Does the level of knowledge of denture hygiene affect their maintenance? / ¿El nivel de conocimiento de higiene protésica afecta el mantenimiento de estas prótesis?

Introduction: The lack of knowledge about denture hygiene can negatively affect their maintenance. On the other hand, good oral hygiene can reduce the chances of plaque accumulation. Objetive: To determine if there is a relationship between knowledge of hygiene and denture maintenance. Material and Methods: A questionnaire was applied to 67 patients who wore partial and/or total removable prostheses daily to evaluate their knowledge of denture hygiene. For the evaluation of denture maintenance, clinical inspection of the removable prosthesis was carried out using the Vigild criterion to observe the amount of plaque that was adhered to it. Data were statistically processed with Spearman's correlation test to determine the relationship between hygiene knowledge and denture maintenance. Results: The patients presented a medium (37.3%) and low (56.7%) denture hygiene knowledge; and fair (68.7%) and poor (11.9%) maintenance of their prosthesis. There is a statistically significant relationship between hygiene knowledge and denture maintenance (p<0.001). Conclusion: There is little knowledge of denture hygiene. This level of knowledge has a statistically significant relationship with the maintenance of the prostheses.

Introducción: El desconocimiento sobre la higiene de prótesis, de los pacientes portadores de estas, puede afectar negativamente en el mantenimiento protésico, una correcta higiene puede disminuir las probabilidades de acúmulo de placa. Objetivo: Determinar si existe relación entre el conocimiento de higiene y el mantenimiento protésico. Material y Métodos: Para la evaluación del conocimiento en higiene protésica se aplicó un cuestionario a 67 pacientes que utilizaban diariamente prótesis removibles parciales y/o totales; y para la valoración del mantenimiento protésico se realizó la inspección clínica de la prótesis removible mediante el criterio de Vigild, observando la cantidad de placa que se encontraba adherida. Se procesaron los datos estadísticamente con la prueba de correlación de Spearman para determinar la relación entre el conocimiento de higiene y el mantenimiento protésico. Resultados: Los pacientes presentaron un conocimiento de higiene protésica medio (37,3%) y bajo (56,7%); y un mantenimiento de la prótesis de forma regular (68,7%) y malo (11,9%). Existiendo relación estadísticamente significativa entre el conocimiento de higiene y el mantenimiento protésico (p<0, 0 01). Conclusión: Existe un bajo conocimiento de higiene protésica, teniendo este nivel de conocimiento una relación estadísticamente significativa con el mantenimiento que evidenciaban las prótesis.

¿La glicerina influye en la estabilidad del color de la resina compuesta? / Does glycerin influence the color stability of composite resin?

Introducción: El efecto del oxígeno sobre la superficie de las resinas al momento de la fotopolimerización origina una capa que es susceptible a los pigmentos. El uso de la glicerina puede bloquear este efecto. Objetivo: Determinar si existe diferencia en la estabilidad del color de la resina compuesta nano-híbrida sometida a un agente colorante, al aplicar o no la glicerina. Métodos: 60 discos de resina se dividieron en Grupo 1 (sin glicerina) y Grupo 2 (con glicerina). La fotopolimerización se realizó por 20 s con la lámpara LED Bluephase®N. Se realizó la primera medición del color con el espectrofotómetro Easyshase®V y se registraron los valores arrojados para L* (luminosidad), a* (eje rojo-verde) y b* (eje azul-amarillo). Posterior a la inmersión por 1 mes de las muestras en Coca-Cola®, manteniéndolas en una incubadora a 37 ºC, se realizó la segunda medición del color. Se procesaron los datos estadísticamente con la prueba t de Student para determinar las variaciones en la estabilidad del color de ambos grupos y compararlos entre sí. Resultados: En todos los especímenes del experimento existió alteración en la estabilidad del color de la resina. La media de la distancia entre el color inicial y el color final del Grupo 1 fue de ΔE = 6,91, mientras en el Grupo 2 fue ΔE = 3,74. Se halló diferencia estadísticamente significativa entre ambos grupos analizados (p < 0,001). Conclusiones: La glicerina es una sustancia efectiva para bloquear el efecto del oxígeno en la superficie de la resina y evitar la formación de la capa inhibida de oxígeno, aumentando la estabilidad del color de la resina compuesta nano-híbrida(AU)

