Eating Behaviours, Oral Hygiene, and Caries in a Population of Spanish Children with Divorced Parents: A Cross-Sectional Study.

Dental caries are a public health problem that is influenced by dietary habits. This cross-sectional study aimed to investigate the feeding and hygiene habits that divorced parents exercise over their children compared to non-divorced parents, and how this may influence the rate of caries in their children. The data of participants (n = 174) with an average age of 12.17 ± 2.04 years were examined to assess the mean decayed/missing/filled teeth (DMFT) index, and they were asked questions about their oral hygiene habits. At the same time, their parents answered the parental feeding style questionnaire. A moderation analysis was conducted with family control of oral hygiene habit levels as an independent variable, decayed teeth as a dependent variable, and feeding control as a moderating variable. Results showed that divorced parents were found to have more problems in controlling their children's hygiene and dietary habits, have less control over their children's feeding, and make more use of instrumental feeding, which led to children of divorced parents having more caries. Despite the limitations linked to the cross-sectional design of the study and considering both the convenience sample and the impossibility of controlling for all aetiological factors linked to the development of caries, it can be concluded that children of divorced parents have an increased risk of tooth decay. However, parental controlled feeding interferes with the effect of family controlled oral hygiene habits on the decayed tooth, decreasing the rate of caries.

Manejo integral quirúrgico y ortodóntico del autotrasplante de un canino incluido en maxilar. A propósito de un caso / Integral surgical and orthodontic treatment of an autotransplanted maxillary canine: case report

Introducción: El tratamiento de caninos incluidos maxilares, se basa prin cipalmente en la tracción ortodóntica. Cuando esta fracasa, se suele plantear como alternativa la extracción del canino y la posterior colocación de un implante dental. El autotrasplante se plantea como opción de tratamiento siempre que la extracción íntegra del canino sea viable ya que aporta muchas ventajas como la capacidad de ser movilizados con ortodon cia.Caso clínico: Se describe un caso clínico en el que se realizó un autotrasplante de un canino incluido tras haber fracasado la tracción en una paciente joven. Tras realizar una cirugía regenerativa, fue sometida a tratamiento de ortodoncia y restaurador. Después de 20 meses de seguimiento la paciente se encuentra asintomática, sin signos de movilidad ni reabsorción y con un estable estado periodontal de dicho diente.Conclusión: A pesar de las limitaciones, se puede concluir que siempre que sea viable, el autotrasplante puede constituir una alternativa válida cuando la tracción ortodóntica no funciona, principalmente en pacientes jóvenes en los que no están indicados los implantes (AU)

Introduction: The main treatment of impacted canines is orthodontics. In case of failure, extraction of the canine and the subsequent placement of a dental implant is given as an alternative. Autotransplantation is considered a treatment option as long as the full extraction of the canine is viable, because it provides many advantages as the ability of mobilization with orthodontics Case report: Description of a clinical case in which an autotransplantation of an included canine was carried out after traction failed in a young patient. After regenerative surgery was realized in its surroundings the patient underwent orthodontic and restorative treatment. 18 months of follow–up later the patient remains asymptomatic, with no mobility or resorption signs and with a healthy periodontal state in said canine. Conclusion: Autotransplantation can be a suitable alternative when orthodontic traction has failed, as long as it is viable, especially in young patient when implants are not recommended (AU)

A retrospective study on the effect of the COVID-19 pandemic on dental treatments in adults.

BACKGROUND: The aim was to analyze the prevalence of dental treatments that were not performed in a dental care university referral center in the capital of Spain during the first wave of the COVID-19 pandemic. METHODS: This was a retrospective observational study based on the registry of medical records. Sex, age, nationality, and the type of treatment that was not performed in the service of the Integrated Adult Dental Clinic subject of the Dentistry degree at the Rey Juan Carlos University of Madrid were analyzed. RESULTS: A total of 392 medical records were analyzed. The prevalence of the treatments that were not performed was 58.67% (95% CI 53.74-63.44) of conservative treatments, 47.45% (95% CI 42.55-52.39) of periodontal treatments, 27.30% (95% CI 23.12-31.91) and 13.52% (95% CI 10.49-17.26) of clinical activities. The patients most affected by the absence of dental treatment ranged in age from 35 to 74 years. Age, sex, and nationality were not influential in not performing dental treatments. CONCLUSIONS: The COVID-19 pandemic could have negatively influenced treatments, such as conservative and periodontal treatments, that increasing the risk of tooth loss in adults.

