Regeneration of periodontal intrabony defects using platelet-rich fibrin (PRF): a systematic review and network meta-analysis.

One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments.

Pyrosequencing Analysis of O-6-Methylguanine-DNA Methyltransferase Methylation at Different Cut-Offs of Positivity Associated with Treatment Response and Disease-Specific Survival in Isocitrate Dehydrogenase-Wildtype Grade 4 Glioblastoma.

The O-6-methylguanine-DNA methyltransferase (MGMT) gene is a critical guardian of genomic integrity. MGMT methylation in diffuse gliomas serves as an important determinant of patients' prognostic outcomes, more specifically in glioblastomas (GBMs). In GBMs, the absence of MGMT methylation, known as MGMT promoter unmethylation, often translates into a more challenging clinical scenario, tending to present resistance to chemotherapy and a worse prognosis. A pyrosequencing (PSQ) technique was used to analyze MGMT methylation status at different cut-offs (5%, 9%, and 11%) in a sample of 78 patients diagnosed with IDH-wildtype grade 4 GBM. A retrospective analysis was provided to collect clinicopathological and prognostic data. A statistical analysis was used to establish an association between methylation status and treatment response (TR) and disease-specific survival (DSS). The patients with methylated MGMT status experienced progressive disease rates of 84.6%, 80%, and 78.4% at the respective cut-offs of 5%, 9%, and 11%. The number was considerably higher when considering unmethylated patients, as all patients (100%), regardless of the cut-off, presented progressive disease. Regarding disease-specific survival (DSS), the Hazard Ratio (HR) was HR = 0.74 (0.45-1.24; p = 0.251); HR = 0.82 (0.51-1.33; p = 0.425); and HR = 0.79 (0.49-1.29; p = 0.350), respectively. Our study concludes that there is an association between MGMT unmethylation and worse TR and DSS. The 9% cut-off demonstrated a greater potential for patient survival as a function of time, which may shed light on the future need for standardization of MGMT methylation positivity parameters in PSQ.

IS THE PHOTOBIOMODULATION THERAPY EFFECTIVE IN CONTROLLING POST-SURGICAL SIDE EFFECTS AFTER THE EXTRACTION OF MANDIBULAR THIRD MOLARS? A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The extraction of third molars is one of the most performed surgical procedures in oral and maxillofacial surgery. Pain, oedema, and trismus are the most frequently complications related in the surgical postoperative period. The literature has indicated PBM as a potential adjuvant method to reduce these complications. The aim of this review and meta-analysis is evaluate the PBM, as an optimal method to improve patient experience and minimize postoperative morbidity. Additionally, we seek to determine which wavelength, site, and frequency of application are most effective. METHODS: This review was registered in PROSPERO (CRD42023429966) and followed PRISMA guidelines. The search was carried out in the main databases, PubMed/MEDLINE, Cochrane Library, Embase, Scopus, and Lilacs, including reviews in the most important journals in the area of oral surgery and laser applied to oral surgery. In addition, all article references and also gray literature were reviewed. After the studies selection, the relevant data was collected. All the studies were randomized controlled trials and the patients were allocated into two groups: active PBM and inactive PBM. The statistical analysis was carried out using Stata v.16, and the methodological quality and risk of bias were assessed by the Jadad scale and RoB 2.0, respectively. RESULTS: Where included 22 studies and 989 subjects, to all with a minimum follow-up of 7 days. Pain and oedema showed statistically significant results in favor to the active PBM group. Especially when laser applied in infrared mode, for pain and oedema at 48 h, MD = -1.80 (CI95% -2.88, -0.72) I²â€¯= 92.13% and MD = -1.45 (CI95% -2.42, -0.48) I²â€¯= 65.01%, respectively. The same is not true for trismus at 48 h, MD = 0.07 (CI95% -0.06, 0.21) I²â€¯= 3.26%. The meta-analysis also presented results in respect of laser site of application and number of PBM sessions. CONCLUSIONS: PBM with infrared laser, in a combination intraoral and extraoral application, in one session in the immediate postoperative period, has been shown to be effective to achieve the objectives of reducing pain and oedema after third molar extraction.

Coronectomy of lower third molars in intimate relation to the inferior alveolar nerve: A report of two cases.