Introduction: The effect of oxygen on the surface of resins at the moment of photopolymerization creates a layer which is susceptible to pigments. The use of glycerin may block this effect. Objective: Determine whether there is a difference in the color stability of nanohybrid composite resin subjected to a coloring agent when glycerin is either applied or not applied. Methods: Sixty resin disks were distributed into Group 1 (without glycerin) and Group 2 (with glycerin). Photopolymerization was performed for 20 s with a Bluephase®N LED lamp. The first color measurement was taken with an Easyshase®V spectrophotometer, recording the values obtained for L* (luminosity), a* (red-green axis) and b* (blue-yellow axis). The second color measurement was taken after immersion of the samples for one month in Coca-Cola®, maintaining them in an incubator at 37ºC. Statistical data analysis was performed with Student's t test to determine the color stability changes occurring in the two groups and compare them. Results: Color stability changes were observed in all the resin samples. Mean distance between initial and final color was ΔE = 6.91 in Group 1 and ΔE = 3.74 in Group 2. A statistically significant difference was found between the two groups analyzed (p < 0.001). Conclusions: Glycerin is an effective substance to block the effect of oxygen on the resin surface, preventing the formation of an oxygen-inhibited layer and raising the color stability of the nanohybrid composite resin(AU)

Estabilidad cromática de una cerámica de feldespato monocromática utilizada en sistema CAD/CAM sometida a inmersión de diferentes soluciones de tinción / Color stability of a monochromatic feldspar ceramic used in CAD/CAM system immersed in different staining solutions

RESUMEN: Objetivo: Determinar la estabilidad cromática de una cerámica de feldespato monocromática utilizada en sistema CAD/CAM sometida a inmersión de diferentes soluciones de tinción. Materiales y métodos: 90 discos de cerámica feldespática monocromática, divididos en 3 grupos según solución de tinción: agua destilada, café y té. Se realizaron 3 tomas de color: el día 0, 14 y 28, con un espectrofotómetro. Para determinar la diferencia de color (ΔE*), se restó la 2da y la 1era medida para los 14 días; y la 3era y la 2da medida para los 28 días. Resultados: Los resultados se interpretaron utilizando el Índice del Departamento Nacional de Normas (NBS). La muestra inmersa en agua destilada presentó valores ΔE* 1.424 y ΔE* 1.233; la muestra en café presentó valores ΔE* 3.327 y ΔE* 3.901; la muestra inmersa en té presentó valores ΔE* 4.597 y ΔE* 5.201. Se obtuvieron diferencias significativas al comparar la estabilidad cromática en las tres soluciones de tinción a los 14 y 28 días (p<0.001). Conclusiones: Existe diferencia significativa en la estabilidad cromática de una cerámica de feldespato monocromática sometida a inmersión de diferentes soluciones de tinción. Se obtuvieron cambios de color marcados en las muestras inmersas en café y en té.

ABSTRACT: Objective: Determine the color stability of a monochromatic feldspathic ceramic used in CAD / CAM system subjected to immersion in different staining solutions. Methods and materials: 90 monochromatic feldspathic ceramic discs were divided into 3 groups according to staining solution: distilled water, coffee and tea. Three color samples were taken: on days 0, 14 and 28, with a spectrophotometer. To determine the color difference (ΔE *), the 2nd and 1st measure were subtracted for the 14 days; and the 3rd and 2nd measure for the 28 days. Results: The results were interpreted using the National Standards Department Index (NBS). The sample immersed in distilled water presented values ΔE * 1,424 and ΔE * 1,233; the sample in coffee presented values ΔE * 3,327 and ΔE * 3,901; the sample immersed in tea presented values ΔE * 4,597 and ΔE * 5,201. Significant differences were obtained when comparing the chromatic stability in the three staining solutions at 14 and 28 days (p <0.001). Conclusion: There is a significant difference in the chromatic stability of a monochromatic feldspar ceramic subjected to immersion in different staining solutions. Marked color changes were obtained in the samples immersed in coffee and tea.

