Cambios dimensionales de los tejidos en los procedimientos de alargamiento coronario / Dimensional changes in tissues after crown lengthening procedures

INTRODUCCIÓN: Las coronas clínicas cortas son subsidiarias de recibir un tratamiento de alargamiento coronario. En ocasiones es necesario restaurar los dientes después del procedimiento. En estos casos es importante no invadir el espacio biológico para evitar las distintas reacciones del periodonto. El objetivo de esta revisión es analizar los cambios dimensionales que se producen a nivel de los tejidos duros y blandos antes y después de la intervención para poder planificar de forma más precisa la restauración posterior. MATERIAL Y MÉTODOS: Se realizó una búsqueda en Pubmed con las palabras clave "crown lengthening", limitada a artículos en lengua inglesa, publicados entre los años 1990-2009, que fueran estudios clínicos. La recuperación de los documentos se realizó en la hemeroteca de la Facultad de Odontología de la UCM y en la base de datos Compludoc. Dos evaluadores revisaron los artículos de forma individual. RESULTADOS Y DISCUSIÓN: Los siete artículos, que incluían tanto estudios en animales como en humanos, que fueron incluidos en la revisión, analizaban índice gingival, nivel óseo, profundidad de sondaje, nivel de inserción y anchura biológica, y longitud de la corona y posición de margen gingival. CONCLUSIONES: El nivel óseo se altera los 3 primeros meses, pero posteriormente se mantiene constante. Los estudios a más largo plazo no encuentran diferencias significativas en profundidad de sondaje a hueso 6 y 12 meses después del alargamiento

INTRODUCTION: Short clinical crowns may be treated with crown lengthening techniques. Sometimes teeth need to be restored after the surgery. In these cases it is important not to invade the biological width to avoid the different reactions of the periodontium. The objective of this review is to examine the dimensional changes that occur at the level of hard and soft tissues after surgery in order to plan more accurately the subsequent restoration. MATERIAL AND METHODS: We performed a search in PubMed with the keyword "crown lengthening", limited to English language articles, that were published between the years 1990-2009, which were clinical trials. The recovery of documents was held in the periodicals of the Faculty of Dentistry in UCM, and in Compludoc database. Two evaluators reviewed the papers individually. Results and DISCUSSION: The seven articles, including studies in both animals and humans, which were included in the review, analyzing gingival index, bone level, probing depth, attachment level and biological width, and crown length and the position of the gingival margin. CONCLUSIONS: Bone level is altered during the first 3 months, but thereafter remains constant. The longer-term studies found no significant differences in bone probing depth at 6 and 12 months after the surgery

Efectos de un colutorio de clorhexidina y cinc sobre una población infantil maloclusiva / Efficacy of a mouthrinse containing chlorhexidine and zinc in a young malocclusive population

Se realiza un estudio aleatorio, estratificado a doble ciego y paralelo en 80 pacientes con diferentes tipos de maloclusiones que posteriormente serían tratados de ortodoncia, con edades comprendidas entre 9 y 14 años, para ver la eficacia de un colutorio de clorhexidina y cinc.La duración del estudio fue de 6 semanas. Los participantes se distribuyeron en cuatro grupos, cada uno de 20 pacientes: experimental (digluconato de clorhexidina, 0,006 por ciento, y acetato de cinc, 0,34 por ciento), control positivo (digluconato de clorhexidina, 0,12 por ciento), estándar (triclosán, 0,15 por ciento; cloruro de cinc, 0,20 por ciento, y alantoína, 0,20 por ciento) y placebo. Se midieron en todos los grupos diferentes parámetros clínicos a los 15 y 45 días (índice de placa, gingivitis, cálculo y tinción) y parámetros microbiológicos a los 45 días (gérmenes en placa y saliva). En cuanto a los parámetros clínicos, el colutorio control positivo es el que muestra la mayor eficacia en la reducción del índice de placa y gingivitis; sin embargo, también es el único en el que aumenta la tinción y el índice de cálculo. El colutorio experimental también disminuye el índice de gingivitis, aunque menos que el control positivo, y no tiene ningún efecto negativo sobre el cálculo ni la tinción. Respecto a los parámetros microbiológicos no se encuentran diferencias significativas en el comportamiento de ninguno de los colutorios. Sin embargo, en saliva se encuentra una disminución del Streptococcus mutans en todos los grupos excepto en el placebo. El lactobacilo disminuye especialmente en el colutorio experimental y el grupo estándar. Se puede concluir diciendo que el colutorio de digluconato de clorhexidina y acetato de cinc es recomendable para pacientes maloclusivos jóvenes que van a ser tratados de ortodoncia, ya que produce una disminución del índice de gingivitis y de la cantidad de Streptococcus mutans en saliva sin producir ninguno de los efectos indeseables habitualmente asociados al uso de la clorhexidina (AU)

Chronic myeloid leukemia with expression of ALL-type BCR/ABL transcript: a case-report and review of the literature.

