no association between atopic condition and tests results. Without the oral series, just 23(42,6%) patients had a positive result. Using the Brazilian standard series with the complementary dental series we improved the positivity of the patch test to 47%. CONCLUSION: In patients using prostheses and with oral complaints, patch tests with Brazilian standard series with complementary dental series improve the tests positivity.

Fibro-epithelial Polyp - Report of Two Cases with Literature Review.

Irritation fibroma or traumatic fibroma is a common sub-mucosal response to trauma from teeth or dental prosthesis presenting as a painless, sessile or occasionally pedunculated swelling that can be firm and resilient or soft and spongy in consistency. It rarely occurs before the fourth decade and shows no preference for either sex. Its occurrence corresponds with intraoral areas that are prone to trauma such as the tongue, buccal mucosa and labial mucosa. As the lesion occurs due to continuous trauma and irritation, it important to remove the source of the irritation and then treat it by conservative surgical excision otherwise it will recur.

Alterações bucais causadas pelo uso de próteses removíveis - levantamento epidemiológico dos casos encontrados em um serviço de diagnóstico histopatológico do sul do Brasil / Oral diseases caused by the use of removable dentures - epidemiological survey of cases found in a Histopathological diagnosis service of southern Brazil

O uso de próteses dentárias removíveis possibilita a reabilitação funcional e estética dos pacientes. No entanto, tais próteses precisam ser confeccionadas adequadamente para que não venham causar lesões na cavidade bucal, como por exemplo: hiperplasia fibrosa inflamatória, candidose, granuloma piogênico, mucocele, e fibroma ossificante periférico. Tais lesões são agravadas pela presença de higienização inadequada e uso incorreto da prótese, os quais poderiam ser evitados se após sua instalação o profissional orientasse o paciente quanto às técnicas de limpeza e o acompanhasse periodicamente. Objetivo: assim, o objetivo da presente pesquisa é realizar um estudo epidemiológico observacional transversal, tendo como amostra 126 requisições de exames histopatológicos registradas no Laboratório de Diagnóstico Histopatológico do Instituto de Ciências Biológicas da UPF no período de 1990 a 2011. Material e métodos: de tais requisições foram coletados dados referentes ao paciente, à prótese e à cavidade bucal, os quais foram tabulados e analisados por estatística descritiva de frequência. Resultados: Das 126 lesões registradas, notou-se serem mais frequentes as hiperplasias fibrosas inflamatórias presentes em fundo de sulco, no gênero feminino, em pacientes leucodermas entre 51 e 70 anos de idade. Conclusão: assim, conclui-se que próteses dentárias removíveis mal planejadas e seu uso inadequado são capazes de de gerar lesões na cavidade bucal...

The use of removable dentures allows for functional and esthetic rehabilitation of patients. However, such prostheses need to be prepared properly for that may not cause lesions in the oral cavity, such as: inflammatory fibrous hyperplasia, candidosis, pyogenic ranuloma, mucocele, and peripheral ossifying fibroma. Such injuriesare aggravated by the presence of inadequate cleaning and incorrect use of the prosthesis, which could be avoided if after installation professional to orient the patient and cleaning techniques and accompany periodically. Objective: the objective of this research is to conduct across-sectional observational epidemiological study with a sample of 126 requests histopathology recorded in Diagnostic Histopathology Laboratory of the Institute of Biological Sciences at UPF in the period 1990-2011. Methods the data relating to the patient, the prosthesis and the oral cavity were collected, tabulated and analyzed using descriptive statistics of frequency. Results: out of the 126 injuries recorded was noted to be more frequent inflammatory fibrous hyperplasia present inthe bottom of the groove, in females, in Caucasian patients between 51 and 70 years of age. Conclusion: thus, it is concluded that poorly planned removable dentures and their inappropriate use can generate lesions in the oral cavity...

