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AIM: The enamel defects of Molar-Incisor Hypomineralisation (MIH) share clinical characteristics with hypomineralised second primary molars (HSPM) and hypomineralised primary canines (HPC). The main objective of this study is to determine the prevalence of these entities in a population of patients in a hospital dentistry service. The secondary objectives are to know the number and distribution of lesions, classify them according to their degree of severity and to know which dental surfaces are most affected. METHODS: A cross-sectional and observational prevalence study was carried out over a 32-day period, guided by the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD) together with the descriptive study of the lesions. Healthy patients between 30-42 months and who had all erupted teeth were included. RESULTS: Out of a total of 153 patients, 29 presented HSPM (18.95%) and 17 HPC (11.11%). Check-ups were made on 116 second primary molars (SPM) and 116 primary canines (PC), obtaining 81 HSPM (69.82%) and 31 HPC (26.72%). The lesions observed were mild in 60 molars (74.07%) and in 27 canines (87.09%). As for the 405 surfaces checked, 168 showed HSPM (41.48%) and 43 HPC (10.61%). CONCLUSIONS: The prevalence of HSPM and HPC varies depending on the population studied. It was observed that SPM were affected more often than PC, with the occlusal and buccal surfaces being the most affected, and the majority of the lesions presenting a low degree of severity.
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Diente Molar , Odontología Pediátrica , Estudios Transversales , Hospitales , Humanos , PrevalenciaRESUMEN
The aim of this study was to investigate the effect of a probiotic in preventing infections after third molar surgery. Thirty-eight patients were consecutively enrolled to a double-blind randomised placebo-controlled trial. Patients were asked to take one tablet two times a day containing a mixture of Levilactobacillus brevis CECT7480 (KABP-052) and Lactoplantibacillus plantarum CECT7481 (KABP-051) or placebo for the first post-intervention week. The primary outcome was the postoperative infection rate. Secondary outcomes included swelling, eating difficulties and postoperative pain recorded by the patient using a visual analogue scale (VAS) during the first postoperative week. No statistically significant difference in the infection rate between the groups was found; with only three cases of infections reported (one in the probiotic group and two in the placebo group) on the first week. Compared to placebo, treatment with the probiotic showed a significantly higher reduction in pain and eating difficulties scores at 5, 6 and 7 days post-surgery. Swelling values were not significantly different between the groups at any time point. The findings of this pilot study justify a larger study to clarify the possible role of these bacterial strains on the post-operative pain management following third molar surgery.
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Tercer Molar/cirugía , Dolor Postoperatorio/prevención & control , Probióticos/uso terapéutico , Adolescente , Método Doble Ciego , Femenino , Humanos , Lactobacillus , Masculino , Dolor Postoperatorio/etiología , Dolor Postoperatorio/fisiopatología , Proyectos Piloto , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control , Extracción Dental/efectos adversos , Adulto JovenRESUMEN
AIM: Oral and maxillofacial development is influenced by the lingual frenulum and also affects breathing, occlusion, sucking, swallowing, speech, among others. Ankyloglossia in the newborn may result in breastfeeding difficulties: maternal nipple pain and/or erosion or mastitis, poor weight gain and excessively long breastfeeds. The main objective of this work is to study the prevalence of ankyloglossia in newborns with breastfeeding difficulties. MATERIALS AND METHODS: This is a transversal descriptive study of 302 patients, between 0 and 6 months, who attended the hospital as a result of breastfeeding difficulties. All patients with sucking problems and ankyloglossia were included in this study and followed the multidisciplinary treatment protocol made up of the services of Breastfeeding, Speech Therapy and Orofacial Rehabilitation and Oral and Maxillofacial Surgery. RESULTS: 1,102 newborns were seen at the paediatric service of Hospital de Nens, Barcelona (Spain) during 2 years; 302 had breastfeeding difficulties and of these, 171 were diagnosed with ankyloglossia (60 girls and 111 boys). Coryllos Grade 3 ankyloglossia was the most prevalent (59.6%) type; 85 infants (49.7%) were exclusively breastfed and 26 (50.35%) were mixed fed (formula and breastfeeding). Only 43 patients had a family history of tongue-tie (25.1%). CONCLUSION: Ankyloglossia linked to breastfeeding difficulties must be treated by a multidisciplinary team. We have found a high prevalence of the condition since the population studied are newborns with sucking problems. If a frenotomy is necessary, we recommend stimulating suction with myofunctional therapy before and after surgery to avoid scar retraction.