Damage to the inferior alveolar nerve (IAN) secondary to the extraction of the lower third molar (LTM) is a relatively frequent complication (0.35-8.40%) that can cause temporary or permanent nerve damage. Coronectomy has been proposed as an alternative, which consists of sectioning the coronary portion of the LTM, and deliberately leaving the radicular portion with the pulp intact. Two clinical cases are presented in this article, in which root migration (0-0.3 mm) and a change of angulation (+2º to +9°) occurred. None of the cases developed complications during the follow-up period (12 months). Therefore, coronectomy is a procedure to be considered in selected cases as an alternative to conventional exodontia of the LTM to avoid possible damage to the IAN. Key words:Case report, third molar, mandibular third molar, coronectomy, mandibular nerve, mandibular nerve injuries, root migration.

Oral specimens as a tool for accurate metagenomic analysis: A pilot study.

OBJECTIVES: Acute oral mucosal damage, as well as other inflammatory processes seem to be related to dysbiosis of the oral microbiome. The need to study changes in the oral microbiome led us to hypothesize what type of sample would provide the most representative picture of the entire human oral microbiome. MATERIALS AND METHODS: An observational, and cross-sectional study was carried out. Six healthy adult participants provided 3 different sample types each, that included saliva, oral rinse and mucosal biopsy tissue. We performed 16S rRNA sequencing of the V3-V4 region of the 18 samples using Illumina MiSeq technology. RESULTS: Participants were 27 ± 6,3 years old. Bacterial alpha diversity was higher in oral rinse samples compared to whole unstimulated saliva and oral mucosa tissue (p = 0,005). However, saliva specimens showed a 56 % relative abundance of identified species followed by a 30 % in oral rinse and only 1 % in tissue samples. CONCLUSIONS: This study found differences on oral microbiome composition for each type of sample. Oral rinse should be chosen when higher alpha diversity is needed, whereas whole unstimulated saliva should be more appropriate for larger amount of bacterial DNA. CLINICAL RELEVANCE: The results obtained demonstrate the importance of a correct choice of the optimal type of oral sample for microbiome studies due to the differences found in its composition.

Oral Mucosa and Saliva Alterations Related to Vape.

OBJECTIVES: Electronic nicotine delivery systems (e-cigarette, pod, and vape) are currently among the tobacco consumption of adolescents and young adults. The aim is to show oral mucosa and saliva alterations related to vape. MATERIAL AND METHODS: A vape-user patient, presenting a white plaque in the posterior region of the hard palate, underwent clinical examination, sialometry, pH evaluation, and excisional biopsy of the white lesion. Molecular changes in saliva and vape liquid were analyzed by vibrational spectroscopy. RESULTS: The histopathological analyses showed hyperparakeratosis without dysplasia. Formaldehyde, ketones, and aromatic hydrocarbon species were identified in e-cig liquid by the FTIR. CONCLUSIONS: The use of vape may be related to the development of hyperkeratotic lesions in the oral mucosa as well as significantly modify the patient's salivary patterns as the vape liquid presents carcinogenic and cytotoxic components in its composition.

Prevalence of human herpesvirus in plasma and saliva of cirrhotic patients: A pilot study.

AIMS: The objective of this study was to identify the presence of human herpesvirus (HHV) in the plasma and saliva of hepatic-cirrhosis patients and correlate it with clinical data and laboratory tests. This is a pilot, observational, and cross-sectional study. METHODS AND RESULTS: Specimens of plasma and saliva from 72 cirrhotic individuals were analyzed by means of polymerase chain reaction. The patient population had a mean age of 54.84 years old (SD ± 10) and was 70% males (51/72). Approximately 47% (n = 34) of the patients had leukopenia and HHV was not identified in the plasma specimens. The main species of HHV identified in the saliva were HHV-7 (n = 42, 62%) and Epstein-Barr virus (EBV) (n = 30, 41%). Moreover, there was a significant decrease in the total number of leukocytes and lymphocytes in saliva containing EBV (P = .038 and P = .047, respectively). CONCLUSION: The results show that the presence of EBV in the saliva of cirrhotic patients was correlated with their circulating immune status. It may be possible that the immune dysfunction displayed by the cirrhotic patients plays a role in the shedding of EBV into saliva.

Insights into MLH1 Methylation in Endometrial Adenocarcinoma through Pyrosequencing Analysis: A Retrospective Observational Study.

