Pre-surgical socket analysis for immediate implant placement.

BACKGROUND: Traditional protocols for implant surgery suggest a healing period of 2-3 months from dental extraction to implant placement. Based on all the volumetric modifications produced by that approach, there are authors who advocate for immediate implantology. The aim of the present study was to determine the prevalence of different sockets, and the dimensions of the bone around the upper anterior incisors and canines, to determine the predictability of immediate implants in our population. MATERIAL AND METHODS: This is an observational, cross-sectional study based on cone-beam computed tomography images of the anterior maxila of patients attending the Odontological Hospital of the University of Barcelona (OHUB) and requesting for implant treatment. Different measurements were performed on every analyzed tooth, and also they were categorized by using the main dental sockets classifications. RESULTS: Bone attachment levels and cortical thickness are lower in women compared to men in all three types of teeth (the difference in the bone attachment levels ranges from 4.68%-8.63% and in the bone thickness goes from 0.02-0.58mm). Bone attachment level gradually reduces with age. The reductions observed in all the measurements are higher in the case of canines, compared with the other teeth. The differences from patients <45 years old and patients between 55-64 years old are 13.58±14.55mm in the case of central incisors, 10.04±5.52 in the case of lateral incisors and 22.39±13.65mm in the case of canines. CONCLUSIONS: According to our results, the canines are the teeth with the greatest complexity when it comes to immediate implantology treatments. Furthermore, that kind of treatment is more complex as age increases, since we observed a gradual percentage of unfavourable sockets in older patients.

Cirugía periapical y regeneración: revisión sistemática / Periapical surgery and regeneration: systematic review

Introducción: Tras un cirugía periapical, suele estar asociado un defecto óseo que puede ser regenerado o no según la literatura. El objetivo es analizar si la regeneración ósea asociada a la cirugía periapical tiene efectos beneficiosos en la curación de los diferentes defectos. Material y Mètodos: Revisión sistemática realizada en Medline-Pubmed, Scopus y Cochrane. Se consideraron criterios PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Ensayos clínicos aleatorizados, estudios de casos y controles, de cohortes y transversales publicados entre enero 2011 y abril 2022, que analizaran el èxito de la cirugía periapical combinada o no con diferentes tècnicas de regeneración ósea, idioma inglès o español, realizados en humanos y adultos (≥16años) fueron incluidos. Resultados: Se incluyeron un total de 8 artículos que analizaban una "n" total de 285 sujetos con 35 abandonos. Se analizan diferentes tipos de lesiones: lesiones transversales, defectos apicomarginales y lesiones periapicales, excepto un estudio que compara las tres. Se utilizan diferentes materiales de regeneración. Se obtuvo un rango de èxito de regeneración ósea entre 81,6% y 93,7%. Discusión: Los avances en equipos de magnificación visual aumento, instrumentos y materiales endodónticos son la razón de un mayor èxito de las cirugías periapicales. Las imágenes en 3D, son valiosas para obtener un mejor diagnóstico del tamaño y tipo de defecto, y planificar así el tratamiento considerando la necesidad de regenerar o no. Aunque los resultados siguen siendo inciertos parece ser que en los defectos transversales y apicomarginales es mejor regenerar, al contrario de los defectos periapicales. (AU)

Introduction: According to the literature, after a periapical surgery there usually remains a bone defect that may be regenerated or not. The aim of this review is to analyse whether bone regeneration associated with periapical surgery is favourable on the healing of different defects. Material and Methods: A systematic review was performed in Medline-Pubmed, Scopus and Cochrane. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were considered. Randomized clinical trials, case-control, cohort and cross-sectional studies published between January 2011 and April 2022, that analyses the success of periapical surgery associated or not with different bone regeneration techniques, English or Spanish, humans and adults (≥ 16years) studies were included. Results: A total of eightreports were included. They evaluated 285 subjects, with 35 subjects that dropped out. Different types of lesions were analysed in each report: through-and-through lesions, apico-marginal lesions, and periapical lesions, except for one that compared all of them. Different kinds of bone regenerative materials were used. A range of success of between 81,6% and 93,7% of bone regeneration was achieved. Discussion: Improvements in augmentation equipment, instruments, and materials are the reason for the large success of periapical surgery. 3D images are useful to make a better diagnosis of the size and kind of the defect and, in this way, to plan the treatment considering the need to regenerate or not. Although the results remain uncertain, it seems that for through-and-thought and apico-marginal lesions, it is better to regenerate in contrast with periapical lesions. (AU)

Treatment of recurrent aphtous stomatitis: A systematic review.

