Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study.

BACKGROUND: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferior alveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predict neurosensory alterations from preoperative imaging. MATERIAL AND METHODS: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Prior to surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance. Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its contact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) were recorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-square test, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI) of 95%. RESULTS: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramic radiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more types of superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in only three cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations were observed in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed. CONCLUSIONS: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTM extraction by means of preoperative imaging did not show a significant statistical correlation with post-surgical incidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predict an increased risk of IAN injury.

Viruela del mono: una nueva amenaza para los dentistas. Vías de contagio / Monkeypox: a new threat to dentists. Contagion routes

El propósito de esta revisión es resumir la virología del virus de la viruela del mono, su transmisión, epidemiología, manifestaciones clínicas, manifestaciones orales, tratamiento y las posibles implicaciones para los dentistas. Se analizan los riesgos de transmisión a trabajadores de la salud. Un paciente asintomático o con síntomas tempranos no específicos puede acudir a la clínica dental para tratamiento odontológico. Los pacientes contagiados asintomáticos o con contacto con el virus, si el tratamiento no es urgente, deben respetar 21 días de cuarentena tras la exposición. Las gotículas respiratorias y los aerosoles a los que estamos expuest os los odontólogos al atender a los pacientes son una de las principales vías de transmisión.Sin embargo, la profesión odontológica está preparada para este nuevo reto ya que aún estamos aplicando todas las medidas de prevención aprendidas con la pandemia de COVID-19 (mascarillas FFP2, gafas, guantes, ventilación, etc) (AU)

The purpose of this review is to summarize the virology of the monkeypox virus, transmission, epidemiology, clinical features, oral manifestations, treatment, and possible implications for dentists. The risks of transmission to health workers are analyzed. A patient with no symptoms or early non-specific symptoms may come to the dental clinic for treatment. These patients or those who have been in contact with the virus, if the treatment is not urgent, must wait 21 days after exposure, which is the quarantine time. Respiratory droplets and aerosols to which dentists are exposed when caring for patients are one of the main routes of transmission. The dental profession is prepared for this new challenge as we are still applying all the prevention measures learned from the COVID-19 pandemic (FFP2 masks, goggles, gloves, ventilation, etc.) (AU)

Valoración de las diferentesopciones de tratamientoen el manejo clínico delSíndrome de Boca Ardiente(SBA) / ASSESSMENT OF THE DIFFERENT TREATMENT OPTIONS IN THE CLINICAL MANAGEMENT OF BURNING MOUTH SYNDROME (BMS)

Introducción: El Síndrome de Boca Ardiente (SBA), cuya definición y fisiopatología continúan siendo un tema de debate actual, tampoco cuenta con unas pautas universalmente aceptadas para su tratamiento. Por ello, el objetivo del presente trabajo es presentar una valoración de los distintos tratamientos para el manejo clínico de los pacientes con SBA en base a la evidencia científica disponible, para que se valore su aplicación en cada caso concreto. Material y métodos: Se realizó una búsqueda en las bases de datos de PubMed (MEDLINE) y The Cochrane Library (Wiley) sobre los distintos tratamientos del SBA. Con los datos obtenidos respecto a la efectividad de cada modalidad terapéutica y los efectos adversos que produce, se han elaborado tres diferentes líneas de tratamiento. Resultados: En la primera línea de tratamiento encontramos los chicles, la LLLT (terapia con láser de baja potencia, en inglés), el protector lingual, la psicoterapia, clonazepam tópico, ALA (ácido alfa-lipoico, en inglés) y la Catauma. Conclusión: Hacen falta más investigaciones que brinden una orientación suficiente a los clínicos sobre las modalidades terapéuticas efectivas y que permitan establecer una correcta estrategia en el manejo del SBA (AU)

Introduction: The definition and pathophysiology of Burning Mouth Syndrome (BMS) remain a subject of ongoing debate, and there are no universally accepted guidelines for its treatment. Therefore, the objective of this paper is to present an assessment of the different treatments for the clinical management of patients with BMS on the basis of the available scientific evidence, so that their application in each specific case can be assessed. Material and methods: A search was carried out in the PubMed (MEDLINE) and The Cochrane Library (Wiley) databases on the different treatments for BMS. With the data obtained regarding the effectiveness of each therapeutic modality and the adverse effects it produces, three different lines of treatment have been developed. Results: The first line of treatment includes chewing gum, LLLT (low level laser therapy), tongue guard, psychotherapy, topical clonazepam, ALA (alpha lipoic acid) and Catauma. Conclusion: Further research is required to provide sufficient guidance to clinicians on effective therapeutic modalities and to establish a correct strategy in the management of BMS (AU)