Background: In cancer care, the MLH1 gene is crucial for DNA mismatch repair (MMR), serving as a vital tumor suppressor. Evaluating MLH1 protein expression status, followed by analysis of MLH1 promoter methylation, has become a key diagnostic and prognostic approach. Our study investigates the complex link between MLH1 methylation and prognosis in endometrial adenocarcinoma (EA) patients. Methodology: MLH1 methylation status was accessed by a Pyrosequencing (PSQ) assay. Qualitative positivity for methylation was established if it exceeded the 11% cut-off; as well, a quantitative methylation analysis was conducted to establish correlations with clinicopathological data, relapse-free survival, and disease-free survival. Results: Our study revealed that 33.3% of patients without MLH1 methylation experienced relapses, surpassing the 23.3% in patients with methylation. Furthermore, 16.7% of patients without methylation succumbed to death, with a slightly higher rate of 17.6% in methylated patients. Qualitative comparisons highlighted that the mean methylation rate in patients experiencing relapse was 35.8%, whereas in those without relapse, it was 42.2%. This pattern persisted in disease-specific survival (DSS), where deceased patients exhibited a higher mean methylation level of 49.1% compared to living patients with 38.8%. Conclusions: Our findings emphasize the efficacy of PSQ for evaluating MLH1 methylation. While unmethylation appears to be associated with a higher relapse rate, the survival rate does not seem to be influenced by methylation. Quantitative percentages suggest that elevated MLH1 methylation is linked to relapse and mortality, though a study with a larger sample size would be essential for statistically significant results.

Parents' perspectives on dental team as advisors to promote HPV vaccination among Spanish adolescents.

PURPOSE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention. METHODS: Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis. RESULTS: In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05). CONCLUSION: Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed.

Osseointegrated dental implants that will undergo radiotherapy. Does risk of osteoradionecrosis exist? A scoping review.

OBJECTIVE: Given the absence of a standardized action protocol for treating patients with dental implants (DIs) who are subjected to radiotherapy (RT), we have conducted an extensive review and analysis of published literature on this subject. Our objective is to gain a comprehensive understanding of the impact of RT on the bone surrounding osseointegrated implants during and after treatment. STUDY DESIGN: We conducted a literature review using PubMed (MEDLINE) to identify studies describing the effects of RT on preexisting osseointegrated and/or loaded DIs. Articles published between January 1963 and December 2023 were considered for inclusion. RESULTS: A total of 1,126 articles were retrieved, 64 full articles were reviewed, and only 13 articles were included in this review upon meeting the criteria. A total of 667 patients and 2,409 implants were included. Osteoradionecrosis (ORN) was observed in approximately 19 implants following antineoplastic treatment. CONCLUSIONS: The interaction between DIs and RT is a complex and multifaceted issue that requires further research and clinical guidance. Although certain studies indicate a possible connection between DIs, radiation, and ORN risk, the precise relationship remains unclear. Factors such as radiation dosage, implant characteristics, material, and timing of placement significantly influence this association.

Role of thyroid hormones in burning mouth syndrome. Systematic review

Background: Burning mouth syndrome is an idiopathic condition characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. In the case of secondary burning mouth syndrome is associated with local or systemic factors (such as thyroid disorders) that can cause these symptoms. The aim of this review was to study the relationship between thyroid disorders and burning mouth syndrome.Material and methods: The present study followed the PRISMA guidelines. An electronic search strategy was developed for PubMed/Medline, Scopus and Cochrane. The following combination of keywords and Boolean operators were used: Thyroid AND burning mouth; Thyroid AND burning mouth syndrome; Hypothyroidism AND burning mouth; Hypothyroidism AND burning mouth syndrome; Hyperthyroidism AND burning mouth; Hyperthyroidism AND burning mouth syndrome. The results were processed by existing free software in https://www.graphpad.com/. To evaluate the association of the categorical variables we used the Fisher test at a level of significance of p-value ≤ 0,05. As a primary summary measure the Odds Ratio (OR) has been used. To analyze the risk of bias the guidelines of the GRADE guide were used and the grade of evidence was analyzed by the guide of Joanna Briggs Institute: Levels of Evidence and Grades of Recommendations.Results: After applying the inclusion and exclusion criteria, 5 studies were selected for review. The Chi-square was 10.92 and the Odds Ratio was 3.31 with respect to TSH values with p <0.0001 (Fisher's test). The population of patients with TSH alterations is increased in 80.49% and decreased in 19.51%.Conclusions: It can be concluded that thyroid hormone abnormalities are a factor in secondary burning mouth syndrome; specially in patients with hypothyroidism. (AU)