BACKGROUND: Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity. MATERIAL AND METHODS: we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago. RESULTS: we used the following keywords: "treatment", "aphtous stomatitis", "canker sores"; combined with Boolean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7th day was of -6,29 ± 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 ± 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 ± 1,6 points, and a reduction of the size of the lesions of 4,42 ± 1,02mm on the 7th day. CONCLUSIONS: Besides the classic treatments for RAS, we have to take into account other treatment modalities, above all the different kinds of laser.

Enfermedades periodontales necrotizantes: factores de riesgo y tratamiento. Revisión sistemática / Necrotizing periodontal diseases: risk factors and treatment. A systematic review

Introducción: Las enfermedades periodontales necrotizantes son cuadros agudos que se acompañan de signos y síntomas locales y sistémicos que se caracterizan por la necrosis de tejidos gingivales, periodontal, pudiendo incluir otros tejidos orales dependiendo de la severidad de la infección. En esta revisión sistemática queremos evaluar cuáles son los factores predisponentes de mayor relevancia para el desarrollo de estas infecciones, así como las medidas terapéuticas más efectivas para tratarlas. Material y métodos: Realizamos una búsqueda bibliográfica en tres bases de datos (PubMed, Cochrane y Scopus) de los últimos 10 años. Se usaron las siguientes palabras clave: “necrotisingulcerative gingivitis”, “necrotising ulcerative periodontitis”, “necrotising ulcerative stomatitis” y “aetiology”; combinados con los operadores boleanosAND y OR. Resultados: Después de aplicar los criterios de exclusión, quedan 19 artículos. Entre los factores de riesgo más importantes encontramos la malnutrición severa, la mala higiene oral y los depósitos de placa dental, las infecciones previas y los cuadros de inmunosupresión. En cuanto a las intervenciones terapéuticas, la literatura destaca el desbridamiento supra y subgingival. La terapia farmacológica más utilizada es el metronidazol como monoterapia o combinado con amoxicilina. Los coadyuvantes más empleados fueron los colutorios de clorhexidina y el peróxido de hidrógeno. Conclusiones: Las enfermedades periodontales necrotizantes son entidades de etiología mayormente bacteriana inespecífica que están sujetas a factores causales que afectan al estado general del paciente. El tratamiento de las mismas se basa en el control de los factores de riesgo a la vez que se soluciona la infección. (AU)

Introduccion: Periodontal necrotising diseases are acute conditions accompanied by local and systemic signs and symptoms characterised by gingival tissues necrosis; however, they can include periodontal or other oral tissues depending on the severity of the infection. In this systematic review we want to evaluate which are the most relevant predisposing factors for the development of these infections, as well as the therapeutic approaches that have shown affectivity against them. Material and methods: A bibliographic search of the last 10 years was conducted in three databases (PubMed, Cochrane y Scopus). We used the following keywords: “necrotising ulcerative gingivitis”, “necrotising ulcerative periodontitis” , “necrotising ulcerative stomatitis” y “aetiology”; combining them with Boolean operators (AND and OR). Results: After applying the exclusion criteria, 19 papers remained. Among the most important risk factors we found severe malnutrition, the bad oral hygiene and deposits of tartar, previous infections and immunosuppression. Regarding to therapeutic interventions, literature highlights supragingival and subgingival debridement. The most used pharmacological strategy is monotherapy with metronidazole or combined with amoxicillin. The most used adjuvant treatments are chlorhexidine and peroxide mouthwashes. Conclusions: Periodontal Necrotising diseases are entities which have a mainly unspecific bacterial cause and depend on causative factors that affect to patient's general state. Their treatment is based on the control of risk factors while we solve the infection. (AU)

Papel de la histamina en el Liquen Plano Oral, Leucoplasia y en el Carcinoma Oral de Células Escamosas. Revisión sistemática / Role of histamine in Oral Lichen Planus, Leukoplakia and in Squamous-Cell Oral Carcinoma. Systematic review