Estomatitis subprótesis en pacientes con prótesis de más de dos años de uso / Subprosthesis stomatitis in patients with prostheses over two years of use

Introducción: la estomatitis subprótesis es la alteración más frecuente en los pacientes rehabilitados con prótesis, multicausal, lo cual hace complejo su estudio y, más aún, su pronóstico. Objetivo: determinar la frecuencia de estomatitis subprótesis en los pacientes rehabilitados por más de 2 años. Métodos: se realizó un estudio observacional, descriptivo, transversal y prospectivo en la Clínica Estomatológica Andrés Ortíz Junco del municipio Güines, provincia Mayabeque. La población objeto de estudio estuvo integrada por 111 pacientes, mayores de 15 años, de ambos sexos, que acudieron a consulta en el periodo comprendido desde enero de 2010 hasta marzo de 2012, eran portadores de prótesis de más de dos años y presentaban signos de estomatitis subprótesis. Se confeccionó una planilla para la recolección de la información con variables como: edad, sexo, localización y grado de severidad de la lesión. Resultados: el sexo femenino predominó respecto al masculino con un 69,37 por ciento. Los grupos de 35 a 59 y 60 y más son los más representativos con el 43,24 por ciento y 45,05 por ciento respectivamente. La lesión se presentó con más frecuencia en el maxilar para un 89,19 por ciento respecto a la mandíbula con el 16,22 por ciento. Predominó el grado I 48,65 por ciento seguido del grado II 39,64 por ciento. El grado III resultó el menos representativo con un 11,71 por ciento. Conclusiones: el sexo femenino fue el más afectado y el grupo etáreo de 60 y más. Predominó el grado I y el maxilar el sitio más común

Introduction: subprosthesis stomatitis is the most frequent alteration in rehabilitated patients with prostheses, multicausal, which makes its study complex, moreover, its prognosis.Objective: to determine the frequency of subprosthesis stomatitis in rehabilitated patients for more than two years.Methods: an observational, descriptive, transversal and prospective study was carried out at Andrés Ortiz Junco Dental Clinic of Guines municipality, Mayabeque province. The study population consisted of 111 patients, older than 15 years, of both sexes, who went to consultation in the period from January 2010 to March 2012, they were prosthesis bearers for over two years and showed signs of subprosthesis stomatitis. A form was designed to collect information with variables such as age, sex, location and gravity degree of the lesion.Results: females predominated with respect to males in 69,37 por ciento. Groups 35-59 and 60 and over are the most representative with 43,24 por ciento and 45,05 por ciento respectively. The lesion occurred more often in the mandible for a 89,19 por ciento compared to the mandible 16,22 por ciento. Grade I predominated 48,65 por ciento followed by grade II 39,64 por ciento. Grade III was the least representative with 11,71 por ciento.Conclusions: females were the most affected and the age group of 60 and over. Grade I predominated and the mandible was the most common site

Atrofia paraprotética de los maxilares / Paraprosthetic atrophy of the jaws

El objetivo de esta presentación es describir las alteraciones provocadas por la desadaptación o sobrecarga sectorizada de las prótesis mucosoportadas sobre el terreno de soporte óseo. Luego, relacionarlas con las alteraciones periprotéticas asociadas más comunes, y realizar la descripción de una de las alteraciones atróficas paraprotéticas de mayor casuística, con sus consecuencias en el sistema estomatognático. Finalmente, describir los tratamientos protéticos no implantológicos y la prevención de estas alteraciones con prótesis convencionales e implanto-asistidas

Detección e identificación de Candida dubliniensis por métodos fenotípicos en estomatitis sub-protésica: reporte de un caso / Detection and identification of methods for phenotypic Candida dubliniensis in denture stomatitis: report of case

La Estomatitis Sub-Protésica es una afección comúnmente observada en sujetos portadores de prótesis dentales removibles. Son numerosos los reportes publicados en los que se asocia esta patología con la presencia de hongos del Género Candida, y particularmente con Candida albicans. No obstante, algunas cepas identificadas como C. albicans, pudieran no tratarse en realidad de este microorganismo sino de Candida dubliniensis, más aún si se toma en cuenta que ambas especies producen clamidoconidias. Es por ello que resulta necesario comparar distintos métodos fenotípicos que permitan diferenciar en buena medida a ambas especies. En este artículo se describe el caso de una paciente portadora de prótesis removible superior con diagnóstico clínico de Estomatitis Sub-Protésica, a quien se le tomó muestras del paladar afectado y de la prótesis implicada. Se emplearon diferentes métodos fenotípicos de identificación diferencial de ambas especies, entre estos: CHROMagar Candida, Agar tabaco, Agar Pal´s, Agar Tween 80, medio de tomate y zanahoria y de Agar Sabouraud con NaCl al 6,5% (P/V). También se realizaron la pruebas de termotolerancia a 45ºC, aglutinación en latex, así como la identificación a través del sistema ID 32C (bioMerieux). Una vez empleados los métodos antes mencionados, la especie encontrada en el paladar de la paciente fue C. dubliniensis, en tanto que la que se halló en la prótesis fue C. albicans, siendo esta la primera vez que se detecta e identifica en nuestro país a C.dubliniensis en pacientes que presentan esta patología bucal.