Comparación entre trazados cefalométricos manual y digital en radiografías laterales del cráneo / Comparison between Manual and Digital Cephalometric Tracing in Side Radiographies of the Skull

Resumen Objetivo: Evaluar la diferencia del trazado cefalométrico manual con el digital en radiografías laterales de cráneo. Materiales y métodos: Inicialmente se realizó un piloto para calibrar al investigador principal, en donde se analizaron 10 radiografías pertenecientes a cinco pacientes del Servicio de Radiología del Centro Odontológico de nuestra institución para evaluar la concordancia entre los dos evaluadores y establecer el tamaño de la muestra. Finalmente, se analizaron 78 radiografías cefalométricas de 39 pacientes, en las que se realizó el trazado cefalométrico de Steiner manual y digital. Esas radiografías se analizaron en una escala 1:1 y posteriormente se evaluó la diferencia de las mediciones mediante el análisis univariado, se determinó en mediana e intervalo intercuartil por separado. En el análisis bivariado, se aplicó la prueba de signo de rangos de Wilcoxon y muestras pareadas para determinar la diferencia de las mediciones cefalométricas de Steiner entre el tipo del análisis cefalométrico. El nivel de significancia se fijó en p < 0,05 y confiabilidad al 95%, respectivamente. Resultados: No hubo diferencia significativa en la mayoría de las mediciones hechas de manera manual y digital, siendo el ángulo interincisal la única medición angular en la cual hubo diferencia significativa al obtener un resultado de p = 0,002. Mientras tanto, en las mediciones lineales, la única medición en la que hubo diferencia significativa fue en el segmento incisivo inferior - NB con p = 0,005. Conclusión: No se encuentran diferencias significativas entre el trazado cefalométrico manual y el digital. No obstante, es importante tener en cuenta que la muestra o población evaluada es reducida para definir conclusiones.

Abstract Objective: To evaluate the difference of the manual cephalometric tracing with the digital tracing on lateral cranial radiographs. Materials and Methods: Initially, a pilot study was carried out to calibrate the principal investigator, where 10 radiographs belonging to 5 patients of the Radiology Service of the Dental Center, were analyzed to evaluate the intraclass concordance between the two evaluators. To establish the size of the sample, finally, 78 cephalometric radiographs of 39 patients were analyzed, in which the manual and digital Steiner cephalometric tracing was performed. These radiographs were analyzed on a 1: 1 scale and then the difference of the measurements was evaluated using the univariate analysis, which was determined in the median and interquartile range, separately. In the bivariate analysis, the Wilcoxon rank sign test and paired samples were applied to determine the difference of Steiner's cephalometric measurements between the cephalometric analysis type. The level of significance was set at p < 0.05 and 95% reliability, respectively. Results: There was no significant difference in most of the measurements made manually and digitally. The interincisal angle the only angular measurement in which there was a significant difference when obtaining a result of p = 0.002, while, in the linear measurements, the only measurement in which there was significant difference was in the lower incisor segment - NB with p = 0.005. Conclusion: There is no significant difference between manual and digital cephalometric tracing, nevertheless it is important to keep in mind that the simple or population evaluated is reduced to define conclusions.

Comparación entre edad cronológica y dental en niños de dos localidades peruanas de diferente altitud / Comparison between chronological and dental age in children from two peruvian locations at different altitude

RESUMEN Introducción: El nivel de maduración dental como indicador del nivel de maduración general de acuerdo con el método de Demirjian, puede ser afectado por la altitud geográfica. Objetivo: Determinar la relación de las edades cronológica y dental según el método Demirjian en niños de dos localidades peruanas con diferente altitud. Métodos: Se realizó un estudio observacional, analítico, retrospectivo de corte transversal, que tuvo como muestra a 179 radiografías panorámicas de niños peruanos entre 6 y 12 años: 109 radiografías de niños de la ciudad de Lima y 70 radiografías de niños de la ciudad de Huancayo. Se determinó la edad dental según el método de Demirjian, luego se relacionó con la edad cronológica en cada paciente de las dos localidades; posteriormente se comparó las diferencias de las edades en las dos ciudades. Resultados: Se encontró correlación estadísticamente significativa entre la edad dental y la cronológica en ambos sexos de pacientes de la ciudad de Lima (p< 0,001); mientras que solo se encontró correlación estadísticamente significativa entre la edad dental y la edad cronológica en el sexo masculino en la ciudad de Huancayo (p< 0,001 para el sexo masculino y p= 0,740 para el femenino). La comparación de las diferencias entre edad cronológica y edad dental de los pacientes de las dos ciudades es no estadísticamente significativa (U de Mann-Whitney, p= 0,057). Conclusiones: No se encontró correlación significativa entre las edades dentales y cronológicas en el sexo femenino de los pacientes habitantes a mayor altitud y al comparar las diferencias, entre la edad cronológica y la edad dental según el método Demirjian, en los habitantes de las localidades peruanas no se encontró diferencia estadísticamente significativa(AU)