Introducción: Los queratinocitos presentes en las células epiteliales del cuerpo humano producen, de manera continuada, pequeñas cantidades de histamina que se mantienen en equilibrio en el epitelio oral. Cuando este equilibro se ve alterado, se produce un aumento de histamina en el tejido oral pudiendo provocar lesiones. Objetivo: En este trabajo de revisión se estudia la relación del exceso de histamina en el Liquen Plano Oral, la Leucoplasia oral y en el Carcinoma Oral de Células Escamosas. Material y método: Búsqueda bibliográfica en la literatura de estudios caso control y retrospectivos acerca del papel de la histamina en el Liquen Plano Oral, la Leucoplasia Oral y el Carcinoma Oral de Células Escamosas. Resultados: Se ha observado un aumento del número de mastocitos y de histamina en los tejidos orales con patología comparado con los tejidos sanos. Conclusión: Este aumento del número de mastocitos y de histamina en los tejidos orales con patología, provocan una desorganización en los precursores de la inflamaciónpudiendo así dañar el epitelio oral. (AU)

Introduction: Keratinocytes present in the epithelial cells of the human body produced, continuously, small amounts of histamine that are kept in balance in the oral epithelium. When this balance is disturbed, there is an increase in histamine in the oral tissue and it can cause injuries. Objective: In this review work we studied the relationship of excess histamine in Oral Lichen Planus, oral Leukoplakia and Oral Squamous Cell Carcinoma. Material and Method: Bibliographic search of the literature of case control and retrospective studies about the role of histamine in Oral Lichen Planus, Oral Leukoplakia and Oral Squamous Cell Carcinoma. Results: An increase in the number of mast cells and histamine has been observed in oral tissues with pathology compared to healthy tissues. Conclusion: This increase in the number of mast cells and histamine in oral tissues with pathology can cause disorganization in the precursors of inflammation and thus can further damage the oral tissue. (AU)

Implantes dentales en pacientes con liquen plano oral. Revisión sistemática / Dental implants in patients with lichen planus. Systematic review

Introducción: El liquen plano se considera una enfermedad muco-cutánea crónica, en la que la etiopatogenia se considera una alteración autoinmune mediada por células, con una prevalencia entre 0.5 y 2%. La colocación de implantes dentales en pacientes con dicha enfermedad puede hacer cambiar el éxito del tratamiento. Material y Método: se realizó una búsqueda en la base de datos Pub Med y Med line, utilizándose como palabras clave: “lichen planus” y "dental implant". El criterio de inclusión fue de estudios en humanos con liquen plano oral a los que se les había tratado con implantes dentales osteointegrados publicados en lengua inglesa que sean observacionales, experimentales y series de casos publicados entre 1990 y 2020. Resultados: Se selecciona un total de 13 artículos, la N total de implantes fue de 362 implantes colocados en 148 pacientes. El seguimiento de los implantes es de 2 a 10 años. Hay un fracaso de 45 (12,43%) implantes, de los cuales 42 sucede en pacientes con liquen plano activo y 3 en cuadros de liquen erosivo sin especificar si está en fase activa o no. La tasa de fracaso fue mayor en las mujeres (61%) en comparación con los hombres (44%). En uno de los casos, se diagnostica carcinoma oral de células escamosas [COCE] 3 años después de la colocación del implante, lo que corresponde al 0,2% de los casos. Conclusión: el liquen plano oral es una enfermedad autoinmune que debemos tener en cuenta cuando colocamos implantes y controlar periódicamente. (AU)

Introduction: Lichenplanus is considered a chronic mucocutaneous disease, in which etiopathogenesisis considered a autoimmune disorder, with a prevalence between 0.5 and 2%. Placing dental implants in patients with this disease can change the success of the treatment. Material and Method: A search was made in the Pub Med and Med line database, using as keywords: "lichen planus" and "dental implant". The inclusion criteria was studies in humans with oral lichen planus who had been treated with osseo integrated dental implants published in English, which are observational, experimental or clinical cases published between 1990 and 2020. Results: A total of 13 articles are selected, the N of implants was 362 implants placed in 148 patients. The follow-up of the implants is from 2 to 10 years. There is a failure of 45 (12,43%) implants, of which 42 occurs in patients with active lichen planus and 3 in a erosive lichen without specifying if they are in the active phase or not. The failure rate was higher in women (61%) compared to men (44%). In one case, oral squamous cell carcinoma [OSCC] is diagnosed 3 years after implant placement, which corresponds to 0.2% of cases. Conclusion: oral lichen planus is an auto immune disease that we must take into account when we place implants and control periodically. (AU)

Incidence rate of metastases in the oral cavity: a review of all metastatic lesions in the oral cavity.