CML with exclusive expression of ALL-type bcr/abl has only been rarely described. In some cases, the presence of this fusion gene has been associated to a differentiated subtype of CML that share some features with CMML, while in another case this molecular hallmark has been associated to a bad prognosis of the disease with a blast phase as clinical presentation or an early transformation to blast phase. We report a case of a 30-year-old woman who was diagnosed of CML in chronic phase in May 1989. She received treatment first with busulfan, achieving hematological remission and afterwards with interferon and Hydroxiurea. In February 1998, she was admitted at our hospital for an ABSCT. Then, molecular studies were performed. Multiplex PCR revealed the presence of a 481 bp product identified as the ela2 bcr/abl transcript and confirmed by sequencing. After 9 years from diagnosis, the patient remains in hematological remission and in good clinical condition.

Use of reverse-transcriptase polymerase chain reaction (RT-PCR) for carcinoembryonic antigen, cytokeratin 19, and maspin in the detection of tumor cells in leukapheresis products from patients with breast cancer: comparison with immunocytochemistry.

This study evaluates the role of reverse-transcriptase polymerase chain reaction (RT-PCR) assay for carcinoembryonic antigen (CEA), cytokeratin 19 (CK19), and maspin transcripts to identify breast cancer cells (BCC) in leukapheresis products (LP) collected from breast cancer (BC) patients and compares these results with those obtained using immunocytochemistry (IC). Eighty-four LP obtained from 33 patients with stage II-III BC and control subjects without BC were screened for the presence of BCC by IC and CK19, CEA, and maspin expression using RT-PCR. CEA RT-PCR and IC were the only specific markers, as no false positives were detected in any patients without BC. CK19 RT-PCR gave 11% false positives, whereas maspin RT-PCR with 25% was the most unspecific marker. In LP from BC patients, positive results were observed in 70% and 63% for CK19 and CEA RT-PCR, respectively. For maspin RT-PCR, this percentage was 22%, and for IC it was 17%. There was a good correlation between the CEA and CK19 RT-PCR (p = 0.018). No correlation between CEA and CK19 RT-PCR and IC was found, and although 5 of the 6 IC+ samples were CEA+/CK19+, great discrepancies in the group of IC- samples were observed. Our data suggest that RT-PCR assays for CEA and, to a lesser extent, for CK19 have more sensitivity and specificity than IC to detect BCC in LP.

Minimal illegitimate levels of cytokeratin K19 expression in mononucleated blood cells detected by a reverse transcription PCR method (RT-PCR).

Cytokeratin K19 (CK19) expression was evaluated by a reverse transcription PCR method (RT-PCR) in the RNA obtained from peripheral blood stem cell collections (PBSC) from four patients with breast cancers (BC) and 34 mononucleated blood cell (MBC) negative controls (17 PBMC from normal subjects 12 PBSC from different types of leukaemias--M3, M4Eo, M2, etc.--and two from patients with Hodgkin's lymphoma; and three bone marrow (BM) collections). Two BC tissues were taken as positive controls. The method studied (Datta YH, Paul T, Adams PT, Drobyski WR. Sensitive detection of occult breast cancer by reverse transcription polymerase chain reaction. J Oncol 1994;12:475-8) is sensitive enough to allow the detection of CK19 transcripts in a 10(-6) dilution of cDNA reverse transcribed from 1 microgram of BC RNA, but CK19 transcripts were also detected in 64% of the RNA obtained from the MBC controls. However, the amplified product detected in the control samples represents the transcript of the CK19 gene as confirmed by the results of Mae III digestion. It should be pointed out that although the CK19 expression was detected, the levels of expression in PBMC were almost negligible for they disappeared at 1:5 cDNA dilution. Moreover, a direct relationship between the number of BC cells added to PBMC and the increasing dilution levels of the cDNA necessary to prevent CK19 expression was observed. This allows us to conclude that the cDNA dilutions make it possible to distinguish the false from the true positive samples and that, in addition, the cDNA dilutions inform about the degree of BC cell contamination.

[Levels of cytokeratin CK19 expression in mononuclear blood cells evaluated using a reverse PCR (RT-PCR)]. / Niveles de expresión de la citoqueratina CK19 en células sanguíneas mononucleadas evaluada mediante un método de PCR reversa (RT-PCR).