ABSTRACT Introduction: The degree of dental maturation as an indicator of the degree of general maturation, according to Demirjian's method, may be affected by geographic altitude. Aim: To determine the relationship between chronological age and dental age according to Demirjian's method in children from two Peruvian locations at different altitudes. Methods: An observational, analytical, retrospective, cross-sectional study was performed on a sample of 179 panoramic radiographs of Peruvian children aged 6 to 12 years. Group A: 109 radiographs of children from Lima City; Group B: 70 radiographs of children from Huancayo City. Dental age was determined according to Demirjian's method and related to chronological age for each patient from each location, and the differences were compared for ages in both cities. Results: A statistically significant correlation was found between dental and chronological age for both sexes in patients from Lima City (p< 0.001), but only for male patients from Huancayo City (p< 0.001 for males and p= 0.740 for females). The differences between chronological age and dental age were not statistically significant in patients from either city (Mann-Whitney U test, p= 0.057). Conclusions: No significant correlation was found between dental age and chronological age in female patients living at higher altitude, and no statistically significant difference was found between chronological age and dental age according to Demirjian's method for children living in either city(AU)

Use of virtual reality as a learning environment in dentistry.

Second Life (SL) is an online virtual world with a social environment that may serve as a valuable learning supplement to traditional preclinical teaching methods. The educational advantages of this virtual world include immersion and interactivity. The aim of this study was to compare the efficacy of using 3-dimensional interactive platforms (3DIPs) designed in SL to that of traditional teaching methods for developing students' understanding of dental clinical situations that are difficult to simulate in real life. For this study, 3DIPs were developed to compare the acquisition of 3 learning objectives: understanding concepts, procedural aspects of interaction with the patient, and spatial interpretation of anatomical structure interactions. A representative dental topic, the use of a semiadjustable articulator, was selected. A quasi-experimental design with 2 groups and pretest-posttest comparison was used. The students in the control group received the conventional teaching established for the subject, which does not include SL experiences. The students in the experimental group received conventional instruction and had access to all 3DIPs for 4 weeks without limitation. The pretest and posttest consisted of a multiple-choice test with 20 questions. A Student t test was used to compare the test results of the groups (significance level α = 0.05). The posttest scores for the understanding of concepts and spatial interpretation were significantly higher in the experimental group than in the control group (P < 0.05). However, there was no statistically significant difference between groups in posttest scores on the topic of procedural aspects. Students who used cooperative methods for acquisition of knowledge were observed to be highly motivated. The results suggest that the SL environment helps students to understand anatomical interactions that are difficult to observe in real life, is attractive to students, and contains tools with high didactic potential.

Association Between Self-Perceived Oral Health and Clinical Indicators.

PURPOSE: To determine whether self-perceived oral health impact and satisfaction measure oral health in the same way as do clinical indicators in adults and older adults. MATERIALS AND METHODS: The population consisted of adult patients aged 20 to 59 years receiving care at "Juan Pablo II" Health Care Centre and older adult patients aged 60 or more years from the home for the elderly "Virgen del Amor Hermoso", Lima, Peru. The indices Oral Impacts on Daily Performance (OIDP) and Oral Satisfaction Scale of 0-10 (OSS 0-10) were used to evaluate perceived impact of and satisfaction with oral health. In addition, the following internationally validated criteria established by the World Health Organization (WHO) were used as clinical indicators: Decayed-Missing-Filled Teeth (DMFT) Index, O'Leary's Hygiene Index, Community Periodontal Index, Motivation to Hygiene Index, Denture Situation Index, Need for Denture Index, Denture Hygiene Index and Oral Mucosal Lesion Index. RESULTS: Forty-four adults and 53 older adults participated. OIDP showed that the greatest perceived difficulty in daily performance was "eating and enjoying food" (adults: 77.3% and older adults: 79.2%). The OSS 0-10 showed that among adults, 43.1% were dissatisfied, 20.5% were neutral and 36.4% were satisfied, while among older adults, 45.3% were dissatisfied, 22.6% were neutral and 32.1% were satisfied. A statistically significant association was found between OSS 0-10 and 1. DMFT index in adults; 2. upper denture situation in older adults; and 3. denture hygiene in older adults. A highly significant inverse linear correlation was found between OIDP and OSS 0-10 in adults and older adults. CONCLUSION: The perceived impact of oral health does not have a demonstrable association with oral health problems when used as an instrument for measuring oral health status, whereas perceived satisfaction with oral health has a better association with the clinical indicators.