Denture stomatitis is a condition commonly observed in subjects with removable dentures. There are numerous reports published in which this disease is associated with the presence of fungi of the genus Candida, particularly Candida albicans. However, some strains identified as C. albicans, may not actually be this organism but Candida dubliniensis, especially if one takes into account that both species produce clamidoconidias. That is why it is necessary to compare different phenotypic methods to differentiate largely to both species. This article describes the case of a patient with upper removable prosthesis with a clinical diagnosis of Denture Stomatitis, whom he took samples of the palate is affected and the prosthesis involved. Different methods were used phenotypic differential identification of both species, among them: CHROMagar Candida Agar snuff, Pal's Agar, Tween 80 Agar, tomato and carrot medium, and Sabouraud Agar with 6.5% NaCl (P / V ). Also thermotolerance tests performed at 45 ° C, latex agglutination, and identification by ID 32C system (bioMerieux) were used. Once employed the above methods, the species found in the mouth of the patient was C. dubliniensis, whereas that was found in the prosthesis was C. albicans, marking the first time it is detected and identified in our country C.dubliniensis in patients with this oral pathology.

Perforaciones de las paredes radiculares en la preparación de las cavidades para alojar pernos metálicos en pacientes que acudieron a la Cátedra Integrada de la Facultad de Odontología de la Universidad Nacional de Asunción entre los años 2006 al 2009 / Perforations of the root walls in the preparation of the cavities to accommodate metal bolts in patients who attended the integrated Chair of the Faculty of Dentistry, National University of Asunción between 2006 to 2009

La perforación radicular se define como una lesión que comunica la cavidad pulpar con el ligamento periodontal o tejido óseo circundante que puede tener origen iatrogénico o patológico. En general las perforaciones iatrogénicas son provocadas durante la praxis del cirujano dentista; mientras que las patológicas proceden de caries y reabsorciones dentales. El objetivo de este estudio fue determinar la frecuencia de perforaciones de las paredes radiculares en preparaciones cavitarías para alojar pernos metálicos en pacientes que acudieron a la Cátedra de Clínica Integrada de la Facultad de Odontología de la Universidad Nacional de Asunción entre los años 2006 al 2009, por medio de un estudio observacional descriptivo de corte transversal, temporalmente retrospectivo. Los datos fueron extraídos de las fichas y radiografías panorámicas de los pacientes tratados de dicha cátedra. No teniendo conocimiento, hasta la fecha, de investigaciones sobre el tema de nuestro medio, se planteó este estudio en el que se encontró que 9 (8,3%) de 108 dientes con postes radiculares presentaban perforaciones, estando localizadas el 88,9% de las mismas en el tercio medio. En cuanto al tipo de poste según su fabricación, el 55,6% de los postes de las piezas dentarias peroradas eran coladas y 7 de ellos (78%) tenían más de un tercio de diámetro radicular en cervical. Se destaca la importancia del estudio radiográfico antes, durante y después de las preparaciones para alojar pernos metálicos a fin de evitar esta complicación, el fracaso de las restauraciones final y el mantenimiento de la pieza dentaria en la cavidad bucal.

