Synergistic antimicrobial effect of photodynamic therapy and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa: An in vitro study.

BACKGROUND: To date, no studies on the combined use of photodynamic therapy (PDT) and chitosan against peri-implantitis have been published. The aim of this study was to evaluate the possible synergistic antimicrobial effect of PDT and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. METHODS: A total of 60 titanium discs were included in this study. The discs were randomized into three bacterial contaminations (n = 20 discs per bacterium). After being cultured (incubated for 48 hours) they were randomized again into four different disinfection modalities (n = 5 discs per treatment): control (without treatment), PDT, chitosan 3 mg/mL, and PDT + chitosan 3 mg/mL. After the treatments, the colony forming units (CFU) were measured to determine antimicrobial effects, and field emission scanning electron microscopy (FESEM) was used to study cell morphology and titanium adherence. RESULTS: For all the evaluated bacteria and all the variables studied the order from highest to lowest antimicrobial effectiveness was: PDT + chitosan 3 mg/mL > chitosan 3 mg/mL > PDT > control. Although, all disinfection methods were significantly effective when compared to control, the combined treatment of PDT + chitosan 3 mg/mL had the greatest antimicrobial effect against the three studied bacteria. CONCLUSIONS: The combination of PDT and chitosan has a synergistic antimicrobial effect against the bacteria S. aureus, E. coli, and P. aeruginosa, all closely related to peri-implantitis. However, further in vivo studies are needed because this study provides data based on an in vitro scenario that might not be extrapolated to patients with peri-implantitis.

Evaluation of Quality of Life and Satisfaction in Patients with Fixed Prostheses on Zygomatic Implants Compared with the All-on-Four Concept: A Prospective Randomized Clinical Study.

Purpose: No published research has compared patients' quality of life and satisfaction with fixed prostheses supported by zygomatic implants with those supported by all-on-four prostheses. The aim of this study was to evaluate patients' quality of life and satisfaction with fixed prostheses on zygomatic implants compared with the all-on-four concept. Materials and Methods: A total of 80 patients with atrophic edentulous maxillae were randomized into two groups: Group 1 (rehabilitated with fixed prostheses supported by 2-4 zygomatic and 2-4 conventional implants in the anterior region) and Group 2 (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after placement of the definitive prostheses, patients completed OHIP-14 and satisfaction questionnaires. Results: In all seven domains of the OHIP-14 and in the overall scores, a worse quality of life was found in Group 2 patients, with statistically significant differences between the two groups (p ≤ 0.05). Patients with zygomatic implants were more satisfied with their prostheses, with a statistically significant difference (p < 0.001). Conclusions: According to the results of this study, rehabilitation of patients with edentulous atrophic maxillae with prostheses supported by zygomatic implants combined with anterior implants provided better patient quality of life and satisfaction than prostheses supported by four implants.

Genotype of Null Polymorphisms in Genes GSTM1, GSTT1, CYP1A1, and CYP1A1*2A (rs4646903 T>C)/CYP1A1*2C (rs1048943 A>G) in Patients with Larynx Cancer in Southeast Spain.

BACKGROUND: some types of cancer have been associated with the presence of single nucleotide polymorphisms (SNPs) of some genes that encode enzymes: glutathione-S transferase (GST), whose alteration leads to loss of function and a lower capacity to eliminate toxic GSTM1 and GSTT1 null genotypes; SNPs causing loss of function of CYP1A1 or CYP1A1-2 cytochrome P450 enzymes related with a lower capacity to deactivate hydrocarbons related to smoking, which involves a higher risk of developing some smoking-dependent cancers including larynx cancer. OBJECTIVE: to compare the presence of null SNPs in genes GSTM1, GSTT1, and CYP1A1 rs 4646903 T>C, and CYP1A1-2 RS1048943 A>G in patients with hypopharyngeal and larynx cancer with a healthy control group. MATERIALS AND METHOD: The study included a total of 80 patients with hypopharyngeal and laryngeal cancer and 23 healthy subjects. Genomic DNA was obtained from saliva samples, determining genotype GSTM1 (present +, or null -), GSTT1 (present + or null -). Polymorphisms (SNP) in CYP1A1 T>C (present + CC, or absent - TC/TT), and CYP1A1-2 A>G (present + GG, or absent - AG/AA). RESULTS: the mean age of patients with larynx cancer was 62 years and of control subjects 63 years. Of the total sample, over 95% were men, and over 90% were smokers. The presence of null genotypes for GTM1 was 50% in patients with larynx cancer (p = 0.042), while GSTT1 was 88.75% (p = 0.002). CYP1A1 rs4646903 T>C polymorphisms were detected in 100% of cases of larynx cancer and 17.39% of healthy subjects (p > 0.001). CONCLUSIONS: patients with larynx cancer present more gene GSTM1 and GSTT1 null polymorphisms, and CYP1A1 rs4646903 T>C polymorphisms.