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Anquiloglosia/epidemiología , Anquiloglosia/fisiopatología , Lactancia Materna , Conducta en la Lactancia , Anquiloglosia/rehabilitación , Femenino , Humanos , Lactante , Recién Nacido , Frenillo Lingual/cirugía , Masculino , Terapia Miofuncional , Prevalencia , Factores de Riesgo , España/epidemiologíaRESUMEN
AIM: The main objective was to study supernumerary teeth diagnosed during the routine checkups at the Paediatric Dentistry Service of Hospital de Nens, Barcelona (Spain), for four months. MATERIALS AND METHODS: A transversal, descriptive study, was performed in 1,960 patients, aged 1 to 17 years, visited during routine oral checkups. An intraoral exploration (with intraoral mirror and probe) was performed to all patients, and subjects older than 5 years also underwent panoramic x-ray examination. RESULTS: A total of 33 patients showed supernumerary teeth (1.68%), 22 boys and 11 girls. A total of 10 patients (8 boys/2 girls) had supernumerary teeth in the temporary dentition, 20 patients (12 boys/8 girls) in the permanent dentition and 3 patients (2 boys/1girls) in both temporary and permanent dentition. A total of 46 supernumerary teeth were diagnosed. CONCLUSION: Any alteration in the number of teeth in patients younger than 5 years are difficult to diagnose, as x-rays are usually not taken. We believe that starting at 5 years old, a radiological exploration (panoramic x-ray) has to be carried out as a complement to the clinical examination.
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Diente Supernumerario/epidemiología , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Incisivo/anomalías , Lactante , Masculino , Radiografía Panorámica/estadística & datos numéricos , Factores Sexuales , España/epidemiología , Erupción Dental/fisiología , Diente Primario/anomalías , Diente no Erupcionado/epidemiologíaRESUMEN
The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a "fragment that looks like canine" found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor's crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition.
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Bone-tissue engineering is a therapeutic target in the field of dental implant and orthopedic surgery. It is therefore essential to find a microenvironment that enhances the growth and differentiation of osteoblasts both from mesenchymal stem cells (MSCs) and those derived from dental pulp. The aim of this review is to determine the relationship among the proteins fibronectin (FN), osteopontin (OPN), tenascin (TN), bone sialoprotein (BSP), and bone morphogenetic protein (BMP2) and their ability to coat different types of biomaterials and surfaces to enhance osteoblast differentiation. Pre-treatment of biomaterials with FN during the initial phase of osteogenic differentiation on all types of surfaces, including slotted titanium and polymers, provides an ideal microenvironment that enhances adhesion, morphology, and proliferation of pluripotent and multipotent cells. Likewise, in the second stage of differentiation, surface coating with BMP2 decreases the diameter and the pore size of the scaffold, causing better adhesion and reduced proliferation of BMP-MSCs. Coating oligomerization surfaces with OPN and BSP promotes cell adhesion, but it is clear that the polymeric coating material BSP alone is insufficient to induce priming of MSCs and functional osteoblastic differentiation in vivo. Finally, TN is involved in mineralization and can accelerate new bone formation in a multicellular environment but has no effect on the initial stage of osteogenesis.
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Células Madre Mesenquimatosas/citología , Osteoblastos/citología , Proteína Morfogenética Ósea 2/metabolismo , Diferenciación Celular , Pulpa Dental/citología , Fibronectinas/metabolismo , Humanos , Sialoproteína de Unión a Integrina/metabolismo , Células Madre Mesenquimatosas/metabolismo , Osteoblastos/metabolismo , Osteogénesis , Osteopontina/metabolismo , Tenascina/metabolismoRESUMEN
The potential for osteogenic differentiation of dental pulp mesenchymal stem cells (DPMSCs) in vitro and in vivo has been well documented in a variety of studies. Previously, we obtained a population of cells from human dental pulp called dental pulp pluripotent stem cells (DPPSCs) that could differentiate into mesodermal, ectodermal and endodermal progenies. We compared the osteogenic capacity of DPPSCs and DPMSCs that had been isolated from the same donors (N=5) and cultivated in the same osteogenic medium in 3D (three dimensions) Cell Carrier glass scaffolds. We also compared the architecture of bone-like tissue obtained from DPPSCs and human maxillary bone tissue. Differentiation was evaluated by scanning electron microscopy, whereas the expression of bone markers such as ALP, Osteocalcin, COLL1 and Osteonectin was investigated by quantitative real time polymerase chain reaction (qRT-PCR). We also used calcium quantification, Alizarin red staining and alkaline phosphatase (ALP) activity to compare the two cell types. New bone tissue formed by DPPSCs was in perfect continuity with the trabecular host bone structure, and the restored bone network demonstrated high interconnectivity. Significant differences between DPPSCs and DPMSCs were observed for the expression of bone markers, calcium deposition and ALP activity during osteogenic differentiation; these criteria were higher for DPPSCs than DPMSCs. Both DPPSCs and differentiated tissue showed normal chromosomal dosage after being cultured in vitro and analysed using short-chromosome genomic hybridisation (short-CGH). This study demonstrates the stability and potential for the use of DPPSCs in bone tissue engineering applications.