Mucoepidermoid carcinoma of the salivary glands: a retrospective study of 51 cases and review of the literature / Carcinoma mucoepidermoide de glándulas salivales. estudio retrospectivo de 51 casos y revisión de la literatura

The aim of this study is to present the casuistic of mucoepidermoid carcinoma of salivary glands in patients diagnosed at “Dr. Eduardo Cáceres Graziani” National Institute for Neoplastic Diseases, Lima, Perú. From January 2002 to December 2012, 51 cases were diagnosed as mucoepidermoid carcinoma. The number of female patients was higher, with 28 cases (54.9%), and regarding age distribution, 33.3% of the patients were under 30 years old. Pain was one of the main symptoms, and 74.5% of the mucoepidermoid carcinomas were located in the parotid gland. It is concluded that epidemiology regarding age and gender of the 51 cases analyzed was in the same range as other studies, and that most cases were located in major salivary glands, in agreement with reports on other populations. Other characte ristics showed a homogeneous distribution.

El propósito de este estudio es presentar la casuística del carcinoma mucoepidermoide de glándulas salivales de pacientes diagnosticados en el Instituto Nacional de Enfermedades Neoplásicas “Dr. Eduardo Cáceres Graziani” Lima, Perú, desde el 2002 hasta el 2012. Realizamos un estudio retrospectivo en el cual fueron incluidos sujetos con diagnóstico primario de carcinoma mucoepidermoide en glándulas salivales. Entre enero de 2002 y diciembre de 2012, se registraron 51 casos. El número de pacientes de sexo femenino fue mayor, con 28 casos (54,9%) y con respecto a la distribución por edades, el 33,3% de los pacientes eran menores de 30 años de edad. El dolor fue uno de los síntomas principales. El 74,5% de los carcinomas mucoepidermoides se localizaron en la glándula parótida. De los hallazgos obtenidos se concluye principalmente que en lo que respecta a la distribución epidemiológica de edad y género de los 51 casos analizados estas variaron en el mismo rango de otros estudios. También se distingue que el mayor número de casos estuvieron localizados en glándulas salivales mayores, dato en concordancia con otras poblaciones reporta das. Las demás características presentaron una distribución homogénea.

Restauraciones posteriores con resina compuesta: relato de caso clínico / Composite resin restauration of posterior teeth: a case report

Con la evolución de las resinas compuestas y la creciente exigencia estética de los pacientes, su uso en dientes posteriores puede ser considerado una alternativa bastante viable y eficiente tanto en el aspecto funcional como estético. Este trabajo tiene como objetivo relatar un caso clínico presentando una secuencia clínica de una restauración con resina compuesta en las piezas 24 y 25, devolviendo la función y estética en los dientes restaurados...

With the evolution of the composite resins and the higher aesthetic demand of patients, its use in posterior teeth can be considered a very viable alternative and efficient in terms functional and aesthetic aspects. This paper has the objective to present a clinic case demonstrating a clinical response of a composite resin restoration in the 24 and 25 teeth, restoring function and aesthetics to the restored teeth...

Evaluación radiográfica y microscópica de la acción de quelantes en la remoción del barro dentinario / Radiographic and microscopic evaluation of the action of chelating agents in dental smear layer removal

