OsteoMac: A new player on the bone biology scene.

The knowledge of bone biology has undergone major advances in recent decades. In bone, resorbing osteoclasts have classically been described as tissue-resident macrophages, however, it is currently known that a new subtype of macrophages, called OsteoMacs, are specialised bone-resident macrophages, which, depending on certain conditions, may play an important role not only in bone homeostasis, but also in promoting pro-anabolic functions or in creating an inflammatory environment. There is growing evidence that these osteal macrophages may influence the development of bone-loss diseases. It is essential to understand the biological bases underlying bone physiological processes to search for new therapeutic targets for bone-loss diseases, such as osteoporosis, rheumatoid arthritis, or even periodontal disease. This narrative review provides an update on the origin, characterisation, and possible roles of osteoMacs in bone biology. Finally, the potential clinical applications of this new cell in bone-loss disorders are discussed.

Antiagregantes plaquetarios y cirugía oral: retirar o no retirar, esa es la cuestión / Antiplatelet therapy and oral surgery: to discontinue or not, that is the question

Las enfermedades cardiovasculares constituyen una de las patologías sistémicas más prevalentes en el mundo occidental. Muchos pacientes cardiópatas han tenido un episodio coronario agudo y están siendo tratados con antiagregantes plaquetarios. La terapia con estos fármacos puede suponer un reto para el odontólogo, que debe enfrentarse a un importante dilema: o mantener el fárma co, con el consiguiente riesgo hemorrági co, o retirarlo, con la posibilidad de que se produzcan complicaciones tromboembólicas, suponiendo un riesgo para la vida del paciente. Por ello, los odontólogos deberíamos conocer cuál debe ser el manejo de este tipo de pacientes ante la perspectiva de realizar un procedimiento quirúrgico en la cavidad oral o incluso una simple extracción dentaria. Los objetivos de esta revisión narrativa son, en primer lugar, recordar la fisiología plaquetaria y los mecanismos de forma ción del trombo plaquetario; en segundo lugar, profundizar en los mecanismos de acción de los diferentes fármacos antia gregantes plaquetarios; y, en tercer lugar, ya que no existen guías clínicas al res pecto, realizar un abordaje crítico de las pautas existentes para el manejo odonto lógico de este tipo de pacientes, en aras de prevenir la aparición de posibles com plicaciones, no solo locales, sino, lo que es más importante, complicaciones sisté micas. En estos casos, antes de retirar la terapia antiagregante, convendría sope sar el riesgo hemorrágico versus el riesgo de generar un nuevo episodio tromboem bólico, como puede ser la trombosis dstent o la recidiva del accidente coronario agudo, eventos que podrían poner en riesgo la vida del paciente (AU)

Cardiovascular disease is one of the most prevalent systemic pathologies worldwide; those patients usually have had an acute coronary event which is treated with antiplatelet therapy. These drugs represent a challenge for the dentist, who must face a major dilemma: either maintain the drug, with the consequent bleeding risk, or withdraw it, with the possibility of thromboembolic complications, entailing a risk to the patient’s life. Therefore, dentists should know how to manage patients treated with these drugs when performing a surgical procedure or even a simple tooth extraction. The objectives of this narrative review are, firstly, to recall platelet physiology and the mechanisms of platelet thrombus formation; secondly, to go more deeply into the mechanisms of action of the different antiplatelet drugs; and thirdly, since there are no clinical guidelines on this topic, to critically review the existing guidelines related to the dental management, in order to prevent the appearance of possible complications, not only local, but more importantly, systemic complications. In these cases, before interrupting antiplatelet therapy,the risk of bleeding should be evaluated against the risk of generating a new thromboembolic episode, such as stent thrombosis or recurrence of the acute coronary accident, events that could put the patient’s life at risk (AU)

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)

Periosteal Pocket Flap technique for lateral ridge augmentation. A comparative pilot study versus guide bone regeneration.

BACKGROUND: Implant rehabilitation of posterior mandibular defects is frequently associated to a horizontal bone loss. There exist several regenerative techniques to supply this bone deficiency, one of which is the Periosteal Pocket Flap Technique (PPF) proposed by Steigmann et al. to treat small horizontal bone defects. The present study proposes a modification of this technique based on the concurrent use of PPF with the use of xenogeneic and autologous bone and Plasma Rich in Growth Factors (PRGF). The aim of this study is to evaluate clinical and radiographic outcomes of the PPF with the use of xenogeneic and autologous bone and PRGF in comparison with conventional Guided Bone Regeneration (GBR) procedures. METHODS: Nine patients were enroled in the study (7 women and 2 men, mean age: 53 ± 2.74 years) and allocated to PPF or GBR. In both groups implant placement was performed simultaneously to bone regeneration. Preoperative CBCT scans were performed for each patient. Surgical time and postoperative pain were recorded, as well as tissue healing. Moreover, horizontal bone gain (mm), graft surface area (mm2) and graft volume (mm3) were evaluated. RESULTS: Nine surgeries were performed: 6 PPF and 3 GBR. Regarding clinical outcomes, operative time was significative greater in GBR group than in PPF group (51.67 ± 3.51 min vs. 37 ± 5.69 min; p = 0.008). Postoperative pain was higher in GBR compared to PPF (p = 0.011). Regarding radiographical results, there were not significant differences in horizontal bone gain (PPF: 9.43 ± 1.8 mm; GBR: 9.28 ± 0.42 mm), surface area (PPF: 693.33 ± 118.73 mm2; GBR: 655.61 ± 102.43 mm2), and volume (PPF: 394.97 ± 178.72 mm3; GBR: 261.66 ± 118 mm3) between groups. CONCLUSIONS: This prospective study demonstrates that the combination of autograft/xenograft and PRGF in PPF technique is a simpler, cheaper, and faster technique than GBR technique for achieving moderate lateral bone augmentation in implant treatment. Future randomised clinical studies are needed to confirm the results.