BACKGROUND: Metastases in the oral cavity are rare and account for only 1 to 3% of all malignant lesions in this area. The primary location from which most metastases have been described in the oral cavity in adult patients include lungs, breasts, kidneys and colon. MATERIAL AND METHODS: A systematic search of the literature was carried out following the PRISMA statement in PubMed database. Clinical trials and case series published in the last 10 years [2010-2020] were eligible to be selected. The headings and keywords used in the searches were "cancer" AND "oral metastases", "incidence" AND "oral metastases", "oral metastases" AND "jaw bone", "oral metastases" AND "soft tissue". RESULTS: For the study of the incidence of metastases in the oral cavity, 9 reports of clinical trials and 7 retrospective studies of case series have been included in this article. The primary locations from which more metastases have been described in the oral cavity are lungs (30.6% or 183 cases), breasts (22.2% or 133 cases), liver (15.5% or 93 cases), prostate (9 % or 54 cases), thyroid glands (8.1% or 49 cases), kidneys (7.3% or 44 cases), skin (2.3% or 14 cases), soft tissues (2% or 12 cases), colon (2% or 12 cases) and gastrointestinal (0.6% or 4 cases). These metastases have a predilection for hard tissues. The clinical presentation of these lesions varies from painless granulomatous lesions to lytic areas in the jaws. CONCLUSIONS: Although metastases in the oral cavity is an uncommon pathology, early diagnosis is needed so that in the event that it is the first manifestation, it allows the primary tumor to be diagnosed as soon as possible.

Postsurgical Prosthetic Rehabilitation after Mandibular Ameloblastoma Resection: A 7-Year Follow-Up Case Report.

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.

Tratamiento Laser-Lok® en implantes dentales. A propósito de un caso clínico / Laser-Lok® treatment on implants dental. About a clinical case

Uno de los retos más importantes, hoy en día, en implantología oral es evitar la pèrdida ósea alrededor de los implantes oseointegrados y funcionales con el paso del tiempo. Una de las superficies que se ha desarrollado en los últimos años es la resultante de la microtexturación mediante láser. Diversos estudios han demostrado la adhesión del tejido conectivo a las superficies tratadas con láser en la zona cervical de los implantes oseointegrados, consiguiendo de este modo un sellado biológico a este nivel. Revisamos lo publicado sobre este tema y presentamos un caso clínico de inserción de un implante unitario con tratamiento láser en su zona cervical desde su colocación hasta la restauración final, donde se observa la buena integración de los tejidos y el èxito del caso a largo plazo. (AU)

There are certainly situations where the standard implants can not be placed or suppose a risk for the crestal bone maintenance. The narrow implants have been used for a wide variety of indications, stablishing scientifically-based treatment protocols with excellent long-term results.In the present study we present a narrative review of narrow implants highlighting their indications and limitations, and a case report where narrow implants have been sh it is evident that narrow implants are an alternative when rehabilitate edentulous spaces with low available bone in the horizontal direction or reduced mesio-distal spaces in aesthetic areas. (AU)

Sífilis: manifestaciones orales, revisión sistemática / Syphilis: oral manifestations, systematic review

INTRODUCCIÓN: la sífilis es una infección bacteriana, que se puede transmitir por contacto sexual o de forma congénita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. MATERIAL Y MÉTODO: se realizó una búsqueda en la base de datos PubMed, utilizándose como palabras clave: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "oral manifestations", "oral lesions". Como criterios de inclusión se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sífilis y trabajos en inglés y español. No hubo restricción por fecha. RESULTADOS: se seleccionaron un total de 18 artículos, la N total de pacientes fue de 201. El 10,05% padecía sífilis primaria, el 52,76% sífilis secundaria y el 36, 68% sífilis terciaria. Las lesiones orales predominantes de la sífilis primaria fueron úlceras, inflamación, chancro sifilítico; en la sífilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamación, lesiones papulares, lesiones maculares, lesiones erosivas; en la sífilis terciaria aparecen gomas sifilíticos, lesiones leucoplásicas y atrofia lingual. DISCUSIÓN: la sífilis es una infección bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnóstico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomática

INTRODUCTION: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. MATERIAL AND METHOD: a search was made in the PubMed database, using as keywords: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "Oral manifestations", "oral lesions". The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. RESULTS: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. DISCUSSION: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form

Transoral robotic surgery vs open surgery in head and neck cancer. A systematic review of the literature.