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Técnicas de Cultivo de Célula/métodos , Pulpa Dental/citología , Células Madre Mesenquimatosas/citología , Osteogénesis , Adolescente , Adulto , Bioensayo , Diferenciación Celular , Proliferación Celular , Separación Celular , Forma de la Célula , Células Cultivadas , Hibridación Genómica Comparativa , Femenino , Humanos , Masculino , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/ultraestructura , Osteoblastos/citología , Osteoblastos/metabolismo , Fenotipo , Células Madre Pluripotentes/citología , Células Madre Pluripotentes/metabolismo , Células Madre Pluripotentes/ultraestructura , Andamios del Tejido , Adulto JovenRESUMEN
OBJECTIVES: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications. MATERIAL AND METHODS: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data. RESULTS: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes. DISCUSSION: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present. CONCLUSIONS: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement.
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Implantación Dental/métodos , Extracción Dental , Humanos , Factores de TiempoRESUMEN
The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods presented a large percentage of apoptotic cells, although large scale production of necrotic cells was not detected. In summary, although rotary surgical instrument and piezoelectric devices are frequently used instruments for oral osteotomy, fresh autogenous bone chips collected from them did not present a viable bone cell source.
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Trasplante Óseo , Maxilar/trasplante , Osteotomía , Recolección de Tejidos y Órganos/métodos , Adulto , Apoptosis , Separación Celular/métodos , Supervivencia Celular , Diseño de Equipo , Femenino , Citometría de Flujo , Técnica del Anticuerpo Fluorescente , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Osteotomía/instrumentación , Proyectos Piloto , España , Instrumentos Quirúrgicos , Recolección de Tejidos y Órganos/instrumentaciónRESUMEN
Potent stem/progenitor cells have been isolated from normal human dental pulps, termed dental pulp stem cells (DPSCs). However, no study has described the presence of stem cell populations in human dental pulp from the third molar with embryonic phenotypes. The dental pulp tissue was cultured in media with the presence of LIF, EGF, and PDGF. In the present study, we describe a new population of pluripotent stem cells that were isolated from dental pulp (DPPSC). These cells are SSEA-4(+), Oct4(+), Nanog(+), FLK-1(+), HNF3beta(+), Nestin(+), Sox2(+), Lin28(+), c-Myc(+), CD13(+), CD105(+), CD3(-), CD45(-), CD90(low), CD29(+), CD73(low), STRO-1(low) and CD146(-). We have investigated by SEM analysis and q-RT-PCR the capacity of DPPSCs to 3D differentiate in vitro using the Cell Carrier 3D glass scaffold into tissues that have similar characteristics to embryonic mesoderm and endoderm layers. These data would support the use of these cells, which are derived from an easily accessible source and can be used in future regeneration protocols for many tissue types that differentiate from the three embryonic layers.
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Pulpa Dental/citología , Células Madre Pluripotentes Inducidas/citología , Tercer Molar , Adolescente , Adulto , Biomarcadores/metabolismo , Diferenciación Celular , Células Cultivadas , Pulpa Dental/metabolismo , Femenino , Humanos , Células Madre Pluripotentes Inducidas/metabolismo , Células Madre Pluripotentes Inducidas/ultraestructura , Masculino , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/ultraestructura , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Andamios del Tejido , Adulto JovenRESUMEN
A case of polymorphous low-grade adenocarcinoma arising in the right nasal cavity of a male patient with previous history of kidney transplantation is reported. The tumor contained extensive areas of undifferentiated carcinoma, probably arising from the low-grade component. This combination of findings has not been previously reported in this variety of salivary gland tumor.