Chemopreventive effect of pomegranate and cocoa extracts on ultraviolet radiation-induced photocarcinogenesis in SKH-1 mice.

Non-melanoma skin cancer (NMSC) has a high and increasing incidence all over the world. Solar radiation is the main aetiology for humans. Although most research into photocarcinogenesis uses UVB as a source of radiation, UVA is also carcinogenic in long term. Pomegranate (PGE) and cocoa (CE) extracts have been used for medicinal purposes for time immemorial. Recently, it has been claimed that some of their properties may be an effective preventative measure against photocarcinogenesis and photoaging, but to date in vivo models have not been tested using RUVA, the objective of the present work. A lower incidence of lesions was observed in SKH-1 mice treated with PGE (p<0.001), and lower incidence of invasive squamous carcinoma in both treatment groups (p<0.001 for PGE and p<0.05 for CE); the PGE group also showed a lower level of cell proliferation than the control group (p<0.001). Significantly greater p53 alteration was observed in the control group than the treatment groups (p<0.001 for PGE and p = 0.05 for CE). No significant differences were found in relation to TIMP-1 and MMP-9. Taken together, the results suggest that oral feeding of PGE and CE to SKH-1 mice affords substantial protection against the adverse effects of RUVA, especially PGE.

Prevalence of human papillomavirus in the saliva of sexually active women with cervical intraepithelial neoplasias

BACKGROUND: The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. MATERIAL AND METHODS: Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. RESULTS: The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p = 0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p < 0.001; p = 0.017; p = 0.002; and p < 0.001, respectively); condom use was also found to be related to the presence of oral HPV (p < 0.001). CONCLUSIONS: The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results

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Attitudes of dental implantologists in Spain to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients

BACKGROUND: The implantologists frequently prescribe antibiotics, analgesics and anti-inflammatories in dental implant surgery. The aims of this study were to evaluate the attitudes of implantologists in Murcia (Spain) to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients during different implant dentistry procedures, and to see how these are influenced by individual dentist's academic level, professional experience, and ongoing training (attending courses or reading scientific literature on medication use). MATERIALS AND METHODS: This cross-sectional study included a total of 200 implantologists from the Murcia area (Spain), who each completed a two-page questionnaire consisting of 26 questions. RESULTS: The implant procedure in which most dentists (n = 97) prescribed antibiotics was multiple implant surgery with flap raising, in which 55.6% of these 97 respondents used a prophylactic antibiotic regime for 7 days after implant placement. All subjects (n = 200) prescribed analgesics for eight out of the eleven procedures included in the survey and anti-inflammatories in six. Dentists with higher academic levels or longer professional experience prescribed more antibiotics, but those who underwent continuous training (attending courses or reading scientific literature) reduced antibiotic prescription. CONCLUSIONS: Dentists often prescribed antibiotics, analgesics and anti-inflammatories in almost all implant procedures in healthy patients, but ongoing training reduced the frequency of antibiotic prescription in some procedures

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Impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment.

BACKGROUND: Few studies have reported the impact of audiovisual implant surgery information on anxiety and fear. PURPOSE: To investigate the impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment. MATERIALS AND METHODS: This study included 300 patients due to undergo surgery to place a single implant. An interview topic guide and the Krantz Health Opinion Survey (KHOS) survey were used to assess the information patients already had about treatment and how much information they were seeking. Afterwards were randomized into two groups (n = 150): group 1 (verbal information) and group 2 (audiovisual information). Before surgery, anxiety and fear were assessed using State-Trait Anxiety Inventory (STAI), Modified Corah Dental Anxiety Scale (MDAS), and Dental Fear Scale (DFS) scales. After treatment, all patients described their satisfaction with the information received with a VAS. RESULTS: Before receiving information, both groups were homogenous in their knowledge of the implant procedure (P = .825) and the quantity of information sought (KHOS; P = .080). After receiving information, group 2 patients presented more anxiety and fear than group 1 (STAI-State, STAI-Treat, MDAS, DFS; P < .001). After surgery, both groups were equally satisfied with the information received and the need for additional information (P = .689; P = .199, respectively). CONCLUSIONS: Audiovisual information generated greater anxiety and fear than conventional verbal information in patients undergoing implant surgery.

