Evaluación de la ansiedad en los estudiantes de Odontología durante la pandemia de la COVID-19 / Assessment of anxiety in dental students during the Covid-19 pandemic

La pandemia por COVID-19 ha tenido un gran impacto en la actividad dental, y grandes repercusiones en la educa ción dental. El objetivo de este estudio fue analizar la presencia de ansiedad en los estudiantes de odontología durante el primer confinamiento por la COVID-19, y estudiar su relación con factores sociode mográficos, la sintomatología relacionada con la enfermedad, la realización de cua rentena y el miedo a contraer la enferme dad.Se realizó un estudio observacional y transversal con un cuestionario donde se registraron los datos marcados en los objetivos y se realizó la escala de ansie dad generalizada (GAD-7). El análisis estadístico se realizó mediante la prue ba Chi-cuadrado de Pearson, la prueba exacta de Fisher y un análisis de regre sión lineal multivariante.Los resultados mostraron unos niveles elevados de ansiedad, siendo los estudiantes ≥26 años, las mujeres y los que guardaron cuarentena los que presentaron mayor ansiedad. La realización de pruebas diagnósticas supuso una disminución del nivel de ansiedad.Los estudiantes de odontología se vieron directamente afectados durante el confinamiento, siendo necesario implementar medidas como la realización de estudios que valoren su evolución a lo largo de los siguientes cursos, desde el punto de vista de su salud mental y desarrollo curricular (AU)

Dental activity and education have been severely affected by the COVID-19 pandemic. The aim of the present study was to evaluate the anxiety levels in dental students during the first confinement due to COVID-19, and to analyze its relationship with sociodemographic factors, disease-related symptoms, the carrying out of quarantine and fear of contracting the disease. An observational and cross-sectional study was carried out through a questionnaire, which the previously mentioned data were recorded and anxiety was evaluated using the generalized anxiety scale (GAD-7). Statistical analysis was performed using Pearson’s Chi-square test, Fisher’s exact test, and multivariate linear regression analysis. The results showed high levels of anxiety, furthermore, the students ≥26 years old, women and those who were in quarantine had the highest anxiety. Diagnostic testing led to a decrease in the level of anxiety. Dentistry students were directly affected during the confinement, and it is necessary to implement measures such as studies to assess their evolution throughout the following courses, from the point of view of their mental health and curricular development (AU)

Plasma rich in growth factors (PRGF) and leukocyte-platelet rich fibrin (L-PRF): comparative release of growth factors and biological effect on osteoblasts.

PURPOSE: To compare the release of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-I) and interleukin 1ß (IL-1ß) of plasma rich in growth factors (PRGF) and leucocyte platelet-rich fibrin (L-PRF) and to evaluate their biological implication in osteoblasts. METHODS: Blood from 3 healthy volunteers was processed into PRGF, immediate L-PRF (L-PRF 0') and L-PRF 30 min after collection (L-PRF-30') and a control group. Growth factors release were analyzed at 7 times by ELISA. Cell proliferation, collagen-I synthesis and alkaline phosphatase activity were assessed in primary cultures of human osteoblasts. RESULTS: A slower controlled release of IGF-I, VEGF and PDGF was observed in the PRGF group at day 14. A higher synthesis of type I collagen was also quantified in PRGF. L-PRF released significantly higher amounts of IL-1ß, that was almost absent in the PRGF. CONCLUSIONS: The addition of leukocytes dramatically increases the secretion of proinflammatory cytokines, which are likely to negatively influence the synthesis of type I collagen and alkaline phosphatase (ALP) by osteoblasts.

Effects of GH on the Aging Process in Several Organs: Mechanisms of Action.