Manejo de un defecto estético en maxilar anterior con injertos de tejidos duros y blandos e inserción diferida de un implante dental. A propósito de un caso / Management of an aesthetic defect in the anterior maxilla with hard and soft tissue grafts and delayed insertion of a dental implant. Case report

Introducción: Hay alteraciones óseas en las crestas alveolares que presentan un defecto volumétrico que dificultan la inserción de un implante dental en la posición tridimensionalmente correcta. Existen diferentes técnicas quirúrgicas de aumento óseo, entre ellas están los injertos en bloque o Split Bone Bloque Technique (SBBT). Esta técnica combina laminas corticales y hueso particulado de origen autólogo, logrando una integración más rápida del injerto. El objetivo de ese caso es describir el manejo y abordaje clínico de un defecto de alto compromiso estético y complicación quirúrgico-protésica mediante colgajo rotado de paladar, SBBT y posterior provisionalización de un implante dental osteointegrado. Caso clínico: Varón de 54 años que acude a la Clínica Universitaria de la Universidad Rey Juan Carlos con una dehiscencia del tejido blando que sobrepasaba la línea mucoginvival a nivel del incisivo 1.1 cursando con movilidad del fragmento vestibular El paciente no refería sintomatología ni signos patológicos. Se estableció como plan de tratamiento la extracción del diente y aumento del tejido blando mediante la técnica de colgajo rotado de paladar a pedículo posterior. Y posteriormente se realizó la regeneración ósea horizontal mediante SBBT. Conclusión: La regeneración ósea mediante SBBT es una técnica predecible con altas tasas de éxito tanto horizontal como vertical. Asociado a la regeneración, el manejo del tejido blando con colgajos o injertos de tejido conectivo permite obtener el volumen deseado. (AU)

Introduction: There are bone alterations in the alveolar crests that present a volumetric defect that makes inserting a dental implant in the correct threedimensional position difficult. There are different surgical techniques for bone augmentation, including block grafts or the Split Bone Block Technique (SBBT). This technique combines cortical laminas and particulate bone of autologous origin, thus achieving a faster integration of the graft. The aim of this case is to describe the management and clinical approach of a defect with high aesthetic compromise and surgical-prosthetic complication by means of a rotated palatal flap, SBBT and subsequent provisionalization of an osseointegrated dental implant. Case study: A 54 year old man attended the University Clinic of the Rey Juan Carlos University with a dehiscence of the soft tissue that went beyond the mucoginvival line at the level of incisor 1.1 with mobility of the vestibular fragment. The patient did not report any symptoms or pathological signs. Tooth removal and soft tissue augmentation using the rotated palatal to posterior pedicle flap technique were established as a treatment plan. Horizontal bone regeneration was then performed using SBBT. Conclusion: Bone regeneration using SBBT is a predictable technique with high success rates both horizontally and vertically. Associated with regeneration, soft tissue management with flaps or connective tissue grafts makes it possible to achieve the desired volume. (AU)

Self-reported prevalence of periodontal disease among the Spanish population and immigrants: 2006, 2011/12 and 2017: a population-based study.