Genotyping of the C>T allele of rs16906252, predictor of O16-methylguanine-DNA methyltransferase (MGMT) promoter methylation status, in erosive atrophic lesions of oral lichen planus.

BACKGROUND: DNA promoter methylation is usually an early stage in carcinogenesis process, including oral cancer. The purpose of this study was to investigate the association between T allele of specific single nucleotide polymorphism (SNP) C>T rs 16906252 and O16-methylguanine-DNA methyltransferase (MGMT) methylation as prospective biomarkers of malignant transformation in oral lichen planus (OLP), a chronic autoimmune mucocutaneous disease. METHODS: This research is an observational, analytical case-control study where a total of 85 subjects (43 control individuals and 42 OLP patients) participated. The samples (mouthwashes) from all volunteers were analyzed, and DNA extraction was carried out. The genotyping of the rs 16906252 SNP in the MGMT gene was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Statistical analyses of Student t test and multiple logistic regressions were used. RESULTS: C>T genotype in the control and OLP groups was detected in 2.3% and 19.0%, respectively. The presence of this genotype was associated with methylation of the MGMT gene. In fact, taking into account age and gender, subjects with C>T genotype were 10.5 (95% CI 1.03-106; P = 0.047) times more likely to methylate promoter region of the MGMT gene. CONCLUSIONS: These findings indicate that C>T allele of rs 16906252, predictor of MGMT promoter methylation status, may be an important feature in the clinical prognosis of premalignant lesions of OLP, although this finding requires further clinical and laboratory investigation.

Salivary myeloperoxidase and malondialdehyde are increased in patients exhibiting an asymptomatic mandibular impacted third molar

Background: To determine whether saliva is a good means of evaluating concentrations of oxidative stress bio-markers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare bio-marker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before ex-traction) with a healthy control, and to determine how biomarkers are modified by extraction. Material and Methods: 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues were obtained during surgery to measure biomarkers. One month after extraction, saliva samples were collected to assess changes of oxidative stress. Results: Salivary MPO and MDA showed positive correlation with concentrations in follicular tissue (MPO: correlation coefficient = 0.72, p = 0.025; MDA: = 0.92, p = 0.001). Patients with asymptomatic MITMs showed higher salivary concentrations of oxidative stress biomarkers than healthy control subjects, with statistical significance for both MPO (p < 0.001) and MDA (p < 0.001). One month after extraction, salivary biomarkers decreased significantly in the study group (p < 0.001)

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Crestal bone loss around submerged and non-submerged implants during the osseointegration phase with different healing abutment designs: a randomized prospective clinical study.

OBJECTIVE: To evaluate peri-implant crestal bone loss during the osseointegration period, comparing submerged and non-submerged implants with healing abutments of different design. MATERIALS AND METHODS: A total of 90 Avinent®  dental implants (Avinent Implant System, Barcelona, Spain) were placed in 90 patients. All were sited in the posterior mandibular zone to replace teeth 3.6 or 4.6. Patients were divided randomly into three groups: submerged (n = 30), non-submerged with anatomical healing abutment (n = 30), and non-submerged with esthetic healing abutment (n = 30). Peri-implant crestal bone loss was evaluated in intraoral radiographs taken at baseline, 1, and 3 months after implant placement. RESULTS: Peri-implant crestal bone loss at the end of the (3-month) osseointegration period was lowest in the submerged group (0.11 ± 0.14 mm), followed by the esthetic non-submerged group (0.15 ± 0.06 mm), but without statistically significant difference between these groups (P = 0.234). The greatest bone loss was produced in the non-submerged group with anatomical healing abutments (0.37 ± 0.12 mm), with significant differences between this group and the other two (P < 0.001). CONCLUSIONS: On the basis of these findings, bone resorption during the osseointegration period using the non-submerged technique varied significantly depending on the morphology of the healing abutment used. The non-submerged technique with an esthetic healing post-produced an equally predictable outcome compared with the submerged technique.