Introducción: el tratamiento endodóntico realiza la limpieza y conformación del sistema de conductos radiculares, ya que virutas de dentina y materiales orgánicos, como los microorganismos, creadas por la acción de la instrumentación, forman el llamado barro dentinario. Objetivo: evaluar in vitro la remoción del barro dentinario y la disminución de la densidad de túbulos dentinarios, con soluciones irrigadoras quelantes. Métodos: se trata de un estudio experimental para el cual fueron seleccionados 30 dientes unirradiculares de humanos después del examen radiográfico inicial, y en el que se constató la presencia de canal único, ausencia de calcificación, reabsorción interna y tratamiento endodóntico concluido o en proceso. Luego se procedió a la instrumentación con tres diferentes soluciones irrigadoras: ácido etilenodiaminetetracético 17 por ciento, ácido cítrico 10 por ciento e hipoclorito de sodio 5,25 por ciento (grupo control). Posteriormente se evaluó radiográficamente cada diente instrumentado con el uso de una escala de densidad que fue confeccionada de aluminio con diferentes marcadores de densidades. Para el análisis por microscopio electrónico de barrido se utilizaron tres dientes de cada grupo, tratados con diferentes soluciones irrigadoras. Siete dientes de cada grupo se infiltraron con azul de metileno para la lectura de la infiltración marginal en el microscopio estereoscópico. Los dientes fueron evaluados en sus tres tercios: cervical, medio y apical. Resultados: se encontró que radiográficamente no hubo diferencia estadísticamente significativa entre los promedios de las densidades de los grupos de dientes en todos los tercios. Por microscopio electrónico de barrido se encontró una diferencia estadísticamente significativa entre los tres grupos de sustancias irrigadoras (p < 0,001), en el tercio cervical la remoción del barro dentinario fue mayor. Y por microscopio óptico se observó una mayor infiltración en el grupo de ácido etilenodiaminetetracético seguido del grupo ácido cítrico y por último el grupo control. Conclusión: el análisis de la densidad radiográfica y microscópica mostró que las sustancias quelantes fueron eficientes en la remoción del barro dentinario, excepto en el grupo control. Ninguna de las sustancias demostró alteraciones de densidad radiográfica de los túbulos dentinarios(AU)

Introduction: as part of endodontic treatment, root canals are cleaned and shaped, since shavings of dentin and organic materials, such as microorganisms, resulting from the action of instrumentation, create the so-called dental smear. Objective: carry out an in vitro evaluation of smear layer removal and dentinal tubule density reduction using chelating irrigation solutions. Methods: an experimental study was conducted for which 30 single-rooted human teeth were selected after initial radiographic examination to verify the presence of a single canal, absence of calcification, internal resorption and endodontic treatment either completed or underway. Next, instrumentation was performed with three different irrigation solutions: 17 percent ethylenediaminetetraacetic acid, 10 percent citric acid and 5.25 percent sodium hypochlorite (control group). Each instrumented tooth was then evaluated radiographically using a density scale made of aluminum with different density markers. Scanning electron microscope analysis was performed on three teeth from each group, which were treated with different irrigation solutions. Seven teeth from each group were infiltrated with methylene blue to determine marginal infiltration under the stereomicroscope. The teeth were evaluated on their three thirds: cervical, middle and apical. Results: radiographs did not reveal any statistically significant difference between the mean densities of the different groups of teeth in all thirds. Scanning electron microscopy showed a statistically significant difference between the three groups of irrigation substances (p < 0,001), with greater smear layer removal from the cervical third. Optical microscopy showed that infiltration was greatest in the ethylenediaminetetraacetic acid group, followed by the citric acid group, and lowest in the control group. Conclusion: analysis of radiographic and microscopic density revealed that except for the control group, chelating agents were efficient in removing dental smear. None of the substances showed any alteration in the radiographic density of dentinal tubules(AU)

Malignant lymphoma of the oral cavity and the maxillofacial region: Overall survival prognostic factors

Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus (AU)

Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p ≤ 0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p = 0.042), clinical stage (p = 0.007) and performance status (p = 0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma.

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p≤0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p=0.042), clinical stage (p=0.007) and performance status (p=0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors.

OBJECTIVE: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. STUDY DESIGN: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. RESULTS: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). CONCLUSION: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus.

Efectos bucales de la nuez de betel / Oral effects of the betel nut

La nuez de betel o nuez de areca es una semilla de la palmetra de betel (areca catechu), una de las plantas más polulares del mundo. Diversos pueblos asiáticos, por influencias culturales, tienen la costumbre de masticar la semilla de esta especie vegetal. Entre sus principios activos, la arecaina y la arecolina, son alcaloides comparables a la nicotina en los efectos nerviosos estimulantes. La sustancia activadora causa un relajamiento agradable en la boca, sensación que se propaga al sistema nervioso central. Sin embargo, masticar regularmente la nuez de betel, tiñe la saliva de rojo vivo y ennegrece los dientes, siendo extremadamente perjudicial para la salud oral, causando la pérdida precoz de dientes. A pesar de sus efectos maléficos, existe la dificultad de erradicar el hábito, debido a su carácter cultural, donde las manchas son motivo de orgullo. La agencia internacional de investigación del cáncer (IARC) clasifica a la nuez de betel como un cancerígeno, existiendo numerosos estudios que relacionen la costumbre con neoplasias bucales. El estudio tiene por finalidad realizar un análisis crítico sobre el uso de esta sustancia, buscando informar a la comunidad para prevenir sus efectos maléficos.