BACKGROUND: TORS has become one of the latest surgical alternatives in the treatment of oropharynx squamous cell carcinomas (OPSCC) and has become increasingly accepted by surgeons as a treatment option. Surgical robots were designed for various purposes, such as allowing remote telesurgery, and eliminating human factors like trembling. The study aimed to compare systematic review of the available literature in order to evaluate the safety and efficacy of Transoral Robotic Surgery (TORS) compared with open surgery. MATERIAL AND METHODS: We performed a systematic review of the available literature in order to evaluate the safety and effectiveness of TORS compared with open surgery. We compared TORS and open surgery based on 16 outcomes divided in to 3 groups: intra-operative complications, post-operative complications, and functional and oncologic outcomes. An electronic search of observational studies was carried out using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Oral Health Group Trials Register, and Scielo. Data analysis was carried out in accordance to Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) and the quality of the studies were evaluated using the Newcastle-Ottawa Scale. No language restrictions were imposed. RESULTS: From the 4 studies identified (Newcastle-Ottawa Scale mean score 6.5), 371 patients were revised (186 patients were treated with TORS and 185 with conventional surgery). Overall, TORS, when compared with open surgery, appears to have better functional results (less hospital time, decannulation) and fewer intraoperative and post-operative complications. There is no significant difference when assessing the oncological outcomes (positive margins, survival rate) when comparing both techniques. CONCLUSIONS: TORS has an overall better functional outcome, and less intraoperative and postoperative complications with no difference in positive margins and survival rate when compared with conventional therapy.

Adherencia bacteriana en los materiales de sutura de uso habitual en cirugía bucal. Revision sistemática / Bacterial aggregation in the suture materials usually used in oral surgery. Systematic review

OBJETIVO: Demostrar la existencia de agregación bacteriana a los materiales de sutura que suelen emplearse en la práctica odontológica, comprobar si dicha agregación está relacionada con la inflamación que sucede al acto quirúrgico y por último dar recomendaciones sobre què tipo de sutura se adapta mejor para la prevención de la adherencia bacteriana. MATERIAL Y MÈTODO: Búsqueda bibliográfica a travès de las bases de datos PubMed, Cochrane y Scielo empleando las palabras clave: surgical sutures, bacterial adherence. Como criterios de inclusión se aceptaron los estudios publicados en los últimos 15 años, in vivo o in vitro en relación con la cirugía oral y con un nivel de evidencia científico superior a 3 según los criterios de evidencia científica. Fueron excluidas todas aquellas publicaciones que no tenían como objeto de estudio las sutura seda, Nylon™, Supramid™, Monocryl™, Vicryl™ o Vicryl Plus™. Tambièn se excluyeron todas aquellas publicaciones que no relacionaban los materiales de sutura a la agregación bacteriana. RESULTADOS: Un total de 9 publicaciones se organizaron en función del tipo de sutura empleada, si eran estudios in vivo o in vitro, el número de pacientes/muestras, tiempo transcurrido hasta la remoción de las suturas, si se realizaron controles, si existió algún tipo de reacción inflamatoria, que tipo de bacterias se agregaron y que material obtuvo mayor agregación. DISCUSIÓN: Los materiales de sutura que mayor acúmulo de placa bacteriana presentan bajo las mismas condiciones de tiempo de exposición a bacterias, son los de tipo multifilamento reabsorbible no tratados con antimicrobianos

OBJECTIVE: To demonstrate the existence of bacterial aggregation to the suture materials that are usually used in dental practice, to verify if aggregation is related to the inflammation that occurs after the surgical act and finally give recommendations on what type of suture is best suited for the prevention of bacterial adhesion. MATERIAL AND METHOD: Bibliographic search through PubMed, Cochrane and Scielo databases using the keywords: surgical sutures, bacterial adherence. Inclusion criteria were accepted studies published in the last 15 years, in vivo or in vitro in relation to oral surgery and with a level of scientific evidence of more than 3 according to the criteria of scientific evidence. All those publications that did not have the suture subject Silk, Nylon™, Supramid™, Monocryl™, Vicryl™ or Vicryl Plus™ were excluded. All publications that did not relate suture materials to bacterial aggregation were also excluded. RESULTS: A total of 9 publications were organized according to the type of suture used, whether they were in vivo or in vitro studies, the number of patients/samples, time elapsed until removal of the sutures, controls if they were performed, any type of inflammatory reaction, which type of bacteria were added and which material obtained greater aggregation. DISCUSSION: The suture materials with the greatest accumulation of bacterial plaque present under the same conditions of exposure to bacteria, are the reabsorbable multifilament type not treated with antimicrobials