Long-term evaluation of quality of life and satisfaction between implant bar overdentures and conventional complete dentures: A 23 years retrospective study.

BACKGROUND: Dental implants have been used in edentulous jaws to improve the retention and stability of complete dentures. Attachment to the implants improves stability and function of the prostheses and increases patient satisfaction. PURPOSE: The aim of this study was to evaluate quality of life and satisfaction between patients with implant overdentures and complete dentures for more than 20 years. METHODS: Forty patients with overdentures and 40 patients with conventional complete dentures were included in this study. Both groups are carriers of their prosthesis more than 20 years. All patients completed an OHIP-14 and perception and satisfaction questionnaire related their implant prothesis. RESULTS: Follow-up mean in patients with overdentures were 23.27 ± 1.87 years and 23.20 ± 3.91 years for conventional prosthesis group. A worse quality of life was shown in the group of patients with conventional dentures in the 7 dimensions and in the total value, with statistically significant differences in 6 dimensions and in the total value (P ≤ .05). Patients with implants overdenture were more satisfied than patients with conventional dentures, with statistically significant differences (P < .001). CONCLUSIONS: Implant overdentures on cobalt chrome and gold bars offer an excellent long-term solution for edentulism compared with conventional denture.

Long-Term Fatigue and Its Probability of Failure Applied to Dental Implants.

It is well known that dental implants have a high success rate but even so, there are a lot of factors that can cause dental implants failure. Fatigue is very sensitive to many variables involved in this phenomenon. This paper takes a close look at fatigue analysis and explains a new method to study fatigue from a probabilistic point of view, based on a cumulative damage model and probabilistic finite elements, with the goal of obtaining the expected life and the probability of failure. Two different dental implants were analysed. The model simulated a load of 178 N applied with an angle of 0°, 15°, and 20° and a force of 489 N with the same angles. Von Mises stress distribution was evaluated and once the methodology proposed here was used, the statistic of the fatigue life and the probability cumulative function were obtained. This function allows us to relate each cycle life with its probability of failure. Cylindrical implant has a worst behaviour under the same loading force compared to the conical implant analysed here. Methodology employed in the present study provides very accuracy results because all possible uncertainties have been taken in mind from the beginning.

A low dose of subperiosteal anaesthesia injection versus a high dose of infiltration anaesthesia to minimise the risk of nerve damage at implant placement: A randomised controlled trial.

PURPOSE: To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. MATERIAL AND METHODS: One hundred and twenty patients requiring the placement of a single implant in order to replace a missing first mandibular were randomly allocated to two groups: group A (awake hemilip) subperiosteal crestal injection equal to 0.9 ml of articaine with 0.5% epinephrine and group B (numb hemilip) infiltration equal to 7.2 ml of articaine with 0.5% epinephrine in the vestibular fundus. Intraoperative sensory control using sensory tests was carried out in all patients. Outcome measures were neurological complications, intraoperative and postoperative visual analogue scale (VAS) scores for pain and swelling, and a questionnaire evaluating patient satisfaction. Patients were followed for 1 week postoperatively. RESULTS: There were no cases of nerve injury. Seven days after surgery the postoperative VAS score for pain and swelling was lower in group A in a statistically significant manner (difference = -3.41%; 95% CI: -5.57, -1.26; P = 0.002 and difference = -3.33%; 95% CI: -5.41, -1.25; P = 0.002, respectively). CONCLUSIONS: No nerve damage occurred using either anaesthesia types, therefore the choice of type of anaesthesia is a subjective clinical decision, however it may be preferable to use a low dose (0.9 ml) of subperiosteal anaesthesia, since it is unnecessary to deliver 7.2 ml of articaine to anaesthetise a single mandibular molar implant site.

Salivary Concentration of Oxidative Stress Biomarkers in a Group of Patients with Peri-Implantitis: A Transversal Study.