Factores asociados al uso de prótesis dentales o a problemas reportados en dientes o encías con uso de prótesis orales en adultos mayores de origen México Americanos / Associated factors with the use of dentures or reported dental and gum problems

El objetivo de este estudio fue determinar los factores asociados al uso de prótesis dentales o a problemas orales en dientes o encías al usar las prótesis dentales en adultos mayores de origen México Americanos del estudio EPESE (Established Populations for Epidemiologic Studies of the Elderly) hispano en los Estados Unidos. Se hizo un análisis transversal incluyendo 2992 hombres y mujeres de 65 años o mas entrevistados durante 1993-1994. El 44% de los ancianos reportaron el uso de prótesis dentales parciales o totales. Dentro de las personas que usan prótesis dentales, el 21% reportaron problemas orales con los dientes o las encías al comer. En análisis multivariados, las limitaciones en actividades instrumentales de vida diaria (AIVD) (odds ratios=OR 1.23, intervalo de confianza=IC 95% 1.04-1.45) estuvieron asociados con el uso de las prótesis orales. También, dentro de las personas que usan prótesis dentales, los síntomas depresivos aumentados (OR 1.42, IC 95% 1.04-1.95) y las limitaciones funcionales en AIVD (OR 1.58, IC 95% 1.15-2.17) estuvieron asociados a problemas orales con los dientes o las encías al comer. En conclusión, factores que usualmente afectan la calidad de vida en los adultos mayores, tales como la dependencia funcional y la depresión, están asociados al uso de prótesis dentales o a problemas orales en dientes o encías al usar las prótesis dentales.

The objective of this study was to determine factors associated with using dental prosthesis or oral problems related to their use among older Mexican Americans of the Hispanic Established Populations for Epidemiologic Studies of the Elderly EPESE) in the United States. A cross-sectional analysis was made with data of 2992 men and women aged 65 years and older interviewed during 1993-1994. Forty four % of subjects reported the use of partial or total dental prosthesis. Among those using dental prosthesis, 21% reported problems with teeth or gums when eating. In multivariate analyses, instrumental activities of daily living (IADL) limitations were associated with using dental prosthesis (OR = 1.23, 95% confidence interval - CI = 1.04-1.45). Also, among subjects using dental prosthesis, increased depressive symptoms (OR = 1.42, 95% CI 1.04-1.95) and IADL limitations (OR = 1.58, 95% CI 1.15-2.17) were associated with problems with teeth or gums when eating. In conclusion, factors usually affecting quality of life in older persons such as functional dependency and depression are associated with using dental prosthesis or oral problems with teeth or gums when eating.

Rehabilitaciones protésicas y su calidad como factor de riesgo en la aparición de lesiones en la mucosa bucal / The prosthetic rehabilitations and its risk factor quality in the appearance of buccal mucosa lesions

Las lesiones en la mucosa bucal constituyen un problema importante de salud. Existen diferentes factores de riesgo que favorecen su aparición, por ejemplo, la calidad de las prótesis. Se realizó un estudio observacional, analítico, longitudinal, retrospectivo, de casos y controles entre septiembre del 2006 y enero del 2008 en la Facultad de Estomatología de La Habana, con el objetivo de identificar la calidad de la prótesis como factor de riesgo en la aparición de lesiones en la mucosa bucal. Se evidenció que en el grupo de casos, el 77,4 por ciento eran portadores de prótesis de mala calidad, y el 85,8 por ciento de los controles eran portadores de prótesis de buena calidad. Se concluyó que la calidad de la prótesis constituyó un factor de riesgo en la aparición de lesiones de la mucosa bucal. Las lesiones bucales mßs frecuentes asociadas con el uso de la prótesis estomatológica fueron la estomatitis subprótesis y queilitis comisural(AU)

Buccal mucosa lesions are a significant health problem. There are different risk factors favoring its appearance, e.g. quality of prostheses. We made a observational, analytical, longitudinal and retrospective study of case and control between September 2006 and January 2008 in Stomatology Faculty of Havana City, to identify prosthesis quality as risk factor in appearance of buccal mucosa lesions. We evidenced that in case-group, the 77, 4 percent used prosthesis of a poor quality, and that 85, 8 percent of control used prosthesis of a good quality. We conclude that prosthesis quality was a risk factor in appearance of buccal mucosa lesions. The more frequent buccal lesions associated with use of stomatologic prosthesis were the sub-prosthesis stomatitis and commissural cheilosis(AU)

Lesões da mucosa oral em pacientes idosos: um problema pouco enfatizado por médicos e pesqisadores / Oral mucosa lesions in elderlly inpatients: a problem little emphasized by doctors and researchers