Fractura mandibular tardía post exodoncia de molares inferiores. Caso clínico / Late mandibular fracture after lower third molar extraction: a case report

La extracción del tercer molar es un procedimiento común en cirugía oral. Una de las complicaciones es la fractura mandibular. Con una incidencia postoperatoria menor a un 0.005%. Los factores que contribuyen al riesgo de fractura del ángulo mandibular después de una extracción del tercer molar incluyen el nivel de impactación, la anatomía del diente, infecciones locales previas, edad, sexo, presencia de formaciones quísticas y bruxismo entre otras. Presentamos un caso clínico de fractura mandibular postoperatoria a las cinco semanas tras la exodoncia del 47 y 48 incluidos en posición horizontal. El objetivo final del tratamiento de una fractura mandibular es la consolidación ósea manteniendo la oclusión dental. En nuestro caso, al no tratarse de una fractura que sobrepasaba las corticales y sin desplazamiento mandibular, no fue subsidiaria de un tratamiento quirúrgico y se resolvió con reposo funcional

The lower third molar extraction is a common procedure in oral surgery. One of its complications, although uncommon, is the mandibular fracture. Postoperatively, it has an incidence lower than 0.005%. The factors that may contribute to the risk of the mandibular angle fracture after an extraction of the third molar include the level of impaction are the anatomy of the tooth, previous local infections, age, sex, cysts and bruxism among others. We present a clinical case of postoperative mandibular fracture at five weeks after the extraction of 47 and 48 included in horizontal position. The ultimate treatment goal of a mandibular fracture is to reach a bone consolidation with the premorbid dental occlusion. In our case, as it was not a fracture that surpassed the cortical and there was not a mandibular displacement, it was not need a surgical treatment so it was resolved with functional rest

Cutaneous, genital and oral lichen planus: A descriptive study of 274 patients.

BACKGROUND: Lichen planus (LP) is a chronic autoimmune disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. OBJECTIVE: to evaluate the correlation between oral, genital and cutaneous lichen planus, in a sample of LP patients. MATERIAL AND METHODS: This descriptive study reviewed 274 clinical histories of patients, who all presented histological confirmation of lichen planus verified by a pathologist, attending research centers in Barcelona. RESULTS: A total of 40 LP patients (14.59%) presented genital lesions. Of 131 patients with cutaneous LP (47.8%), the most commonly affected zones were the body's flexor surfaces, representing 60.1% of cases. 24% of patients (n=55) related the start of the lesions with previous stress events. Of the 131 subjects with cutaneous lesions, 19% (n=25) also presented oral lichen planus (OLP). Of the total sample, 53.6% (n=147) of patients presented oral lesions. The systemic diseases most commonly associated with this patient sample were psychological problems such as stress, anxiety and depression (48%), hypertension (27%), gastric problems (12%), and diabetes (9.7%). A family history of lichen planus was found in only 2 cases (0,72%) out of the total of 274. CONCLUSIONS: Any patient with OLP should undergo a thorough history and examination to investigate potential extraoral manifestations. The fact that 37 patients with OLP in this patient series were identified with simultaneous involvement at more than one site highlights the need for thorough evaluation and multidisciplinary approaches to this disease.

Autogenous teeth used for bone grafting: A systematic review.

BACKGROUND: Recently, bone graft materials using permanent teeth have come to light, and clinical and histological outcomes of this material have been confirmed by some studies. The aim of this systematic review was to evaluate the reliability of the autogenous tooth bone graft material applied to alveolar ridge augmentation procedures. MATERIAL AND METHODS: A systematic review of literature was conducted analyzing articles published between 2007 and 2017. The following four outcome variables were defined: a) implant stability b) post-operative complication c) evaluation of implant survival and failure rates, and d) histological analysis. A total of 108 articles were identified; 6 were selected for review. Based on the PICO (problem, intervention, comparison, outcome) model, the chief question of this study was: Can patients with alveolar ridge deficiency be successfully treated with the autogenous teeth used as bone graft? RESULTS: The mean primary stability of the placed implants was 67.3 ISQ and the mean secondary stability was 75.5 ISQ. The dehiscence of the wound was the most frequent complication with a rate of 29.1%. Of the 182 analyzed implants, the survival rate was 97.7% and the failure rate was 2.3%. In the histological analysis, most of studies reported bone formation. CONCLUSIONS: There is insufficient evidence regarding the effects of autogenous teeth used for bone grafting to support any definitive conclusions, although it has been shown clinically safe and good bone forming capacity, and good results are shown about implant stability.