Elevación de seno conBetafosfato Tricálcico yposterior colocación deimplantes. A propósito deun caso / Sinus lift with tricalcium beta-phosphate and subsequent implant placement. Case report

La extracción o pérdida dental supone la remodelación del alveolo y una pérdida progresiva del hueso alveolar residual. Esta disminución en altura, debido a la presencia delseno maxilar en el sector posterosuperior, puede comprometer la disponibilidad ósea adecuada para la colocación de implantes. Como solución a esto, surge la técnica de elevación de seno. En esta técnica, se emplean diversos materiales de injerto, entre los que se encuentran el betafosfatotricálcico (b-TCP). Este material presenta propiedades osteoconductivas y osteoinductivas. Además, se reabsorbe más fácil que otros sustitutos óseos y es fácilmente reemplazado por nuevo hueso. Se ha comparado su comportamiento clínico con otros materiales de injerto, sin encontrar diferencias significativas. Además, a 10 años, los implantes colocados en elevaciones de seno realizadas con b-TCP han mostrado altas tasas de supervivencia. Caso clínico. Se presenta el caso clínico de una paciente, mujer de 52 años de edad, sin antecedentes médicos de interés. Acude a consulta por dolor en el 26. Tras la exploración diagnóstica radiológica e intrabucal se aconsejó a la paciente la extracción del 26. Ocho meses después, y realizando un estudio con CBCT se informó a la paciente sobre la posibilidad de rehabilitación con implantes, previa cirugía de elevación sinusal. Se realizó la elevación sinusal con b-TCP como material de injerto. Pasados tres meses, se procedió a la colocación de tres implantes, adquiriendo estos una buena estabilidad primaria Discusión y conclusiones. Se utilizan diversos materiales de injerto en la técnica de elevación sinusal, injertos de hueso autólogo, xenoinjertos e injerto aloplásticos. Se ha comparado el comportamiento clínico del b-TCP con otros materiales de injerto sin mostrar diferencias significativas. Por otro lado, se ha estudiado un periodo de espera menor a 6 (AU)

Tooth extraction or loss involves alveolar remodelling and progressive loss of residual alveolar bone. This reduction in height, due to the presence of the maxillary sinus in the posterosuperior sector, can compromise adequate bone availability for implant placement. The sinus lift technique has emerged as a solution to this problem. In this technique, various grafting materials are used, including beta-phosphatidic acid (b-TCP). This material has osteoconductive and osteoinductive properties. In addition, it is more easily resorbed than other bone substitutes and is easily replaced by new bone. Its clinical behaviour has been compared with other graft materials, without finding significant differences. In addition, at 10 years, implants placed in sinus lifts performed with b-TCP have shown high survival rates. Clinical case: The clinical case of a 52-year-old female patient with no medical history of interest is presented. She went for consultation due to pain in tooth 26. Following the radiological and intraoral diagnostic examination, the patient was advised to have tooth 26 extracted. Eight months later, and after a CBCT study, the patient was informed about the possibility of rehabilitation with implants, following sinus lift surgery. The sinus lift was performed with b-TCP as graft material. After three months, three implants were placed, acquiring a good primary stability. Discussion and conclusions: different graft materials are used in the sinus lift technique, autologous bone grafts, xenografts and alloplastic grafts. The clinical performance of b-TCP has been compared with no significant differences found. Furthermore, a waiting period of less than 6 months has been studied for the placement of implants. These implants showed high primary stability and survival rates of 99-100%. Therefore, b-TCP is a safe material for sinus lifts and allows the placement of implants in a healing time of less than 6 months (AU)

Medication related to pigmentation of oral mucosa.

BACKGROUND: The diagnosis of oral melanotic lesions is, more often than not, challenging in the clinical practice due to the fact that there are several reasons which may cause an increase in pigmentation on localized or generalized areas. Among these, medication stands out. MATERIAL AND METHODS: In this work, we have carried out a review in the reference pharma database: Micromedex® followed by a review of the scientific published literature to analyse coincidences and possible discrepancies. RESULTS: Our findings show that there are several prescription drugs that can cause pigmented lesions in the oral mucosa. This must be known by clinicians in order to properly diagnose pigmented lesions. We have identified a set of 21 medicaments which cause these lesions, some of which are used frequently in the clinic, such as Metronidazole, Amitriptyline, conjugated oestrogens and Chlorhexidine gluconate. We also found discrepancies with the data published in specialized literature, some of which wasn't reflected in the Summary of Product Characteristics. CONCLUSIONS: Our work highlights the importance of the proper communication of adverse drug reactions (ADR) by health professionals in order to provide thorough and accurate information and diagnosis.