The betel nut or areca nut is the seed of the palm tree of bétele (areca catechu), one of the most popular plants of the world. Asians, by cultural influence, have the custom of chew the seed of this sort of vegetable. Between its active principles: arecaine and arecoline, they are alkaloids comparable to the nicotine in the neural stimulation effects. The active substance causes a pleasant relaxion sensation in the mouth, sensation that is extended to the central nervous system. However, chewing regularly betel nut dryes of red the saliva and blackens the teeth being extremely harmful to the mouth health causing early the loss of the teeth. Despite of the harmful effects, the difficulty to eliminate this habit is due to its deep cultural character. Chewing bétel nuts and have the teeth stained it's a motive of proud. The International Agency of Research of the Cancer (IARC) classifies the bétel nut as carcinogenic acquaintance, and the literature have many studies that relate this custom with the oral cancer. The study has as goal to do a critical analysis of the utilization of this substance, searching to inform to the community their bad effects.

Epidemiology of the sarcomas of the jaws in a Peruvian population

Objective: Analysis of the clinical characteristics of patients with Sarcomas of the Jaws treated in the "Instituto Nacional de Enfermedades Neoplasicas. Dr. Eduardo Caceres Graziani" from 1952-2007.Study Design: Review of 155 clinical records of patients with Sarcomas of the Jaws and record of age, gender, size, location, clinical symptoms and signs, histopathological diagnoses and type of treatment. The data obtained were analyzed by means of Student’s statistical t-test, Fisher and Friedman’s test. Results: Analysis of 155 Sarcomas of the Jaws. The average age of patients was 36.8 years old (range: 1-80 years);the female gender was the most frequent (52.9%); the average tumor size was 5.5 cm; in upper jaw 54.84% occurred and 45.16% in the lower jaw; the predominant sign was facial asymmetry (87.74%) and the predominant symptom: pain (63.23%). The most frequent diagnosis was Osteosarcoma 50.3% followed by Chondrosarcoma18%. Surgery plus radiation therapy was the treatment type of choice with 21.94% of cases. Conclusion: The results of this study demonstrate the delayed diagnosis and facial asymmetry and pain appear as the most important events for the diagnosis of Sarcomas of the Jaws (AU)

Malignant melanoma of the oral cavity. Review of the literature and experience in a Peruvian Population

Objective: To determine the epidemiological profile of malignant melanoma cases treated at the National Institutefor Neoplastic Diseases "Dr. Eduardo Caceres Graziani" (INEN) over the period 1952 to 2008.Study Design: All clinical records with complete data of patients presenting a histopathological diagnosis of malignant melanoma of the oral cavity were reviewed. Data such as age, gender, location, tumor size, disease length, presence of metastasis, treatment received and year of admission were recorded. Results: During the study period 97 cases were found. The average age of patients was 52.85±1.6 years old mostly between 50 and 59 years old; the predominant gender was the female. The most common location was the palate and there was 58.8% of cases with a tumor size bigger than or equal to 4 cm. The length of the disease in 38.1% of the cases was longer than a year and in great part of the cases (69.1%) there was no metastasis. The treatment of choice was the surgery plus radiotherapy in 38.1% of the cases. According to the admission date it was also noted that the number of cases is increasing. Conclusion: The results of this study demonstrate a late diagnosis and an increasing frequency of this neoplasia in the oral cavity (AU)

Uso de dientes humanos en la enseñanza odontológica: aspectos éticos, legales y de bioseguridad / Use of human teeth in dental education: ethical, legal and biosafety