Oral manifestations of Diabetes Mellitus. A systematic review.

BACKGROUND: Diabetes Mellitus has become a global epidemic and presents many complications, usually proportional to the degree and duration of hyperglycemia. The aim of this systematic review was to investigate the different oral manifestations associated with Diabetes Mellitus. MATERIAL AND METHODS: A MEDLINE search for "Diabetes Mellitus and oral manifestations" was performed. A further search was conducted for "diabetes" and its individual oral manifestation. Inclusion criteria were as follows: human clinical studies with a minimum of 30 patients; studies published in relevant scientific journals between January 1998 and January 2016. Nineteen studies fulfilled the inclusion criteria and were analyzed, assessing the strength of scientific evidence according to recommendations made by the Centre for Evidence-Based Medicine, Oxford (OCEBM), which permits adequate assessment of prevalence studies. RESULTS: A total 3,712 patients (2,084 diabetics) were included in the studies reviewed. Of the 19 studies analyzed, 4 were longitudinal studies and 15 cross-sectional studies. Periodontal disease, periapical lesions, xerostomia and taste disturbance were more prevalent among diabetic patients. An association between diabetes and caries and mucosal lesions proved positive in 5 out of 10 studies. CONCLUSIONS: Despite multiple oral manifestations associated with DM, awareness of the associations between diabetes, oral health, and general health is inadequate. It is necessary for doctors and dentists to be aware of the various oral manifestations of diabetes in order to make an early diagnosis.

Probiotics and oral health: A systematic review.

BACKGROUND: Probiotics are microorganisms, mainly bacteria, which benefit the host's health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. OBJECTIVES: To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. MATERIAL AND METHODS: An electronic search in PubMed database with the keywords "oral health AND probiotics AND dentistry" was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. RESULTS: Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. CONCLUSIONS: The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles.

Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review.

BACKGROUND: Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. MATERIAL AND METHODS: A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms "periodontal disease" AND "diabetes mellitus". The review analyzed clinical trials of humans published in English and Spanish. RESULTS: Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of <40 patients, making a total of 108 patients and the remaining ten samples had >40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (p<0.05) as a result of periodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. CONCLUSIONS: The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitus.

Chitosán más clorhexidina (Bexident®Post) en el control del dolor y la inflamación posoperatoria en implantología oral. Estudio piloto / Chitosan and chlorhexidine (Bexident®Post) in controlling postoperative pain and inflammation in oral implantology. Pilot study

OBJETIVOS: Evaluación de la eficacia del chitosán más la clorhexidina en el control del dolor y la inflamación posoperatoria en cirugía implantológica oral. MATERIAL Y MÉTODOS: Es un estudio clínico piloto prospectivo en pacientes a los que se les colocan implantes. A todos los pacientes se les pauta después de la cirugía Bexident(R)Post en gel, tres veces al día durante siete días. Se valora la inflamación, la apertura bucal, el nivel de dolor, el grado de cicatrización y la opinión sobre el producto. RESULTADOS: Se han colocado 138 implantes en 54 pacientes. El 64% eran varones y la media de tiempo quirúrgico fue de 76 minutos. La inflamación y apertura bucal pre y postoperatoria no es significativa con una p= 0,000. Se han consumido 11 unidades analgésicas de media en los 7 días del posoperatorio. El EVA ha sido de 3,0 (DS= 2,0) a las 6 horas, 2,0 (DS= 2,0) a las 24 horas, 2,02 (DS= 1,0) el segundo día, 1,0 (DS= 1,0) el tercer y cuarto día y 0,0 el quinto, sexto y séptimo día. El grado de cicatrización es bueno en el 88,9% (48 pacientes); regular, en el 7,4% (4 pacientes) y malo, en el 3,7% (2 pacientes). 45 pacientes (83,3%) responden positivamente a todas las preguntas referentes al producto. CONCLUSIONES: El producto se muestra fácil de usar, el sabor es adecuado y en este estudio la inflamación, el dolor y el consumo de medicamentos han sido mínimos. OBJECTIVES: Evaluation of the effectiveness of chitosán and chlorhexidine in controlling postoperative pain and inflammation in oral implant surgery. MATERIAL AND METHODS: A prospective pilot clinical study in patients with implants. Bexident(R)Post gel are prescribed three times a day during 7 days to all patients. Inflammation, bucal opening, level of pain, degree of healing and opinion about the product are valued