Immunoexpression profile of hypoxia-inducible factor (HIF) targets in potentially malignant and malignant oral lesions: a pilot study

Abstract Oral potentially malignant disorders (OPMD) are associated with an increased risk of oral squamous cell carcinoma (OSCC). OSCC has an aggressive profile and is the most prevalent among different head and neck malignancies. Most OSCC patients are diagnosed with advanced stage tumors and have a poor prognosis. Cancer cells are able to reprogram their metabolism, even in the presence of oxygen, enhancing the conversion of glucose to lactate via the glycolytic pathway, a phenomenon mainly regulated by hypoxia-inducible factor (HIF) signaling. Thus, several glycometabolism-related biomarkers are upregulated. Objectives This study aimed to evaluate the immunoexpression of the HIF targets GLUT1, GLUT3, HK2, PFKL, PKM2, pPDH, LDHA, MCT4, and CAIX in OPMD and OSCC samples, in order to identify potential correlations between biomarkers' immunoexpression, clinicopathological features, and prognostic parameters. Methodology OSCC and OPMD samples from 21 and 34 patients (respectively) were retrospectively collected and stained for the different biomarkers by immunohistochemistry. Results CAIX and MCT4 expressions were significantly higher in OSCC samples when compared with OPMD samples, while the rest were also expressed by OPMD. GLUT3 and PKM2 alone, and the concomitant expression of more than four glycometabolism-related biomarkers were significantly correlated with the presence of dysplasia in OPMD. When considering OSCC cases, a trend toward increased expression of biomarkers and poor clinicopathological features was observed, and the differences regarding HK2, PFKL, LDHA and MCT4 expression were significant. Moreover, HK2 and CAIX were correlated with low survival rates. GLUT1 and GLUT3 were significantly associated with poor outcome when their expression was observed in the hypoxic region of malignant lesions. Conclusion OPMD and OSCC cells overexpress glycolysis-related proteins, which is associated with aggressive features and poor patient outcome. Further research is needed to deeply understand the glycolic phenotype in the process of oral carcinogenesis.

Leukocyte and platelet rich fibrin in the management of medication-related osteonecrosis of the jaw: A systematic review and meta-analysis

Background: Osteonecrosis of the jaw (ONJ) has a frequent adverse effect after the administration of nitrogenous bisphosphonates, as non-nitrogenous bisphosphonates are metabolized more rapidly and would produce this effect to a lesser extent. The objective of this study is to analyze the results obtained in the literature with the use of L-PRF in the treatment of ONJ through a systematic review and meta-analysis. Material and methods: Medline (via PubMed), Cochrane, Web of Science and Grey Literature Database was screened from which 10 were selected. Results: In the meta-analysis with full resolution, combining the use of L-PRF in the treatment of ONJ, a weighted proportion (PP) of 94.3% of complete resolution is obtained (95% CI: 91.2-97.4, p<0.001), with a low degree of heterogeneity, statistically significant (I2 = 29.02%; p<0.001). When analyzing the non-resolution data, a weighted proportion (PP) of 7.7% (95% CI: 3.6-11.9; p<0.001) was obtained with moderate heterogeneity (I2: 41.87%; p=0.112). In the meta-regression, no significant correlation was found between complete resolution and year of publication (intercept = 2.88, p=0.829). In consistency analysis no major changes in PP are identified when any of the studies are eliminated, demonstrating a high reliability in the combined results. Conclusion: L-PRF alone or in combination with other therapies in treatment of ONJ achieved high percentages of complete lesion resolution (94.3%). In studies where L-PRF is combined with other therapies, and where the effectiveness of the other therapy alone is analyzed, L-PRF has been shown higher percentages of resolution. (AU)

Counselling toward reducing alcohol use, knowledge about its morbidity and personal consumption among students of medical and dental courses in north-western Spain