Objetivos: Estimar a freqüência de lesões da mucosa oral em idosos internados nas várias especialidades de hospital geral, em Belo Horizonte, Minas Gerais; determinar com qual freqüência as lesões detectadas pelos pesquisadores haviam sido identificadas também pelos médicos responsáveis pelos pacientes estudados e veridicar a possível associação dessas lesões com sexo, tabagismo, etilismo, edentulismo e uso de próteses dentárias. Pacientes e métodos: Os pacientes foram selecionados de acordo com a idade (60 anos e mais), a partir do prontuário médico, de onde também se extraíram informações sobre o sexo, realização do exame da cavidade oral pelo médico assistente e sobre a detecção de lesões da mucosa oral pelo mesmo. O diagnóstico das lesões baseou-se nas suas características clínicas. Resultados: Foram avaliados 198 pacientes, com idade média de 75 anos, sendo 116 do sexo feminino e 82 masculino. Foram detectadas lesões nas cavidades orais de 69 pacientes (34,8 por cento). Em apenas 13 pacientes (6,6 por cento) as lesões haviam sido detectadas também pelo médico assistente. As lesões mais freqüentemente encontradas foram candidíase (23 por cento), epulis fissuratum (11 por cento), hiperplasia inflamatória (11 por cento), afta recorrente (10 por cento), papiloma (10 por cento), queilite angular (7 por cento) e leucoplasia (3 por cento). Em relação à associação das lesões com sexo, tabagismo, etilismo, edentulismo e uso de prótese, encontrou-se que o uso de prótese esteve associado com maior número de lesões, especificamente, com hiperplasia inflamatória. Conclusões: Os dados ora apresentados são comparáveis aos observados em outros estudos, mas, diferentemente daqueles, demonstram o pequeno interesse dos médicos pelo exame da cavidade oral dos seus pacientes. Ressaltamos, portanto, a importância deste trabalho, cujos resultados alertam para a necessidade da realização do exame da cavidade oral por todos os profissionais que cuidam de pacientes idosos.

Aims: To estimate the prevalence of oral mucosa lesions in elderly inpatients admitted to different specialities of a general hospital, its possible association with gender, smoking habit, alcohol use, edentulis and dental prosthesis anda how often these lesions go unrecognizes. Patients and methods: The case notes of all patients 60 years of age and older of both sexes were analyzes in order to identify whether the oral cavity was examined by the responsible doctor and what kind of oral mucosa lesions were detected. Results: A total of 198 patients (median age: 75 years) (116 females; 82 males) were evaluated. Oral cavity lesions were detected in 69 patients (34,8 percent). In only 13 patients (6,6 percent) lesions were recognized by the responsible doctor. The most frequently found lesions were: candidiasis (23 percent), epulis fissuratum (11 percent), inflammatory hyperplasia (11 percent), recurrente aphthous ulcer (10 percent), papilloma (10 percent), angular chelilitis (7 percent) and leucoplakia (3 percent). The use of dental prosthesis was associated with a greater number of lesions specifically inflammatory hyperplasia. Conclusions: The prevalence and type of oral mucosa lesions found in our study is similar to other studies. Nevertheless, is was clear that routine examination of the oral cavity was not performed regularly. It's highlighted the importance of routine examination of elderly oral cavity.

Estomatitis subprótesis: estudio clínico y microbiológico de candida / Denture stomatitis: clinical and microbiological study of candida

La estomatitis subprótesis es una patología asociada al uso de prótesis dentales removibles. Su diagnóstico es fundamentalmente clínico y se basa en el reconocimiento de sus lesiones, siendo una de la clasificación de Newton una de las más aceptadas. Además, el diagnóstico debe ser confirmado por la observación microscópica de Candida en las muestras orales. El objetivo de este estudio fue determinar las especies de Candida más frecuentes en la mucosa del paladar y determinar la susceptibilidad in vitro de estas cepas a Nistatina y a Fluconazol. Se examinaron un total de 100 pacientes portadores de prótesis removibles determinando la presencia o ausencia de ES según la clasificación de Newton. A cada paciente se le tomó una muestra de la zona palatina y se le realizó el examen microbiológico. El 75 por ciento de los pacientes presentó alteraciones en la mucosa palatina compatibles con ES (33 por ciento presentó ES tipo I, 42,7 por ciento tipo II y 24 por ciento tipo III; mientras que un 25 por ciento presentó una mucosa sana. EL 53,3 por ciento de los pacientes con ES presentó cultivo positivo para Candida, mientras que un16 por ciento en la mucosa normal. Las especies de Candida albicans fueron las más frecuentemente aislada (75 por ciento), seguida por la C. tropicallis (15 por ciento) y en el resto de los cultivos se presentaron ambas especies (10 por ciento). El 100 por ciento de las cepas estudiadas fueron sensibles a Nistatina y Fluconazol, lo que se evidenció por la formación de un halo de inhibición amplio entre las levaduras. Existe una correlación positiva entre la ES y la presencia del género Candida, siendo la especie C. albicans quien se aisló conmayor frecuencia desde la mucosa palatina de pacientes con ES y sin ella. Todas las levaduras encontradas fueron susceptibles a Nistatina y Fluconazol in vitro, demostrando su efectividad fungicida ante especies del género Candida.