BACKGROUND: Periodontal disease is one of the most common pathologies in the population. Self-reporting has been used as a diagnostic tool in large populations, among other reasons, to detect the needs of potentially vulnerable groups. This study evaluated the prevalence of periodontal disease in people of Spanish nationality and immigrants in Spain. METHODS: This population-based, cross-sectional study was carried out using data obtained from National Health Interview Surveys (NHSs) carried out in 2006, 2011/2012 and 2017 in Spain. Subjects aged 16 years and older were included in the NHS-2006 and aged 15 years and older were included in the other NHSs. The following variables were self-reported by the participants: gum bleeding, tooth mobility, tooth extraction and missing teeth. Chi-square homogeneity tests were performed to assess the main associations between the independent variable (nationality) and the dependent variables (bleeding gums, tooth mobility, tooth extraction and missing teeth). Multinomial logistic regression models were constructed to evaluate the influences of the variables age and sex and their interactions on the main associations. RESULTS: A total of 115,123 participants were included in the NHS-2006 (n = 37,327, 11.38% immigrants), NHS-2011/12 (n = 38,727, 14.39% immigrants) and NHS-2017 (n = 39,069, 13.71% immigrants). The variables directly related to periodontal disease were gum bleeding and tooth mobility. These were significantly associated with nationality in the NHS-2006 and NHS-2017 cohorts. In the NHS-2011/12 cohort, only tooth mobility was associated with nationality. After adjustments for sex, age, and their interactions, immigrant status was associated with increased odds of bleeding in only the NHS-2006 cohort (RR = 1.65, 95% CI 1.38-1.99, p = 0.000). CONCLUSION: Immigrants in Spain have a lower probability of developing signs associated with periodontal disease than the Spanish population. Among the immigrant cohort, females and those in adult age groups had lower prevalence rates than their counterparts.

El reto del abordaje quirúrgico en la rehabilitación sobre un implante unitario en un caso de alto requerimiento estético del sector anterior. Descripción a propósito de un caso / The challenge of the surgical approach in the rehabilitation of a unitary implant in a case of high aesthetic requirements of the anterior sector. Case report

Objetivo: Describir de forma detallada el abordaje clínico basado en la evidencia científica actual de un implante postextracción con carga y provisionalización inmediata. Caso clínico: Se presenta el caso de una paciente mujer de 32 años de edad, que acude por presentar una posible fractura radicular del incisivo central superior izquierdo (ICSI), acompañada de la aparición de un absceso periodontal en la región del fondo de vestíbulo de dicho diente. Tras llevar a cabo la exploración clínica y radiológica, se establece que el pronóstico del ICSI es desfavorable para llevar a cabo un tratamiento conservador del mismo. Tras la valoración de las características clínicas del caso presente, el plan de tratamiento se inclinó por la realización de la exodoncia del ICSI con la colocación simultánea de un IOI postextracción y la carga inmediata con una prótesis provisional del mismo. Conclusiones: La rehabilitación sobre implantes en situaciones de pérdida dental en el sector anterior estético y en especial, en pacientes jóvenes, requiere un plan de tratamiento multidisciplinar en cuanto a la extracción del diente y colocación del IOI en la posición tridimensional correcta, existiendo diferentes aspectos a tener en cuenta para ello, especialmente el remanente óseo residual, la posición del margen gingival, así como la preservación y acondicionamiento de los tejidos duros y blandos periimplantarios mediante injertos y un manejo correcto de una prótesis provisional hasta conseguir un perfil de emergencia y contorno gingival ideal antes de la corona definitiva. (AU)

Objective: To describe in detail the clinical approach based on current scientific evidence for a post-extraction implant with immediate loading and provisionalisation. Clinical case: We present the case of a 32-year-old female patient who presented with a possible root fracture of the upper left central incisor (ULCI), accompanied by the appearance of a periodontal abscess in the region of the bottom of the vestibule of said tooth. After carrying out the clinical and radiological examination, it is established that the ULCI prognosis is unfavourable for carrying out conservative treatment of the tooth. After assessing the clinical characteristics of the present case, the chosen treatment plan was to extract the ULCI with the simultaneous placement of a post-extraction osseointegrated implant (OII) and immediate loading of a provisional prosthesis on the implant. Conclusions: Rehabilitation on implants in situations of tooth loss in the aesthetic anterior sector, especially in young patients, requires a multidisciplinary treatment plan in relation to tooth extraction and placement of the OII in the correct three-dimensional position. There are various aspects to be taken into account, particularly the residual remaining bone, the position of the gingival margin, as well as the preservation and conditioning of the peri-implant hard and soft tissues by means of grafts and proper handling of a provisional prosthesis until an ideal emergence profile and gingival contour is achieved before the final crown. (AU)