AIMS: The sensitivity and specificity of a reverse transcription PCR method (RT-PCR) to detect cytokeratin K19 (CK19) expression was evaluated with the purpose of assessing its capability to detect the presence of breast cancer tumour cells in peripheral blood progenitor cell collection that had to be reinfused to breast cancer patients submitted to intensive chemotherapy as haematopoietic support. PATIENTS AND METHODS: Two breast cancers as positive samples were used and 34 samples of mononucleated blood cells as negative controls: 18 peripheral blood samples from normal subjects, 14 from different types of leukaemias (M3, M4Eo, M2, etc.) and two from two patients with Hodgkin's lymphoma. The method studied is a nested RT-PCR that amplifies the CK19 expression from the sample RNA extracted following the method of phenol-chloroform. RESULTS: The right performance of the method is demonstrated by observing the detection of CK19 transcripts in the breast cancer RNA and by obtaining good blank results both with non transcribed RNA and with DNA. Moreover, the method has an excellent sensitivity such as to allow the detection of CK19 transcripts in a 10(-6) dilution of cDNA reverse transcribed from 1 microgram of breast cancer RNA. The CK19 transcripts were also detected in the 64% of RNA obtained from the mononucleated blood cells controls, although the percentage of positivities was lower (47%) in the RNA from peripheral blood samples. Nevertheless it should be remarked that the levels of CK19 expression in the blood mononucleated cells is almost negligible since it used to extinguish at 1:5 cDNA dilution. CONCLUSIONS: The method studied is specific and has a high sensitivity that explains the detection of CK19 illegitimate expression approximately a half in mononucleated blood cells negative controls. However, the levels of CK19 expression in mononucleated blood cells were almost negligible and it used to extinguish at 1:5 cDNA dilution, therefore it could be concluded that the method might be useful to detect breast cancer occult tumours cells in mononucleated blood cell collection, always provided that a lower amount of cDNA is taken, thus decreasing to nil almost the false positive samples and keeping always a good sensitivity.

Root treatment in vivo with a new rotary periodontal instrument: a profilometer study.

The purpose of this study was to compare, in vivo, in 30 teeth destined for extraction, the abilities of the Scalex rotary bur system and Gracey curettes to obtain a smooth root surface. The time taken for each treatment was also evaluated. The profilometry results showed no significant differences between instruments with regard to roughness or working time, in single-rooted teeth, multirooted teeth, or in pockets of 5 mm or more. Only for distal longitudinal roughness and in pockets less than 5 mm did the Scalex system perform slightly better. There was some improvement in working time when the distal surfaces were instrumented with Scalex. Both systems demonstrated a similar capacity to render smooth surfaces.

[Microbiological changes in subgingival flora after treatment with amoxicillin-clavulanic acid]. / Cambios microbiológicos en la flora subgingival después del tratamiento con amoxicilina-ácido clavulánico.

The association amoxicillin-clavulanic acid can be employed as an alternative to the usual antibiotic therapy of periodontitis. The purpose of this study was to determine subgingival microbial changes in 33 patients with periodontitis after using amoxicillin (500 mgrs.-t.i.d.) and clavulanic acid (125 mgrs.-t.i.d.) for 5 days. It resulted clinically in a decrease of both gingival index and plaque index (not significant) and microbiologically in absence of the main bacterial pathogens found pretreatment, such as Bacteroides melaninogenicus, Bacteroides intermedius, Eikenella corrodens and Actinomyces sp., although it was not able to eliminate Actinobacillus asinomycetemcomitans from a juvenile periodontitis and from a prepuberal periodontitis patient. Atibiotic susceptibility testing showed that all bacteria tested were sensitive to this antibiotic. Although this short term study shows good microbial response of main periodontal pathogens, long term studies are necessary to assess the effect of this antibiotic in periodontitis therapy.

[Bone loss in an urban juvenile population in Oviedo]. / Pérdida ósea en la población juvenil urbana de Oviedo.

Periodontal bone loss in 126 individuals between 9 and 20 years of age was screened radiographically by means of 2 standarized interproximal bite-wings radiographs. This group was selected from a population of 1253 young people according to the criteria of "having one or more probing pocket depths equal or higher than 4 mm". "Bone loss" was measured when the distance from the CEJ to the alveolar crest was greater than 2 mm per cent of this sample had bone loss, being more prevalent in females (34.3%) than in men (18.75%). Vertical defects predominated in the mesial aspect of mandibular first molars. Only one individual had radiographic features typical of localized juvenile periodontitis, representing 0.7% of the selected sample and 0.007% of the population studied.