Background: Alcohol use disorder (AUD) is directly linked to high-risk consumption. Healthcare students have a crucial role to play in its prevention and management. The aim of this study is to analyse alcohol consumption, as well as to consider the knowledge and attitudes regarding morbidity, and the stage of change when providing assistance to quit AUD. Material and Methods: A cross-sectional study was conducted among Dentistry and Medical students using specific and validated questionnaires in an anonymous and voluntary way. Initially, 925 students were invited to participate, of them 500 were reached. Results: Among them 85.9% suffered from AUD of whom 75% were women (p<0.001), and it was considered that the female gender constituted an independent risk factor (OR=2.63, CI 95% 1.55-4.45, p<0.001). The majority of the participants did not achieve the pass mark, nonetheless, the results showed improved levels of knowledge among participants in the latter years of their studies (p<0.001). Dental students demonstrated greater shortcomings in terms of their knowledge of general pathology, whereas the medical students’ knowledge of oral pathologies proved worse (p<0.001). Most of students believed that identifying cases of AUD-affected patients falls within their competence, nonetheless, they believed that they do not have the necessary competencies. Among participants 58.2% were in a stage of change regarding AUD attitudes. Conclusions: The majority of respondents presented AUD. In general, the participants’ knowledge about alcohol was low. Reviewing the syllabuses and evaluating the implementation of gender-differentiated training programmes in both degrees would be considered necessary.(AU)

Oral microbiome and systemic antineoplastics in cancer treatment: A systematic review

Background: Oral mucositis is one of the most common side effects in cancer patients receiving systemic antineoplastics. However, the underlying biological mechanisms leading to this condition are still unclear. For this reason, it has been hypothesised that systemic antineoplastics may cause an imbalance on the oral microbiota that subsequently triggers oral mucosa damage. Material and Methods: A systematic review was performed following the PRISMA protocol and the PICO question established was: patients diagnosed with cancer, who are candidates for receiving systemic antineoplastics (P=Patients), that undergo oral microbiome determinations (I=Intervention), before and after systemic antineoplastics administration (C=Comparison), to analyse changes in the oral microbiome composition (O=Outcome). The bibliographic search was carried out in PubMed and other scientific repositories. Results: Out of 166 obtained articles, only 5 met eligibility criteria. Acute myeloid leukaemia (AML) was the most frequent type of cancer (40 %) among the participants. Only one of the studies included a control group of healthy subjects. Heterogeneity in the protocols and approaches of the included studies hindered a detailed comparison of the outcomes. However, it was stated that a decrease in bacteria α diversity is often associated with oral mucositis. On the other hand, fungal diversity was not associated with oral mucositis although α diversity was lower at baseline on patients developing oral candidiasis. Conclusions: There is insufficient scientific evidence of oral microbiological changes in patients undergoing systemic antineoplastics. Further investigations ought to be carried out to identify microorganisms that might play a key role in the pathogenesis of oral mucosa damage in patients undergoing systemic antineoplastics.(AU)

Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation: a quasi-experimental study

ABSTRACT BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population. OBJECTIVE: To describe and compare the evolution of symptoms in patients diagnosed with AR and septal deviation prior to and following septoplasty (STP). DESIGN AND SETTING: Quasi-experimental study developed in A Coruña University Hospital. METHODS: Patients aged 18-65 years who had been diagnosed with AR and septal deviation were recruited. Obstruction airflow was evaluated before and after surgery, by means of anterior rhinomanometry (RNM). Severity symptoms and quality of life were assessed using a visual analogue scale (VAS) and the ESPRINT questionnaire, respectively. RESULTS: A total of 50 subjects underwent STP and 42 were included in this study. Their mean age at the time of surgery was 34.16 ± 9.74 years (range 18-64). Significant reductions in mean VAS and ESPRINT were observed after surgery (P < 0.01). These outcomes were considered to represent an overall improvement in quality of life. The RNM results also improved significantly, from mean values of 478.07 ± 165.4 cm3/s before STP to 826.4 ± 175.5 cm3/s afterwards (P < 0.01). CONCLUSIONS: The negative correlations of VAS and ESPRINT with RNM, from before and to after STP, demonstrate the efficacy of scales and questionnaires as objective methods for determining obstruction in the absence of rhinomanometry. Patients with allergic rhinitis and septal deviation showed improvements in obstruction severity and medication use after STP.