Patogénesis del dolor en la mucositis oral. Revisión de la literatura / Pathogenesis of pain in oral mucositis. Review of the literature

INTRODUCCIÓN: La mucositis oral es una lesión dolorosa que tiene lugar en la mucosa de la cavidad oral, normalmente su etiología se encuentra asociada a tratamientos farmacológicos en pacientes oncológicos. Se presenta como úlceras bien delimitadas cuya sintomatología dolorosa supone en ocasiones la suspensión del tratamiento oncológico o la alimentación por vía parenteral, siendo por tanto un efecto adverso importante, marcando el devenir en este tipo de terapias contra el cáncer. OBJETIVO: El objetivo del presente artículo es poner en relieve cómo se produce el dolor en esta patología que acontece en la mucosa de la cavidad oral. DISCUSIÓN: La mucositis oral se va a presentar tras una cascada de eventos biológicos que implican diferentes procesos moleculares tras el tratamiento con quimioterapia o radioterapia. El dolor en la mucositis oral puede poseer un componente inflamatorio y también un componente neuropático. En su fisiopatología, el dolor va a estar mediado por diferentes familias de receptores y factores. CONCLUSIÓN: La mucositis oral presenta un gran componente doloroso asociado, en el que cobran especial protagonismo en su aparición, las familias de los receptores y factores TRP, ET-1, TNF y ROS, entre otros. El conocimiento de la patogénesis del dolor en esta patología permitirá desarrollar terapéuticas contra el dolor en estudios futuros

INTRODUCTION: Oral mucositis is a painful lesion that occurs in the mucosa of the oral cavity. Its aetiology is usually associated with drug treatments in cancer patients. It presents as well-defined ulcers whose painful symptoms sometimes lead to the suspension of cancer treatment or parenteral nutrition. They therefore represent a significant adverse effect that marks the future in this type of cancer therapy. OBJECTIVE: The objective of this article is to highlight how pain occurs in this pathology that takes place in the mucosa of the oral cavity. DISCUSSION: Oral mucositis will occur following a cascade of biological events involving different molecular processes following treatment with chemotherapy or radiotherapy. Pain in oral mucositis may have an inflammatory component as well as a neuropathic component. In its pathophysiology, pain will be mediated by different families of receptors and factors. CONCLUSION: Oral mucositis has a large associated painful component, in which the families of TRP, ET-1, TNF and ROS receptors and factors, among others, play a major role in its appearance. Knowledge of the pathogenesis of the pain in this pathology will allow pain therapies to be developed in future studies

Third molar autotransplant planning with a tooth replica. A year of follow-up case report.

The advantages of dental autotransplantation and its high level of clinical success mean that it should be considered as a therapeutic option when replacing a lost tooth. In order to achieve optimum results, it is necessary to know the technique of dental autotransplantation, promoting its use whenever the clinical conditions to perform it are present. The objective of this article is to describe the technique in detail by means of a clinical case of a dental autotransplant whose donor tooth was a third unerupted molar. A 39-year-old male patient with no medical history of interest. On clinical examination, tooth 2.6 shows vertical fracture with indication of exodontia. A compatibility study is carried out using a CBCT and after this, a subsequent preparation of a 3D-printed replica of the donor tooth 2.8 is made. A step-by-step description is given of the autotransplantation technique from 2.8 to 2.6. After this, antibiotic coverage, semi-rigid splinting and root canal treatment are carried out in a short time. Results are shown at 12 months. The main factor for the success of this technique is the preservation of periodontal ligament cells. The unerupted teeth are the only ones that fully preserve the periodontal ligament, but they require greater surgical skills. Autotransplantation is a predictable treatment alternative to dental implants, being above all an option indicated to replace teeth with dental fissures or vertical root fractures or poor restorative and/or endodontic prognosis. The third molars are the most used teeth for transplantation, due to their indications for extraction in a high percentage preserving the entire periodontal ligament. The diagnosis by CBCT and the use of 3D- printed replicas of the tooth to be transplanted have meant a highly significant improvement in the prognosis and predictability of the technique. Key words:Dental autotransplant, tooth replica, third molar.