OBJECTIVES: Evaluation of the effectiveness of chitosán and chlorhexidine in controlling postoperative pain and inflammation in oral implant surgery. MATERIAL AND METHODS: A prospective pilot clinical study in patients with implants. Bexident(R)Post gel are prescribed three times a day during 7 days to all patients. Inflammation, bucal opening, level of pain, degree of healing and opinion about the product are valued. RESULTS: 138 implants were placed in 54 patients. 64% were males and the mean operative time was 76 minutes. The inflammation, pre and post-operative mouth opening are not significant at p= 0.000. 11 analgesic units have been consumed on average during 7 days of post-operative. The EVA was 3.0 (SD= 2.0) at 6 hours, 2.0 (SD= 2.0) at 24 hours, 2.02 (SD= 1.0) the second day, 1.0 (SD= 1.0) the third and fourth day and 0.0 the fifth, sixth and seventh day. The degree of healing is good in 88.9% (48 patients), fair in 7.4% (4 patients) and bad in 3.7% (2 patients). 45 patients (83%) respond positively to al questions regarding the product. CONCLUSIONS: The product is shown as easy to use, the taste is right and in this study, inflammation, pain and medicine use have been minimal. Double-blind study is needed in order to evaluate its effectiveness

El diagnóstico del cáncer oral en el paciente geriátrico / Diagnosis of oral cancer in the geriatric patient

El cáncer oral es una patología frecuente y creciente en el mundo occidental, su incidencia se incrementa año tras año, a pesar de que su localización, en una cavidad fácilmente accesible y explorable permitiría un diagnóstico temprano del mismo, o de las alteraciones potencialmente malignas. Las cifras de nuestro país sitúan una incidencia de 6,7 casos nuevos al año por 100.000 habitantes, con una proporción hombre/mujer de 3 a 1. La proporción de estas neoplasias aumenta de forma gradual con la edad, la posibilidad de que una lesión ulcerosa o proliferativa de cavidad oral, sea un carcinoma es mucho más elevada en pacientes mayores de 65 años. Es nuestra obligación el concienciar a nuestros pacientes, en el cese de hábitos nocivos y en la educación para establecer de la autoexploración una actividad habitual. Sin duda, una exhaustiva exploración física es la primera medida diagnóstica que poseemos asociada ante la mínima sospecha a la realización de una biopsia y el correspondiente estudio histopatológico, que puede establecer la potencialidad maligna de la lesión, así como la evolución de la misma. Disponemos, en la actualidad, de métodos complementarios de diagnósticos, que desde los tradicionales colorantes vitales, pasando por métodos ópticos, hasta la utilización de novedosas técnicas de identificación de receptores moleculares, de alteraciones cromosómicas podrían ser de utilidad en la orientación de factores de riesgo en pacientes predispuestos a padecer la patología, todo ello con el futuro puesto en identificar todos estos riesgos potenciales con un simple análisis de saliva. Lo cierto es que a día de hoy el mejor diagnóstico es la prevención y en el peor de los casos realizarlo lo más precozmente posible para mejorar las perspectivas vitales y la calidad de vida de nuestros pacientes (AU)

Oral cancer is a common and growing in the Western world disease, its incidence is increasing year after year, despite its location in an easily accessible and searchable cavity allow early diagnosis thereof, or of potentially malignant disorders. The figures of our country placed an incidence of 6.7 new cases per year per 100,000population, with a male /female ratio of 3 to 1. It is our duty to educate our patients in the cessation of harmful habits and the Education to establish how to examine a common activity. Definitely a thorough physical examination is the first diagnostic measure we have associated under suspicion for a biopsy and the corresponding histopathology, you can set the malignant potential of the lesion, and the evolution of it. We currently have complementary diagnostic methods, which based from traditional vital dyes, through optical methods, to the use of novel techniques for identifying molecular receptors, chromosomal alterations could be useful in guiding risk factors Patients predisposed to the disease, all in the future on identifying these potential risks with a simple analysis of saliva. The truth is that today the best diagnosis is prevention and the worst do it as early as possible to improve the life prospects and quality of life of our patients (AU)