Estudio clínico de los implantes dentales Naturactis en postextracción dental / Clinical study of naturactis dental implants postextraction dental procedures

Introducción: Los implantes inmediatos postextracción tienen un éxito variable según diferentes autores entre un 92,7% y 98,0%. Su principal indicación es la sustitución de dientes susceptibles de extracción. Su ventaja principal es la de acortar el tiempo de tratamiento rehabilitador y evitar una segunda cirugía. Como inconveniente destaca el requerir, generalmente, técnicas de regeneración tisular guiada. Material y método: 60 implantes Naturactis de Euroteknika (Euroteknika Groupe, Sallanches - Francia) fueron colocados de forma inmediata postextracción siguiendo un protocolo clínico de actuación. 33 pacientes fueron incluidos en este estudio en base a unos criterios de inclusión. Se analizaron variables clínicas (edad, sexo y hábitos tóxicos), quirúrgicos (torque de inserción, evaluación periodontal, estabilidad con Ostell) radiológicos (pérdida ósea crestal). Todos ellos fueron analizados 10 meses vista. Se evitaron las descargas mucoperiósticas en todos los casos. Resultados: Los implantes colocados obtuvieron un torque de inserción >35 Nm tras su colocación así como unos valores >63 ISQ de Ostell. El protocolo quirúrgico fue satisfactorio por los operadores. 4 implantes del total fracasaron de forma temprana (<1 mes). Se constató ausencia de pérdida ósea crestal en los primeros 6 meses de su colocación. La cicatrización y postoperatorio fue satisfactoria con ausencia de complicaciones (AU)

Introduction: Dental implants places in dental fresh sockets, have a variable success according to different authors, between 92,7% and 98%. Its principle indication is to substitute teeth admitting dental extraction. Its principle advantage is a shorter time of treatment up to loading of the prosthesis, also it avoids a second surgery and improves the healing process. As an inconvenient we remark, the need for guided tissue regeneration. Material and method: 60 dental implants (Naturactis from Euroteknika Groupe, Sallanches - Francia) were placed immediate after dental extraction with a clinical protocol. 33 patients were included in this study, based on some inclusion criterias. We analyzed clinical aspects like (age, gender, toxic habits), surgical aspects (insertion torque, periodontal evaluation, ostell stability measure), radiology (crestal alveolar resorption). All these cases were analyzed during 10 months. Mucoperiostical flaps were avioded in all cases. Results: All dental implants placed, achieved at least 35 NM after placed, as well a >63 ISQ measured with Ostell. The surgical protocol was approved by surgeons. 4 of all the implants placed failed in the early stages (<1 month). We verify no crestal bone loss in the first 6 months after the implants were placed. Healing and post surgical procedures were correct without any complication described (AU)

Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review).

Multifocal epithelial hyperplasia (MEH), also known as Heck's disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported.

Interleukin-1 gene polymorphisms and periodontal status in a Spanish population.

The aim of this study was to investigate the possible association between interleukin (IL)-1A (+4845) and/or IL-1B (+3954) gene polymorphisms and the onset and progression of chronic periodontal disease (PD), an issue that remains controversial. The relationship between IL-1ß concentration in the gingival crevicular fluid (GCF) and disease activity was also evaluated. The study was performed on 25 individuals with no gingivitis or PD and on 25 subjects with active chronic PD. Two samples of GCF were obtained from each subject and IL-1ß was determined by enzyme-linked immunoabsorbent assay. Blood samples (10 ml) were drawn from each subject to detect polymorphisms in IL-1A (+4845) and IL-1B (+3954) by polymerase chain reaction. Mean GCF IL-1ß concentrations were higher in patients with active chronic PD compared to the control group. No significant association was found in either group between GCF IL-1ß concentration and the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes. No significant difference was found in either group with regard to the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes (p=0.556). The concentration of IL-1ß in GCF was almost 2-fold higher in patients with chronic PD than in the healthy individuals. The presence of polymorphisms in IL-1A (+4845) and/or IL-1B (+3954) genotypes is not associated with IL-1ß overproduction in GCF and is not a risk factor for chronic PD. IL-1ß is considered a suitable marker of the severity and progression of chronic PD. The presence of IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms does not appear to be a risk factor for chronic PD. Therefore, the IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms cannot be considered genetic markers of chronic PD. Moreover, these polymorphisms do not indicate an overproduction of IL-1ß in GCF.

Alteraciones hematológicas en el paciente periodontal. Alteraciones de la hemostasia / Hematological disorders in the periodontal patient. Haemostasis disorders

Una de las urgencias más comunes a la que nos enfrentamos los profesionales en nuestros gabinetes, es la hemorragia. Para prevenir este tipo de complicaciones durante y después del tratamiento periodontal, se hace necesaria la realización una correcta historia clínica donde se compruebe el correcto funcionamiento de su hemostasia y, de no ser así, deben ser complementadas con pruebas de laboratorio. A través de esta revisión, planteamos la importancia clínica de este tipo de pacientes con desórdenes hemostáticos y, a su vez, propondremos una serie de pautas que podremos seguir a la hora de tratar un paciente periodontal con algún tipo de alteración de la hemostasia (AU)

The haemorrhage is one of the most common emergency in the clinic. To prevent this kind of complication during and afterward the periodontal treatments, is necessary to make a clinical history to rule out any haemostasis disorder. In some cases is necessary to have blood test to discard any haemostasis anomalies. In this review we describe the clinical importance of these patients and how to manage and treat them (AU)

Methylation in oral cancer and pre-cancerous lesions (Review).