In order to investigate the possible beneficial effects of GH administration on the aging process, 24-month-old rats of both sexes and 10-month-old SAMP8 mice were used. Male rats showed increased fat content and decreased lean body mass together with enhanced vasoconstriction and reduced vasodilation of their aortic rings compared to young adult animals. Chronic GH treatment for 10 weeks increased lean body mass and reduced fat weight together with inducing an enhancement of the vasodilatory response by increasing eNOS and a reduction of the constrictory responses. Old SAMP8 male mice also showed insulin resistance together with a decrease in insulin production by the endocrine pancreas and a reduced expression of differentiation parameters. GH treatment decreased plasma levels and increased pancreatic production of insulin and restored differentiation parameters in these animals. Ovariectomy plus low calcium diet in rabbits induced osteoporosis Titanium implants inserted into these rabbit tibiae showed after one month lesser bone to implant (BIC) surface and bone mineral density (BMD). Local application of GH in the surgical opening was able to increase BIC in the osteoporotic group. The hippocampus of old rats showed a reduction in the number of neurons and also in neurogenesis compared to young ones, together with an increase of caspases and a reduction of Bcl-2. GH treatment was able to enhance significantly only the total number of neurons. In conclusion, GH treatment was able to show beneficial effects in old animals on all the different organs and metabolic functions studied.

Effects of locally applied Insulin-like Growth Factor-I on osseointegration

Background: The aim of this study was to assess the effect of local application of IGF-I on osseointegration of dental implants placed in osteoporotic bones. Material and Methods: 16 rabbits were randomly distributed into two groups: eight animals were ovariectomized and fed a low-calcium diet for six weeks, in order to induce experimental osteoporosis, and the others were sham-operated and fed a standard diet. A titanium implant was inserted into the tibiae in both groups. In half of the rabbits, 4 μg of IGF-I was applied into the ostectomy, prior to the implant insertion. A total of 32 implants were placed. Animals were sacrificed two weeks after surgery and decalcified samples were processed for Bone-To-Implant Contact (BIC) and Bone Area Density (BAD) measurements. Analysis of variance (ANOVA) was used for statistical evaluation. P < 0.05 was considered to be significant. Results: Ovariectomy induced statistically significant lower BAD values (p = 0.008) and a tendency towards lower BIC values when compared osteoporotic and healthy groups. The administration of 4 μg of IGF-I did not produce statistically significant differences neither on BIC nor on BAD values, neither in the osteoporotic animals nor in healthy. Conclusions: Within the limitations of this experimental study, local administration of 4 μg of IGF-I was not able to induce any changes in the osseointegration process two weeks after surgery, neither in healthy rabbits nor in the osteoporotic group

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Nasal Floor Elevation for Implant Treatment in the Atrophic Premaxilla: A Within-Patient Comparative Study.

BACKGROUND: There is a lack of evidence regarding success of implants placed in atrophic premaxilla using the nasal floor elevation technique. PURPOSE: This study aimed to compare implants placed in augmented bone in the anterior maxilla using the nasal floor elevation technique with implants placed in the maxillary sinus region using the sinus lift technique. MATERIALS AND METHODS: A within-patient controlled clinical trial was performed on 14 patients receiving 78 implants. The implants were assigned to one of two study groups on the basis of implant location. A total of 37 implants were placed in the nasal fossa region (NF group), and 41 implants were placed in the maxillary sinus region (MS group). Patients were followed up for 4.5 ± 2.2 years, with comparable follow-up times for implants in NF and MS groups (4.7 ± 2.1 and 4.9 ± 2.1 years, respectively; p > .05). Treatment outcomes were assessed and statistically analyzed. RESULTS: Implant success rate was 89.2% in the NF group and 95.0% in the MS group, with no statistically significant difference between them (p > .05). No nasal or sinus membrane perforation or other complications were reported within the follow-up period. Significant differences were found between the two groups in terms of residual bone height, augmented bone height, and implant diameter. CONCLUSIONS: Nasal floor elevation is an effective and safe procedure that can be used for implant placement in atrophic premaxilla with success rates that are comparable to those of implants placed in the maxillary sinus.