PURPOSE: The purpose of this study was to know if peri-implantitis causes an increase in the total salivary concentration of oxidative stress markers. MATERIALS AND METHODS: Seventy patients, 28 men and 42 women, 60 of them with dental implants, 30 of which had peri-implantitis and 30 were healthy. The remaining 10 were the control group: healthy subjects without implants. The average number of implants per patient was 4.70 ± 2.29 in the peri-implantitis group and 2 70 ± 2.11 in the control group. Periodontal/peri-implant variables were assessed, including bleeding index, gingival index, clinical attachment level, probing depth, presence of pockets larger than 4 and 6 mm, pain to percussion, suppuration, gingival hyperplasia or granuloma, crestal bone loss (both mesially and distally), evaluated through periapical radiography. Saliva samples from the 70 subjects were collected for measurement of malondialdehyde high performance liquid chromatography (HPLC) and myeloperoxidase (enzyme-linked immunosorbent assay analysis) concentrations. RESULTS: Implants affected with peri-implantitis had an average follow-up of 26.40 ± 7.97 months. 4.12% of implants with peri-implantitis had a painful response to percussion. 2.06% showed suppuration; 25.77% had granuloma. The mean crestal bone loss in implants wtih peri-implantitis was 3.78 ± 1.17 mm. Total salivary malondialdehyde concentration in the peri-implantitis group (0.52 ± 0.37 µM/l) was slightly higher than that in the group with healthy implants (0.40 ± 0.16 µM/l) and also slightly higher than that in the group of healthy patients without implants (0.41 ± 0.79 µM/l), although the difference was not statistically significant, p value = .442. Myeloperoxidase concentration was slightly higher in the peri-implantitis group (12.32 ± 2.17 ng/ml) than in the group with healthy implants (11.54 ± 2.80 ng/ml) and the group of healthy patients without implants (11.86 ± 2.67 ng/ml), without statistically significant differences, p value = .584. CONCLUSIONS: The salivary concentration of oxidative stress markers in patients with peri-implantitis and without periodontitis is not higher than that found in healthy patients.

Periodontal disease as a risk factor of recurrence of venous thromboembolic disease: a prospective study.

BACKGROUND: In recent years, periodontal disease has been related to a large number of systemic disorders. OBJECTIVE: To study the possible relationship between periodontal disease and high levels of D-dimer in a group of patients with venous thromboembolic disease. MATERIALS AND METHODS: A study was made of 142 patients diagnosed with unprovoked venous thromboembolic disease. All patients underwent oral examination consecutively and randomly. Finally, two groups were obtained: (a) patients with periodontal disease (n = 71); and (b) patients without periodontal disease (n = 71). All patients were subjected to periodontal study, with evaluation of the number of teeth, bleeding index, gingival index, simplified oral hygiene index, community periodontal index of treatment needs, clinical attachment level, probe depth, number of pockets ≥4 mm, number of pockets ≥6 mm. The D-dimer values were evaluated in both groups. RESULTS: D-dimer values were higher in the study group than the control group, with statistically significant differences (p = 0.010). CONCLUSIONS: A relationship is observed between the presence of periodontal disease and high D-dimer levels. Patients with venous thromboembolic disease and periodontal disease could have more risk of a new thromboembolism episode.

No Evidence of Genotoxic Damage in a Group of Patients with Titanium Dental Implants and Different Metal Restorations in the Oral Cavity.

BACKGROUND: Titanium is the most widely used metal in implant dentistry. In spite of its biocompatibility, when it is released into the oral environment, it can have local negative biological effects. PURPOSE: The aims of this study were to detect the concentration of metal ions in patients with dental implants, to evaluate whether or not their release might be influenced by the presence of other metals, and to assay whether these ions might provoke genotoxic damage in oral mucosa cells. MATERIALS AND METHODS: One hundred five patients with a total of 180 dental implants were included. The sample was divided into seven groups (n = 15 per group). Group 1 consisted of patients with metal-porcelain fixed crowns on dental implants; Group 2, patients with metal-porcelain fixed crowns on teeth; Group 3, patients with dental amalgams; Group 4, patients with metal-porcelain fixed crowns on dental implants and metal-porcelain fixed crowns on teeth; Group 5, patients with metal-porcelain fixed crowns on dental implants and dental amalgams; and Group 6, patients with metal-porcelain fixed crowns on dental implants, metal-porcelain fixed crowns on teeth, and dental amalgams. Group 7 was the control group, without any dental treatment. The concentration of metal ions was detected using inductively coupled plasma mass spectrometry; genotoxicity was measured using the buccal micronucleus cytome assay protocol. RESULTS: Group 5 displayed the highest concentration of metal ions in parts per billion (Ti, Co, Ni, Zn, Pd, Sn, and Pb). Group 6 was characterized by the highest presence of Hg. No signs of genotoxic damage were found in any of the study groups. CONCLUSIONS: Patients with titanium dental implants combined with other metal restorations presented higher concentrations of metal ions, but no genotoxic damage was observed in oral mucosal epithelial cells.