Management of odonto-stomatological emergencies during the COVID-19 alarm state in dental clinics in the Autonomous Community of Madrid (CAM), Spain: An observational study

BACKGROUND: Odontology practice has been severely compromised by the pandemic caused by COVID-19 and Spain is one of the countries with higher incidence. Our aim with this study is to find out the number of cases and type of odonto-stomatological emergencies (OSE) treated in four dental clinics of the Madrid capital area and region (CAM) in the period covered between March 17th and 4th of May. MATERIAL AND METHODS: We search the cases in the demographic/epidemiological databases of the CAM regional government and the Illustrious Official College of Dentists and Stomatologists of the First Region (Madrid). RESULTS: We found that the most prevalent pathology was acute apical periodontitis whereas odontogenic abscess showed the lowest frequency. Prosthetic-orthodontic OSE represented 14% of cases. CONCLUSIONS: In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases. Most of OSE were resolved, without referring the patient to a hospital emergency department

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The challenge of the surgical approach in the rehabilitation of an anterior sector unitary implant in a case of high aesthetic requirements; case report

Objective: Provide a detailed description of the current evidence-based clinical approach to a post-extraction implant with immediate loading and provisionalisation. Clinical case: A 32-year-old female patient who attended for a possible root fracture of the upper left central incisor (ULCI), accompanied by a periodontal abscess at the bottom of the vestibule of the same tooth. A clinical and radiological examination established that the prognosis of the ULCI was unfavourable for conservative treatment. After evaluating the clinical features of the case, the treatment plan to extract the ULCI followed immediately by an osseointegrated implant (OII) and loading of a provisional prosthesis on the implant. Conclusions: Rehabilitation on implants in situations of tooth loss in the aesthetic anterior sector, especially in young patients, requires a multidisciplinary treatment plan to extract the tooth and insert an OII in the correct 3-dimensional position. Various aspects need to be taken into account for this, particularly the residual remaining bone, the position of the gingival margin and preservation and conditioning of the peri-implant hard and soft tissues by means of grafts and proper handling of provisional prosthesis, until an ideal emergence profile and gingival contour is achieved before the final crown. (AU)

Cambios en el perfil de las urgencias atendidas por un dentista de guardia 24 horas durante las etapas iniciales de la primera ola de COVID-19 / Changes in urgent dental care provided by a 24-hour on-call dentist during the first wave of the covid-19 pandemic

OBJETIVO: Comparar la asistencia urgente prestada por un dentista de guardia 24 horas a dos grupos de pacientes en dos periodos de la primera ola de Covid-19 en Madrid: durante el confinamiento de la población y cierre de la mayoría de las clínicas dentales y una vez levantado el confinamiento y reabiertas las clínicas. MÉTODO: En ambos grupos se compararon edad y sexo, tiempo transcurrido desde el comienzo de los síntomas, frecuencia de citas nocturnas, frecuencia y duración de tratamientos médicos previos, patologías objeto de consulta y tratamientos realizados. RESULTADOS: En el primer periodo (45 días) se vieron 187 pacientes y en el segundo (19 días), 94 (4.15 y 4.8 pacientes/día, respectivamente). El tiempo transcurrido desde el comienzo de los síntomas en ambos periodos fue 10+/1 y 3+/-1 días. Habían recibido tratamiento antibiótico/antiinflamatorio previo el 80% y el 30% de los pacientes, respectivamente. El diagnóstico más frecuente en el primer periodo fue inflamación pulpar (p = 0.001) y en el segundo, pulpitis irreversible (p < 0.05). En el primer periodo se realizaron más extracciones (58.7% vs 41.5%, p < 0.05) y en el segundo más endodoncias (8.5% vs 2.1%, p < 0.05) y tratamientos farmacológicos (19.1% vs 9.6%, p < 0.05). CONCLUSIONES: Durante el segundo periodo de la primera ola de COVID-19, cuando el confinamiento se levantó y se reabrieron las clínicas, la atención dental urgente cambió con respecto a las primeras 6 semanas de confinamiento estricto, tanto en el perfil de la patología, como en los tratamientos realizados que fueron más conservadores