Effects of localmelatonin application on post-extraction sockets after third molar surgery. A pilot study

OBJECTIVES: The purpose of this study was to assess the anti-inflammatory, analgesic and osteogenic early effects of melatonin on post-extraction sockets of patients requiring third molars extraction. Study DESIGN: A randomized, triple-blind clinical trial was made using a split-mouth design. Both lower third molars of 10 patients were extracted and 3 mg of local melatonin or placebo were applied. Concentrations of interleukin-6 and nitrotyrosine were determined on samples of the clot from the socket by independent ELISA tests. Radiographic bone density was evaluated by measuring Hounsfield Units in panoramic and cross sections obtained by digital scanner. Statistycal analysis by Kolmogorov-Smirnov test was performed for ELISA data. Bone density was analyzed by Shapiro-Wilk test. Subsequently t test was applied. P<0.05 was considered to be significant. RESULTS: The concentration of interleukin-6 increased with the application of melatonin without statistically below to the detectability pattern (<0.001 nM) in Optic Density curve. Bone density in panoramic sections at socket after melatonin application showed no significant difference (561.98 ± 105.92 HU vs 598.82 ± 209.03 HU). In cross sections, bone density in the alveolar region showed no significant difference(377.42 ± 125.67 HU vs 347.56 ± 97.02 HU). CONCLUSIONS: Within the limitations of this pilot study, no differences with the application of melatonin were found in terms of the concentration of interleukin-6 and bone density in post-extraction socket of retained mandibular third molars

Effects of local melatonin application on post-extraction sockets after third molar surgery. A pilot study.

OBJECTIVES: The purpose of this study was to assess the anti-inflammatory, analgesic and osteogenic early effects of melatonin on post-extraction sockets of patients requiring third molars extraction. STUDY DESIGN: A randomized, triple-blind clinical trial was made using a split-mouth design. Both lower third molars of 10 patients were extracted and 3 mg of local melatonin or placebo were applied. Concentrations of interleukin-6 and nitrotyrosine were determined on samples of the clot from the socket by independent ELISA tests. Radiographic bone density was evaluated by measuring Hounsfield Units in panoramic and cross sections obtained by digital scanner. Statistical analysis by Kolmogorov-Smirnov test was performed for ELISA data. Bone density was analyzed by Shapiro-Wilk test. Subsequently t test was applied. P<0.05 was considered to be significant. RESULTS: The concentration of interleukin-6 increased with the application of melatonin without statistically significance (361.32 ± 235.22 pg/ml vs 262.58 ± 233.92 pg/ml). Nitrotyrosine concentrations showed values below to the detectability pattern (<0.001 nM) in Optic Density curve. Bone density in panoramic sections at socket after melatonin application showed no significant difference (561.98 ± 105.92 HU vs 598.82 ± 209.03 HU). In cross sections, bone density in the alveolar region showed no significant difference(377.42 ± 125.67 HU vs 347.56 ± 97.02 HU). CONCLUSIONS: Within the limitations of this pilot study, no differences with the application of melatonin were found in terms of the concentration of interleukin-6 and bone density in post-extraction socket of retained mandibular third molars.

Membranes over the lateral window in sinus augmentation procedures: a two-arm and split-mouth randomized clinical trials.

OBJECTIVE: This study evaluates whether or not, among other factors, membrane-coverage of antrostomy defects improves implant survival in sinus augmentation procedures. MATERIALS AND METHODS: We performed a two-arm and split-mouth randomized controlled clinical trial on 104 and 5 patients respectively. In the two-arm study, antrostomy defects were membrane-covered in 66 procedures and uncovered in 69, before placing a total of 265 implants that were followed up for 1 year. In the split-mouth study, following bilateral sinus augmentation, antrostomy defects were membrane-covered on one side and left uncovered on the contra-lateral. Bone biopsies from each sinus were histologically analysed 6 months later. RESULTS: In the two-arm study, implant survival rates were similar (p = 0.08) in the membrane-covered (96.1%) and uncovered (94.2%) groups. In the split-mouth study, bone augmentation was similar in both groups (p = 0.52). Delayed implant placement (p = 0.04), thick Schneider's membrane (≥2 mm) (p < 0.01), treatment for hypertension (p = 0.04) and non-smoking (p = 0.01) seemed to be associated with lower risk of implant failure. CONCLUSIONS: Implant survival in sinus lifting procedures could be influenced significantly by timing of implant placement, Schneider's membrane thickness, antihypertensive treatment and smoking habits, but not by antrostomy membrane coverage.