Salivary LDH in oral cancer and potentially malignant disorders: A systematic review and meta-analysis.

OBJECTIVES: To evaluate whether salivary lactate dehydrogenase (LDH) levels are increased in patients with oral cancer (OC) or oral potentially malignant disorders (OPMD) when compared to a healthy control group (CG). MATERIAL AND METHODS: We conducted a comprehensive search of specialized databases (PubMed/MEDLINE, The Cochrane Library, Web of Science, Scopus, and OpenGrey), including observational analytical studies evaluating the salivary LDH levels (in UI/L or µ/L) in OC or OPMD patients and compared them with a CG. RESULTS: Thirteen case-control studies were included. A total of 755 patients were evaluated, including 303 OC cases, 149 OPMD cases, and 303 controls. The meta-analysis showed that LDH levels were higher within the OC group than the CG (SMD 9.49; 95% CI 6.97-12; p = .00001). Patients with oral leucoplakia (SMD 11.67; 95% CI 1.01-22.33; p = .03) and oral submucous fibrosis (SMD 25.83; 95% CI -1.74-53.40; p = .07) also presented higher levels than the CG. In addition, OC patients had higher salivary LDH levels than oral leucoplakia patients (SMD 5.62; 95% CI 2.14-9.11; p = .002). Heterogeneity was high across all the evaluated studies. CONCLUSIONS: The determination of salivary LDH may be a useful method for screening and tracking OC and OPMD, but new protocolized studies are required to establish precise cutoff values.

Evaluación de la cantidad de hueso neoformado al emplear materiales de relleno en elevación de seno maxilar con abordaje lateral / Evaluation of the amount of new bone formed using graft materials in maxillary sinus augmentation with lateral window technique

Introducción: La cirugía de elevación de seno es un procedimiento realizado en cirugía bucal para conseguir aumentar el volumen óseo en sectores posteriores de maxilares atróficos y así poder rehabilitar la zona con implantes dentales. El objetivo de esta revisión es conocer la cantidad de hueso neoformado, en función del tipo de biomaterial empleado, en la técnica de elevación de seno mediante técnica abierta. Material y métodos: Para cumplir con dicho objetivo se ha llevado a cabo una búsqueda bibliográfica en las principales bases de datos (PubMed/MEDLINE, Cochrane Library, Scopus y Web of Science). Resultados: 18 artículos han sido incluidos para su comparación y discusión en esta revisión. En todos ellos, el estudio histomorfométrico de los materiales de injerto en la elevación de seno fue llevado a cabo, permitiendo conocer la cantidad (%) de hueso nuevo formado con cada biomaterial. Los materiales de injerto empleados son diversos, encontrando hueso autólogo, aloinjerto, xenoinjerto y materiales sintéticos; combinación de algunos de estos materiales entre sí e incluso con concentrados plaquetarios, proteína morfogenética ósea y células madre mesenquimales. Conclusiones: El empleo de hueso autólogo como biomaterial en la cirugía de elevación de seno maxilar mediante técnica abierta, obtiene el mayor porcentaje de hueso nuevo formado. Sin embargo, los resultados obtenidos son también satisfactorios empleando materiales de injerto de diferente naturaleza. (AU)

Introduction: Sinus augmentation is a common procedure performed in dental practice to increase bone volume in atrophic posterior maxilla in order to rehabilitate this area with dental implants. The aim of this review is to know the amount of new bone formation in sinus lift surgery by open technique depending of the biomaterial used. Material and methods: A comprehensive literature search was conducted in the main databases (PubMed/MEDLINE, Cochrane Library, Scopus and Web of Science). Results: The search yielded 18 results that met the inclusion criteria. In all of them, the histomorphometric study of the materials grafted was studied, allowing to know the amount of new bone formed with each biomaterial. The graft materials used are diverse, finding autologous bone, allograft, xenograft and alloplastic materials. Furthermore, it is used the combination of some of these materials with each other and even with platelet concentrates, bone morphogenetic proteins and mesenchymal stem cells. Conclusions: The use of autologous bone as biomaterial in maxillary sinus lift surgery by open technique obtains the highest percentage of new bone formed. However, the results obtained in sinus lift surgery are satisfactory using graft materials of different nature. (AU)

Socket shield technique: A systematic review of human studies.

BACKGROUND AND PURPOSE: Alveolar bone resorption after dental extraction frequently leads to situations in which long-term function and esthetic success of rehabilitations with dental implants is a challenge. Socket shield has been described as an alternative technique to maintain the alveolar ridge when placing immediate implants. The aim of this review is to evaluate the medium- and long-term clinical outcomes of the socket shield technique in human studies. MATERIAL AND METHODS: This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Cochrane Collaboration tool, the Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. RESULTS: Six articles were included in this review. The studies analysed showed lower rates of horizontal and vertical alveolar bone resorption, better maintenance of the buccal plate, less marginal bone loss and better esthetic results than simple placement of immediate implants. However, a lack of homogeneity was found in evaluation methods of the different outcomes, surgical procedures and prosthetic management. CONCLUSIONS: Based on the results of this review, it is possible to suggest that socket shield technique could be a good alternative in terms of alveolar bone maintenance, marginal bone stability and aesthetic outcomes in immediate implant treatment. However, it is not possible to recommend this technique as an alternative treatment with the same long-terms predictability as conventional immediate implants.