Cytogenetic biomonitoring in oral leukoplakia patients with mild dysplasia.

OBJECTIVE: A study is made of DNA damage and apoptosis in a group of patients with oral leukoplakia (OL) with mild dysplasia. MATERIALS AND METHODS: The study comprised 30 patients with a clinicopathological diagnosis of OL with mild dysplasia and 30 controls. Both samples were similar in terms of age and gender distribution. Brush samples of lesion epithelial cells were collected, followed by cell centrifugation, preparation of the slides, fixation and staining, and analysis under the fluorescent light microscope. The exfoliated cells were examined to detect micronuclei (MN), nuclear buds, binucleated cells, condensed chromatin, pyknosis, and cells with karyorrhexis and karyolysis. RESULTS: The patients with OL with mild dysplasia showed a greater frequency of MN (P < 0.001), nuclear buds (P = 0.018), and binucleated cells (P = 0.008). CONCLUSIONS: Cytogenetic biomonitoring is a simple and scantly invasive technique allowing clinicians to assess DNA damage and apoptosis in patients with OL. CLINICAL RELEVANCE: Oral cancer should be detected and controlled in its precancerous stages in order to increase survival rates. Leukoplakia lesions must be biomonitorized periodically. Biomonitorization offers sensibility, no morbidity, speed, and low cost.

Oral and dental health in pregnant women: attitudes among dentists in southeastern Spain.

A study was undertaken to determine the general level of knowledge, attitudes and practices in clinical dental care of pregnant women. This was a transversal descriptive study in the form of a structured and anonymous survey completed by dentists in Murcia (southeast Spain). The questionnaire was sent by e-mail and investigated dentists' knowledge of and attitudes toward different dental procedures applying to pregnant women. The response rate to the questionnaire was 60%. The vast majority of dentists (81.3%) agreed that oral care should be part of general healthcare for pregnant women. However, discrepancies were found in knowledge and attitudes to practice.

Dental implants in patients with oral lichen planus: a cross-sectional study.

PURPOSE: The main aim of this study was to evaluate the patients with oral lichen planus (OLP) and dental implants. MATERIAL AND METHODS: Three groups of 16 patients took part in the study. Group I patients had received dental implants and been diagnosed with OLP; Group II had not received implants but were diagnosed with OLP; Group III had implants but not OLP. Clinical observations and OLP symptoms were registered in each case. Periodontal pocket depth, implant mobility, bleeding upon probing, erythema, pain, and radiolucency around implants were measured. Patient quality of life was evaluated using OHIP 14. RESULTS: Peri-implant mucositis and peri-implantitis were detected in 17.86% and 25% of the OLP-implant group, while the control group with implants showed 18% and 16%. The implant survival rate in patients treated for OLP did not appear to differ from the survival rate among the general population. Quality of life was better among patients with implants and without OLP (p = .001). CONCLUSIONS: The results of the present study suggest that implants do not influence manifestations of OLP. OLP is not a risk factor for peri-implantitis.

High volume local anesthesia as a postoperative factor of pain and swelling in dental implants.

OBJECTIVE: To determine whether the administration of high-volume local anesthesia can influence postoperative pain and swelling, and the degree of patient satisfaction, following dental implant placement. MATERIAL AND METHODS: One hundred patients (45 women and 55 men) between 19 and 80 years old were divided into two groups: group A (n = 50, with placement of an implant using an atraumatic approach in each patient, with sub-periosteal injection of a volume of Ultracain(®) ≤0.9 mL [half a carpule]) and group B (n = 50, involving the same surgical procedure but infiltrating a local anesthetic volume of ≥7.2 mL [four carpules]). Visual analog scales were used in all patients to rate intraoperative pain and postoperative pain and swelling. After the first week, the patients completed a questionnaire evaluating satisfaction with treatment. RESULTS: The intraoperative pain scores were similar in both groups (p = 0.363), while the postoperative pain and swelling scores were significantly lower in group A at all time points. Patient rated satisfaction with the surgical treatment was higher in group A. CONCLUSIONS: Excess injected volume of local anesthetic in dental implant surgery has a negative impact upon both postoperative pain and swelling, and on patient rated satisfaction.