There is considerable interest in the analysis of epigenetic alterations in cancer, including oral cancer and pre-cancerous lesions. These processes affect or inactivate the functions of genes without altering their structure or sequence. One example is the methylation of the promoter region of some genes involved in cell cycle control. Knowledge of methylation patterns is very important for understanding the expression of genes in normal and pathological situations. This review provides an update on research into this issue in oral cancer and pre-cancerous lesions. A greater understanding of this epigenetic alteration could not only assist the diagnosis and prognosis of oral cancer but could also open up novel therapeutic approaches. The presence of methylation in specific tumour suppressor genes could modify their function and alter cell cycle control, so the patients could have an increased risk of developing cancer and also a higher degree of malignancy. The most frequently and extensively studied methylated genes in oral premalignant lesions are p16, MGMT, RARß2, E-cadherin and DAP-kinase.

Tratamiento quirúrgico de las coronas clínicas cortas: Técnica de alargamiento coronario / Surgical treatment of clinical short crowns: Technique of coronary lengthening

Las llamadas coronas clínicas cortas y/o aquellos procesos patológicos dentales cuyos límites anatómicos pueden ser subgingivales o incluso infraóseos, son un problema frecuente en la consulta del odontoestomatólogo. Diversas son las causas que los producen, siendo los más frecuentes la caries, las fracturas dentales y la erupción pasiva alterada. Los motivos para su corrección suelen ser prostodóncicos y/o restauradores aunque, a menudo, son motivos estéticos los que llevan al paciente a nuestras consultas. Al conjunto de maniobras quirúrgicas dirigidas a su corrección se le denomina "técnica de alargamiento coronario". En este artículo analizaremos los principios morfológicos y biológicos que rigen su justificación, sus limitaciones, así corno las propias maniobras quirúrgicas que debemos realizar (AU)

The so called clinic short crowns and/or those dental pathological processes whose limits can be subgingivalor even underosseous, are a frenquent problem in dental office. Diferent causes produce them, being the most frequent: decay, dental fractures and altered passive eruption. The reasons for their treatment are usually prostodontics and/or restorative dentistry although very often, our patients come to us for esthetical reasons. The surgical technique leading to their correction is called "crown lengthening technique". In this article we will analize the morphological and biological principIes which rule their justification, their limits, as well as the own surgical handlings we must carry out (AU)

Les corounnes cliniques courtes et/ou les procés pathologíques dentaires avec des limites anatomiques sousgingivales, ou meme infraosseuse, sont un probléme frécuent dans la clinique du odonto-stomalogue. Plusieurs sont les causes qui les produisent, étant les plus frécuentes la carie, les fractures dentaires et r eruption pasive alterée. Les raisons pour sa correction sont souvent prothétiques et/ou par dentisterie restauratrice, mais le plus souvent ce sont de raisons esthétiques ce qui mément le patient á nos cabinets. L'esemble des manoeuvres chirurgícales dirigé a leur correction rec;:oiele nom de "technique d' élongation coronaire". Dans cette article, on analisera les principIes morfologiques et biologiques qui la justifie, ses limites, ainsi que les maneouvres chirurgicales quw ron doit réaliser (AU)

Tratamiento de las recesiones gingivales mediante injertos de tejido conectivo (Técnica del injerto de tejido conectivo subepitelial). Resultados tras cinco años de evolución / Treatment of gingival recessions with connective tissue grafts (subepithelial connective tissue technique). Results after five years post surgery

Las recesiones gingivales son un hallazgo clínico muy frecuente que a menudo ocasionan problemas estéticos para nuestros pacientes o no les permiten mantener un buen control de placa en estas zonas, lo cual puede derivar en sensibilidades o incluso en caries. Para su tratamiento se han diseñado diversas técnicas de cirugía mucogingival, siendo el injerto libre de tejido conectivo una de las técnicas que hoy por hoy ofrece mayor porcentaje de éxitos y mayor predictibilidad. Si bien se han descrito diversas formas de trasplantar el injerto conectivo al lecho receptor, centraremos nuestro trabajo en la técnica descrita por Langer y Langer en 1985 que, pese a sufrir diversas modificaciones propuestas por diferentes autores, sigue constituyendo la base fundamental en la utilización de este tipo de injertos. Presentamos resultados tras cinco años de evolución (AU)

Gingival recession is a very often clinic complaint which frecuently cause esthetic problems to our patients or do not aIlow them keeping a good plaque control in these areas which can lead to sensibility or even decay. For their treatment, some techniques of mucogingival surgery have been designed, being the connective tissue free graft, so far, one that offers bigger percentage of success as weIl as greater predictibility. Although have been described some ways to graft the connective tissue to the recipient bed, we wiIl focus our work on the technique described by Langer and Langer in 1985 which, in spite of suffering several changes proposed by different authors, it is still the fundamental basis in the use of this kind of grafts. We show results after five years post surgery (AU)