USE OF LOCAL ANESTHETICS WITH A VASOCONSTRICTOR AGENT DURING DENTAL TREATMENT IN HYPERTENSIVE AND CORONARY DISEASE PATIENTS. A SYSTEMATIC REVIEW.

BACKGROUND: Coronary disease and Hypertension are highly prevalent health problems worldwide, with the latter being one of the most common diseases in patients visiting dental clinics. Local anesthetics (LAs) with vasoconstrictor agents (VC) are known to be commonly used in dental practice. For the above-mentioned reasons, dentists should know how to adapt and treat patients with these hazardous conditions. OBJECTIVE: The aim of this study was to find out if the use of local anesthetics (LAs) in combination with vasoconstrictor (VC) agents in dental treatment presents a risk in patient with a known history of Hypertension and/or Coronary disease. MATERIALS AND METHODS: This systematic review was conducted in accordance with The PRISMA guidelines and registered on the PROSPERO database (CRD42020187369). The search strategy was based on Mesh terms, Boolean operator AND, and the PICO model. It was designed to identify all the randomized clinical trials (RCTs) published in the last 30 years, which assessed whether the use of LA with VC agents in dental treatment produces a significant increase/decrease in hemodynamics in patients with known history of Hypertension and/or Coronary disease. The Cochrane Collaboration's tool was used to assess risk of bias of the included RCTs. RESULTS: An initial electronic search resulted in 87 papers; however only 9 RCTs met the inclusion criteria. There was a total of 482 subjects (N = 482), of which 412 had a known history of Hypertension or Coronary disease. CONCLUSIONS: According to the literature reviewed, the use of 1 to 2 cartridges of local anesthetics with 1:80,000, 1:100,000 or 1:200,000 epinephrine in patients with controlled Hypertension and/ or Coronary disease is safe. Randomized clinical trials are essential in determining the safety or risks associated with the use of LAs with VC agents in patients with poorly controlled Hypertension and Coronary disease.

Medication-related osteonecrosis of the jaw associated with implant and regenerative treatments: Systematic review

Background: The aim of this study was to determine if the treatment with bisphosphonates other anti-resorptive and antiangiogenic agents influences the success of regenerative and / or implant treatments. Material and Methods: We reviewed the literature from the last 5 years in the PubMed database, using the following words: "Sinus Floor Augmentation"[Mesh] OR "Dental Implants"[Mesh]) OR "Guided Tissue Regeneration"[Mesh]) AND "Osteonecrosis"[Mesh]. The articles were selected following the inclusion and exclusion criteria and were evaluated using the 22 items of the STROBE declaration. The following PICO clinical question was applied: Does the treatment with agents associated with drug osteonecrosis influence the success of regenerative and implant treatments? Results: The initial search resulted in a total of 27 articles. After eliminating those that did not refer to the topic, were duplicated or did not meet the inclusion / exclusion criteria, a full reading of the articles was made evaluating their methodological quality, obtaining six studies with high methodological quality and two with moderate. Conclusions: The literature regarding this topic is scarce, randomized clinical trials would be necessary to establish protocols relative to implant treatment in patients on antiresorptive treatments. The risk of developing an osteonecrosis associated with the regeneration / implant placement in patients with benign bone diseases is scarce, but it exists and it should not be underestimated. Especially, in the posterior areas of the jaw, if the duration of treatment with BP is greater than 3 years, and if the patient is under therapy with systemic corticosteroids

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Probiotics and oral health: A systematic review

BACKGROUND: Probiotics are microorganisms, mainly bacteria, which benefit the host's health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. OBJECTIVES: To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. MATERIAL AND METHODS: An electronic search in PubMed database with the keywords 'oral health AND probiotics AND dentistry' was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. RESULTS: Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. CONCLUSIONS: The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles

Prevalencia de la pérdida de implantes dentales en una facultad peruana de odontología, entre los años 2001 y 2011 / Prevalence of dental implants loss in a peruvian dental school from 2001 to 2011

Objetivo. Determinar la prevalencia de la pérdida de implantes dentales en una facultad peruana de odontología, entre los años 2001 y 2011. Material y métodos. Estudio descriptivo, retrospectivo, observacional y transversal. Se observaron 431 historias clínicas de pacientes atendidos en la maestría en periodoncia de la USMP, entre los años 2001 y 2011. Fueron colocados 1136 implantes durante ese periodo; estos se agruparon según edad y género del paciente, y maxilar y año en que se colocaron. Se determinó la prevalencia de la pérdida de los implantes dentales, respecto a la cantidad total concerniente a cada categoría. Resultados. La ocurrencia de pérdida de implantes dentales fue de 1,85%, respecto a la cantidad total de implantes dentales colocados. Específicamente, de 1,88% en el maxilar superior, 2,30% en el maxilar inferior, 1,80% en pacientes de género masculino, y 1,57% en pacientes de género femenino. Según la edad del paciente fueron de 2,51% en pacientes sobre los 60 años de edad, 1,20% en pacientes entre los 40 y 59 años, y de 2,60% en pacientes menores de 40 años. La pérdida de implantes dentales producida en el año 2010 fue de 7,98%, siendo la más alta durante todo el periodo estudiado. Conclusiones. Se encontró una mayor prevalencia de pérdida de implantes dentales en el maxilar inferior, en pacientes del género masculino, y en pacientes menores de 40 años de edad. Finalmente, la prevalencia de pérdida de implantes dentales encontrada fue baja respecto al total de implantes dentales colocados en ese periodo.

Objective. To determine the prevalence of dental implants loss in a Peruvian dental school, from 2001 to 2011. Material and methods. A cross, observational, retrospective, descriptive study. 431 medical records of patients attended at the USMPs master in periodontics were seen, from 2001 to 2011. 1136 implants were placed during this period; these were grouped according to age and sex of the patient, and maxillary and year in which they were placed. The prevalence of dental implants loss was determined in respect to the total cases of each concerned category. Results. The prevalence of dental implants loss was 1,85%, relative to the total amount of dental implants placed. Specifically, 1,88% in the maxilla, 2,30% in the mandible, 1,80% in male patients, and 1,57% in female patients. Depending on patients age, it was 2,51% in patients above 60 years old, 1,20% in patients aged from 40 to 59, and 2,60% in patients younger than 40. The dental implants loss produced in 2010 was 7,98% being this the highest. Conclusions. We found a higher prevalence of dental implants loss in the mandible, in male patients, and in patients younger than 40 years old. Finally, the prevalence of dental implants loss was low compared to the total dental implants placed in that period.