AIM: To compare urgent dental care provided by a general dentist 24-hours on-call at two early stages of the first wave of Covid-19 pandemic in Madrid (Spain): during the lockdown of the population and closure of most dental clinics, and once the lockdown was relaxed and dental offices partially reopened. METHOD: In both groups we compared demographic data, time elapsed from onset of symptoms, rate of late-night appointments, proportion of patients receiving pharmacologic treatment and frequencies of the pathologies causing the consultation and treatments performed. RESULTS: In the first and second stages -45 and 19 days respectively- 187 and 94 patients, (4.15 and 4.8 patients/day, respectively) were seen. The time elapsed from onset of symptoms was 10+/1 days in the first group and 3+/-1 days in the second, while 80% and 30% of patients were receiving some medical treatment respectively. Pulpal inflammation predominated in the first stage (p = 0.001) and irreversible pulpitis in the second (p < 0.05). Extractions were more frequent in the first stage (58.7% vs 41.5%, p < 0.05), and root canal therapy (8.5% vs 2.1%, p < 0.05) and pharmacological treatment (19.1% vs 9.6%, p < 0.05) in the second. CONCLUSION: During the second stage of the first wave of COVID-19 pandemic, once lockdown was partially relaxed, significant differences were observed in urgent dental care compared with the first six weeks of the pandemic, both in the profile of the pathology and the treatments provided, which were more conservative

Mucocele de retención. Revisión a propósito deun caso / Retention mucocele. A case report

El mucocele oral es una lesión de los tejidos blandos con alta prevalencia en la cavidad oral, siendo motivo de consulta dadas las alteraciones funcionales y es-téticas asociadas al mismo. Su etiología está relacionada con la alteración en las glándulas salivales, correspondiendo la localización más frecuente al labio inferior. Su tratamiento, aunque en la mayoría de los casos es expectante, consiste en la extirpación quirúrgica debido a que pue-den llegar a ser de tamaño considerable. A continuación se describe el caso de un paciente varón, de avanzada edad, que presenta un mucocele de gran tamaño localizado en el labio inferior, región en la que se practicó su remoción quirúrgica y posterior análisis histopatológico

The oral mucocele is a soft tissue lesion with high prevalence in the oral cavity, the oral mucocele can be find associated with functional and aesthetic alterations. The etiology is related to the alteration in the salivary glands, the most frequent location corresponding to the lower lip. The treatment consists in surgical removal because they can be of considerable size. The following describes the case of a male patient, of advanced age, who has a large mucocele located in the lower lip, a region in which surgical removal was performed and subsequent histopathological análisis

Safety and Efficacy of a New Synthetic Material Based on Monetite, Silica Gel, PS-Wallastonite, and a Hydroxyapatite Calcium Deficient: A Randomized Comparative Clinic Trial.

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0-5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of -0.9 ± 1.3 mm and -0.6 ± 1.5 mm, and a variation in height of -0.1 ± 0.9 mm and -0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.

Gingival hyperplasia as an early manifestation of acute myeloid leukemia. A retrospective review.

BACKGROUND: We study the prevalence of acute myeloid leukemia (AML) among patients with severe gingival enlargement. MATERIAL AND METHODS: We retrospective reviewed the clinical records of patients with severe gingival enlargement, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and gingival bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique. RESULTS: A correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean gingival bleeding index was ≥3 and the degree of dental mobility ≥2.3. 1.7% of patients, with severe gingival hyperplasia were diagnosed with AML. We found a significant association between gingival bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. CONCLUSIONS: Severe gingival enlargement, abundant gingival bleeding, and dental mobility could be early manifestations of a blood dyscrasia. Key words:Acute myeloblastic leukemia, gingival hyperplasia, bleeding, tooth motility, oral health.