Percepción de los estudiantes del grado de Odontología sobre la utilización de un sistema de respuesta interactiva (Kahoot) / Perception of students in dentistry degree on the use of an interactive response system (Kahoot)

Introducción: La adquisición de competencia clínica de diagnóstico en el alumnado de grado de Odontología debe potenciarse con metodologías docentes que le permitan realizar un aprendizaje continuo y autónomo de las materias clínicas. Objetivo: El objetivo del presente trabajo es analizar la percepción de los estudiantes sobre la utilización de la herramienta Kahoot® en la asignatura de Medicina Oral (tercer curso del grado) como estrategia educativa para el reconocimiento de lesiones orales mediante la realización de una encuesta de satisfacción sobre su uso. La herramienta Kahoot® permite a los docentes plantear cuestiones de respuesta múltiple o de verdadero-falso que los alumnos deben responder en un tiempo limitado a través de sus ordenadores personales, teléfonos móviles u otros dispositivos electrónicos conectados a la red wifi. Tras cada respuesta, la herramienta registra la opción correcta y los resultados obtenidos por cada alumno/a, así como su puntuación final y la global del grupo. Materiales y método: Empleamos Kahoot® en cinco de las unidades temáticas del programa durante las clases expositivas. Posteriormente, realizamos al alumnado un test de valoración mediante una escala de tipo Likert (1-5) para registrar la facilidad de utilización y la satisfacción de uso. Resultados: Los resultados obtenidos en los ítems facilidad de uso del sistema (4,31 ± 0,74), motivación (4,18 ± 0,75) y capacidad para aclarar conocimientos (4,13 ± 0,61) muestran una valoración positiva por el alumnado. Conclusiones: Esta metodología de aprendizaje a partir de juegos ha favorecido la enseñanza de conceptos teórico-prácticos y la adquisición de competencias transversales y específicas del grado de Odontología, además de fomentar la participación y el aprendizaje en el aula, lo que orienta al alumnado sobre los principales contenidos del programa y permite una evaluación interactiva de su rendimiento.(AU)

Introduction: The acquisition of clinical diagnostic competence in undergraduate Dentistry students must be enhanced with teaching methodologies that allow them to carry out continuous and autonomous learning of clinical subjects. Aim: The objective of this work is to analyze the students’ perception of the use of the Kahoot® tool in the subject of Oral Medicine (3rd year of the Degree) as an educational strategy for the recognition of oral lesions by conducting a satisfaction survey on its use. The Kahoot® tool allows teachers to pose multiple-answer, or true-false, questions that students must answer in a limited time through their personal computers, mobile phones, or other electronic devices connected to the wifi network. After each answer, the tool records the correct option and the results obtained by each student, as well as their final score and the overall score for the group. Materials and methods: We used Kahoot® in 5 of the thematic units of the program during the lectures/expositive classes. Subsequently, we performed an assessment test on the students using a Likert scale (1-5) to record ease of use and satisfaction with use. Results: The results obtained in the items ease of use of the system (4.31 ± 0.74), motivation (4.18 ± 0.75) and ability to clarify knowledge (4.13 ± 0.61) show the assessment positive by the students. Conclusions: This learning methodology based on games has favored the learning of theoretical-practical concepts and the acquisition of transversal and specific competences of the degree of Dentistry in addition to promoting participation and learning in the classroom, guiding the students on the main contents of the program allowing a interactive evaluation of student performance.(AU)

Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review / Alternativas terapéuticas en el manejo de osteorradionecrosis de los maxilares. Revisión sistemática

Background: to systematically review the literature, comparing the healing of osteoradionecrosis (ORN) amongthe therapeutic alternatives: surgical, pharmacological and combined.Material and Methods: The review was organized according to the PRISMA protocol with regards to the fol-lowing PICO question: patients with ORN of the jaws (P=Patient); all interventions reported (I = intervention);between all therapies (C=Comparison); healing of lesions (O=outcome).Results: Surgical treatment was the most common choice (46.3%) followed by pharmacological treatment, exclu-sively (25.9%) or combined (26.9%). Treatment exclusively by surgical intervention seems to be most effectiveoption, with 51.2% of the lesions healed, OR for healing of 5.7 (CI95% 1.9-16.9, p=0.002). Only 1 case (0.9%) cor-responded to low level laser therapy.Conclusions: It seems clear that early intervention with conservative surgical combined with pharmacologicalmethods improves the prognosis of ORN.(AU)

A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study / Una nueva clasificación morfológica de la cresta alveolar después de la distracción osteogénesis en pacientes humanos. Un estudio de serie de casos retrospectivo de 17 años

Background: To perform a morphologic classification based on the results of bone augmentation after a distractionosteogenesis.Material and Methods: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range,23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dentalimplants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis andANOVA one-way test were used.Results: Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): widealveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface con-cavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath andrequiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position dueto the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost.Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories Ito IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone heightachieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The im-plants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in categoryIII with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035).Conclusions: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categorieswhich provide a useful basis for decision-making regarding implant placement.(AU)