Denture stomatitis (DS) is a condition associated with the use of removable dentures. Its diagnosis is mainly clinical and based in recognition of their injuries, being the Newton’s one of the most accepted classifications. It stresses that the diagnosis should be confirmed by microscopic observation of Candida in oral samples. The aim of this study was to determine the species of Candida more frequent in the palatal mucosa and determine in vitro susceptibility to Nystatin and Fluconazole of these isolated strains. A total of 100 patients were examined by identifying the removable prosthesis presence or absence of DS according to the classification of Newton. Each patient had a complete sample of the area and palate was carried out microbiological examination. 75 percent of patients had abnormalities in the palate mucosa compatible with DS (33 percent presented DS type I, type II 42.7 percent and 24 percent Type III), while 25 percent filed a healthy mucosa. In 53.3 percent of patients with DS presented positive culture for Candida, only 16% had positive culture in the normal mucosa. The species of Candida albicans were the most frequently isolated (75 percent ), followed by C. tropicallis (15 percent ) and the rest of the crops were presented both species (10 percent ). 100 percent of the strains were sensitive to Nistatina and Fluconazole, which was evidenced by the formation of inhibition area in yeast. There is a positive correlation between the DS and the presence of Candida, being C. albicans the kind who was isolated most frequently from the mucosa of patients with DS palate and healthy patients. All yeast were found susceptible to Nystatin and Fluconazole in vitro, demonstrating its effectiveness in Candida.

La Xerostomía en pacientes con prótesis dental / Xerostomia in patients with dental prosthesis

Se realiza una revisión bibliográfica y documental, exhaustiva sobre el problema a estudiar y los objetivos trazados, esencialmente a través de Internet que incluye los últimos veinte años, con el objetivo de obtener una información actualizada sobre el comportamiento de la Xerostomía en los individuos que usan prótesis dental, teniendo en cuenta que la Federación Dental Internacional (FDI) define este síndrome como ®la enfermedad del hombre moderno¼ debido a su carácter casi epidémico, ya que afecta a una de cada cuatro personas y que aumenta a partir de los cincuenta años. Por ser la Xerostomía más prevalente en el adulto mayor, y de estos, un alto porcentaje son desdentados totales o parciales y por tanto requieren del uso de prótesis dental, y teniendo en cuenta además, los trastornos que ocasiona la sequedad bucal para el soporte y funcionamiento de las prótesis, así como los riesgos de enfermedades que afectan la salud bucal y la calidad de vida de la población, se realizó este trabajo que ha posibilitado lograr la actualización sobre este importante problema(AU)

An exhaustive bibliographic and documentary review on the problem to be studied and the objectives laid down is made, essentially through Internet. It includes the last 20 years aimed at obtaining updated information on the behavior of Xerorostomia in those individuals wearing dental prosthesis, taking into consideration that the International Dental Federation (IDF) defines this syndrome as the disease of modern man due to its epidemic character, since it affects one out of four persons and its incidence is higher in individuals 50 and over. Taking into account that Xerostomia is more common in the older adults, of whom a high percentage are totally or partially edentulous that require the wearing of dental prosthesis, and considering the disorders caused by mouth dryness in relation to the support and functioning of the prostheses, as well as the risks for diseases affecting oral health and the quality of life of the population, this paper has made possible the updating of this important problem(AU)