Effect of Strontium-Coated Titanium Implants on Osseointegration in Animal Models: A Literature Systematic Review.

PURPOSE: This study represents a systematic review of the literature to assess the effectiveness of strontium-coated titanium surfaces on osseointegration in experimental assays with healthy, nonosteoporotic and/or nonosteopenic animals. MATERIALS AND METHODS: An electronic search was conducted of the databases MEDLINE/PubMed, Wiley Library, and Web of Science through 2018, with the aim of identifying studies on the osseointegration of titanium implants modified with strontium. RESULTS: A total of 255 papers were found, of which 11 were included in this systematic review. The primary result was the percentage of bone-to-implant contact (BIC) around the titanium implants with or without a strontium-coated surface. The different techniques used to coat titanium surfaces with strontium recorded significant results in terms of the improvement in the implant's quality, as they increased its contact with the bone, bone area, and bone formation, as well as enhanced its biomechanical properties. CONCLUSION: Nine of 11 studies reported that titanium implants coated with strontium showed significantly higher BIC (P < .001 to P < .05). This coating also improved the implants' biomechanical properties.

Genetic study in patients operated dentally and anesthetized with articaine-epinephrine.

Aims: In this study we wanted to figure out if there was a correlation between OPRM1 N40D, TRPV1 I316M, TRPV1 I585V, NOS3 -786T>C and IL6 -174C>G polymorphisms and the response to locally applied articaine-epinephrine anesthetic. Methods: In this observational study, 114 oral cell samples of patients anesthetized with articaine-epinephrine (54 from men 60 from women), were collected from dental centers in Madrid (Spain). High molecular weight DNA was obtained from oral mucosa cells. The analysis of OPRM1 N40D (rs1799971), TRPV1 I316M (rs222747), TRPV1 I585V (rs8065080) and IL6 -174C>G polymorphism was performed through real-time PCR allelic discrimination using TaqMan probes. Polymorphism NOS3 -786T> C (rs2070744) was analyzed using RFLP-PCR. Results: The studied polymorphisms are involved neither in the response to the anesthetic, nor in the intensity of perceived dental pain. However, in a subset of female patients we found that TRPV1 I316M was associated with a delayed onset of anesthesia. Conclusions: There is no association among these polymorphisms and the time elapsed between the application of the anesthetic and the onset of its effect.

Complications in the treatment of mandibular condylar fractures: Surgical versus conservative treatment.

OBJECTIVES: In the present article, we aim to review the main intra- and post-operative complications associated with two different therapeutic approaches for treating mandibular condylar fractures: conservative (CTR) and surgical treatment (ORIF, Open Reduction and Internal Fixation). MATERIAL AND METHODS: We have carried out a retrospective, meta-analytic, observational study using literature review, covering the period between 2000- September 2017. The data obtained were processed using statistical software SPSS v.0.18 and R v.2.11.1. The chi-squared test was used for comparison of relative frequencies for independent samples. RESULTS: A total of 2458 patients with 2810 fractures were collected for study. Patients treated with CTR and ORIF were an average of 29 years old, of those treated with CTR, 72.37% and 27.63% were male or female respectively and, of those treated with ORIF, 70.36% and 29.64% were male or female respectively. The main complications suffered by CTR and ORIF patients were: asymmetry (10.2%/6.4%), residual pain (6.5%/5.6%), temporomandibular joint and articular imbalance (15.9%/10.3%) and malocclusion (11.1%/4.0%), respectively. We only found significant differences between CTR and ORIF in the number of cases of temporomandibular joint and articular imbalance and malocclusion. Facial nerve damage was found exclusively among ORIF patients (8.6%) of which 8.3% were temporary and 0.3% permanent. CONCLUSIONS: The complications associated with either technique are minimal and infrequent, resulting in successful outcomes with minimal morbidity. CTR are associated with complications deriving from delayed mobilization leading to functional limitation, whereas the main complication associated with ORIF treatment was facial nerve damage.

Epidemiological survey on third molar agenesis and facial pattern among adolescents requiring orthodontic treatment.