El uso de dientes naturales en el proceso de enseñanza-aprendizaje de Odontología es fundamental, además los nuevos planes curriculares vigentes en la mayoría de instituciones de enseñanza brasileras de nivel superior dan privilegio a la investigación. Es de fundamental relevancia conocer tanto la procedencia y formas de uso de los dientes humanos extraídos, como los procedimientos de descontaminación y almacenamiento empleados para este fin. El presente trabajo tiene como objetivo analizar la forma de uso de dientes humanos en la enseñanza odontológica en la Facultad de Odontología de la Universidad Federal de Juiz de Fora a partir de la aplicación de 200 cuestionarios a los alumnos de primero a séptimo periodo de formación. Los resultados demuestran que todavía existe una despreocupación en lo que se refiere a los aspectos ético-legales y de bioseguridad en la obtención y manipulación de dientes humanos por parte de los alumnos. Los datos demuestran la relevancia de la funcionalidad del Banco de Dientes Humanos encargada de abastecer de dientes a los académicos, profesores e investigadores, de forma ética y legal dentro de los estándares de bioseguridad, favoreciendo al menor riesgo de contaminación cruzada.

The use of natural teeth in the dental education and research is essential, moreover, the new curriculum model currently in the majority of Brazilian institutions of higher education focuses on research practice. Besides the importance of knowing the origin and ways of using extracted human teeth, another relevant question is whether the procedures for decontamination and storage are being employed. This study aimed to investigate the use of human teeth in dental education in College of Dentistry of Federal University of Juiz de Fora by application of 200 questionnaires to students between 10 and 70 periods. Given the above study, it appears that there is still a lack of concern with the ethical-legal and bio-security in obtaining and handling human teeth by students. Data show the relevance of the functionality of the Human Teeth Bank, with the role of providing teeth to academics, teachers and researchers in an ethical, legal and standards of biosecurity, providing less risk of cross contamination.

Alteraciones estructurales de los dientes / Structural alterations of teeth

El propósito de este artículo de revisión es tener conceptos y criterios de clasificación actualizados y detallados de las características clínicas, radiográficas e histológicas de las patologías que alteran las estructuras dentales, con el fin de lograr un correcto diagnóstico y realizar el tratamiento más adecuado. Estas alteraciones dentales descritas son: hipoplasia del esmalte, amelogénesis imperfecta, dentinogénesis imperfecta, displasia de la dentina y odontodisplasia regional.

The purpose of this review is to have concepts and classification criteria updated and detailed clinical, radiographic and histological pathologies that alter the tooth structure in order to achieve a correct diagnosis and make the most appropriate treatment. These dental alterations described are: Enamel hypoplasia, Amelogenesis imperfecta, Dentinogenesis imperfecta, Dentin dysplasia and Regional odontodysplasia.

Granuloma central de células gigantes en un niño tratado con corticoide intralesional / Central giant cell granuloma in a child treated with intralesional steroid

El granuloma central de células gigantes (GCCG) es una lesión ósea benigna de los maxilares.Debido a su naturaleza localmente destructiva y a su alta recurrencia su tratamiento es muy complejo, requiriendo de procedimientos quirúrgicos repetitivos cuyos beneficios han sido cuestionados por que dejan secuelas estéticas y funcionales importantes. Una alternativa de tratamiento efectivo no quirúrgico es la administración intralesional de corticoide. Se presenta uncaso de GCCG en un niño de 9 años, localizado en la sínfisis mandibular, tratado exitosamente con triamcinolona intralesional. Se muestran la secuencia de cambios radiográficos que ocurrendurante la administración del corticoide y se discute la importancia del control periódico del cortisol plasmático, con la finalidad de detectar y tratar oportunamente la hipofunción del ejehipotálamo-hipófisis-suprarrenal producida por esta terapia.

The central giant cell granuloma (CGCG) is a benign intraoseous lesion of the jaw bones which main problem is related to its treatment. The locally destructive nature and high recurrence ratelead to repetitive surgical procedures with questionable benefits and functional and esthetic impairment. An alternative and effective non surgical treatment is the intralesional injection ofsteroids. It is reported a case of a CGCG in a 9-year-old boy. The lesion was located in the anterior part of the mandible and was treated successfully with intralesional administration oftriamcinolone acetonide. Sequential radiographic changes occurred in the lesion by the corticoid are shown. Emphasis is made about the need to monitor the plasma cortisol in order to detect and to treat alterations of the hypothalamic-pituitary-adreanal axis that can result for the use of corticoid therapy.