BACKGROUND: The aim of this study was to determine the association between facial pattern according to Ricketts cephalometric analysis, and prevalence of third molar agenesis, taking subject age and gender as control variables. MATERIAL AND METHODS: An epidemiological survey was conducted based on a sample of 224 candidates for orthodontic treatment aged 12 to 24 (n=224). Third molar agenesis was recorded using Ricketts cephalometric analyses of lateral teleradiographs and panoramic radiographs. The risk for agenesis was predicted considering the 5 Vert Index parameters (facial axis, facial depth, mandibular plane angle, lower facial height and mandibular arch), facial type (brachyfacial, mesofacial, dolichofacial) and sociodemographic variables (age and sex), using odds ratio (OR) calculated by logistic regression. RESULTS: Third molar agenesis was observed in 25% of the sample. Risk for agenesis is significantly determined by sociodemographic factors (age, OR: 1.2), cephalic patterns (mesofacial vs dolichofacial, OR:4.3; and brachyfacial vs dolichofacial OR: 3.2) and cephalometric patterns (facial axis, OR: 0.8; lower facial height, OR: 0.8; and mandibular plane angle, OR:0.9). CONCLUSIONS: Facial parameters (facial axis, lower facial height, and mandibular plane angle) proved to be strong predictors of the risk for third molar agenesis, the prevalence of agenesis being significantly lower in dolichofacial individuals. Key words:Facial Pattern, Ricketts Analysis, Third Molar Agenesis.

Soft Tissue Augmentation Techniques in Implants Placed and Provisionalized Immediately: A Systematic Review.

The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without provisionalization and to assess the quality of the reports in the literature. Randomized clinical trials, prospective clinical trials, and case series were included in this review. Clinical questions were formulated and organised according to the PICOS strategy. An electronic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web up until June 2016. Interexaminer agreement on eligibility (k = 0.842; p = 0.103) and quality (k = 0.933; p < 0.001) was high. Methodological approaches were assessed using criteria based on design related forms designed by the Dutch Cochrane Collaboration. Finally, 14 papers were identified. In two studies, the implant survival was 90%; for the rest of the studies it was 100%. All studies reported favourable aesthetic, biological, and radiographic outcomes. Surgical and biomechanical complications of this technique were not relevant. This technique effectively compensates for the expected loss of volume of the oral soft tissues and maintains high success rates with good aesthetic results over time.

Effect of topical application of melatonin on serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in patients with type 1 or type 2 diabetes and periodontal disease.

BACKGROUND: The present clinical trial study was designed to assess the effect of topical application of melatonin on serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) in patients with diabetes and periodontal disease in comparison with healthy controls. MATERIAL AND METHODS: Serum levels of TNF-α and IL-6 were measured by enzyme-linked immunosorbent assay and CRP by nephelometry by using the proper commercial kits in 30 patients with diabetes and periodontal disease, and also in a control group of 30 healthy subjects. Periodontograms were performed using the Florida Probe®. Patients with diabetes were treated with a topical application of melatonin (1% orabase cream formula) once daily for 20 days. Healthy subjects were treated with a placebo orabase cream. RESULTS: Patients with diabetes and periodontal disease had significantly higher mean levels of serum TNF-α, IL-6 and CRP than healthy subjects (P < 0.001). Following topical melatonin application, there was a statistically significant decrease in the gingival index and pocket depth (P < 0.001) as well as a significant decrease in IL-6 and CRP serum levels (P < 0.001). Local melatonin application in patients with diabetes and periodontal disease resulted in a significant decrease in CRP and IL-6 serum levels as well as an improvement in the gingival index and pocket depth. Patients with periodontal disease had significantly higher serum CRP, IL-6 and TNF-α values by comparison with healthy subjects. CONCLUSIONS: We conclude that melatonin can modulate the inflammatory action of these molecules in periodontal patients. KEY WORDS: Melatonin, periodontal disease, diabetes mellitus, interleukin-6, tumor necrosis factor-alpha, C-reactive protein, inflammatory markers.