Occlusal polygon area of the molars in six Colombian ethnic groups / Área del polígono oclusal de molares en seis grupos étnicos de Colombia

SUMMARY: Descriptive observational cross-sectional study to determine the AOP of the second molars (55, 65, 75, 85) and the first permanent molars (16, 26, 36 and 46) in 459 study models corresponding to six ethnic groups in Colombia, Embera indigenous of Alto Baudó (Chocó), Caucasoid mestizos of Cali (Valle del Cauca), African descent of Cali (Valle del Cauca), Misak indigenous of Silvia (Cauca), Nasa indigenous of Morales (Cauca), and indigenous of Leticia (Amazonas). There were no significant differences of AOP among the six ethnic groups except when compared to the Amazon Indians with African descent of Cali, Embera indigenous and Nasa indigenous. There was no sexual dimorphism except tooth 65 for all ethnic groups. There was bilateral symmetry except between teeth 16 and 26. The distance matrix showed that Caucasoid mestizos of Cali were grouped with microdont populations, Amazon indigenous, Embera indigenous, Misak indigenous and Nasa indigenous, and African descendants of Cali were grouped with mesodont populations. The Embera and Amazon indigenous had the highest values of OAP associated with the relative isolation and less mestizaje. Overall, there was no sexual dimorphism or bilateral asymmetry. This study coincides with the different theories about reducing the size of the teeth as evolutionary characteristic of hominids.

RESUMEN: Estudio observacional descriptivo de corte transversal en el que se determinó el APO de los segundos molars deciduos (55, 65, 75, 85) y de los primeros molares permanentes (16, 26, 36, 46) en 459 modelos de estudio correspondientes a seis grupos étnicos de Colombia: Indígenas embera del Alto Baudó (Chocó), mestizos caucasoides de Cali (Valle del Cauca), afrodescendientes de Cali (Valle del Cauca), indígenas misak de Silvia (Cauca), indígenas nasa de Morales (Cauca) e indígenas de Leticia (Amazonas). No se encontraron diferencias significativas en el APO de los seis grupos étnicos, excepto entre indígenas del Amazonas y de afrodescendientes de Cali, e indígenas embera e indígenas nasa. No se evidenció dimorfismo exual en ninguno de los seis grupos. Hubo simetría bilateral, excepto entre los dientes 16 y 26. La matriz de distancias demostró que los mestizos caucasoides de Cali se agrupan con poblaciones microdontes, indígenas del amazonas, indígenas embera, indígenas misak e indígenas nasa; mientras que los afrodescendientes de Cali se agrupan con poblaciones mesodentes. Los indígenas embera y del Amazonas presentaron altos valores del APO, asociado a su aislamiento relativo y bajo mestizaje. En términos generales, no hubo dimorfismo sexual ni asimetría bilateral. Los resultados de este estudio concuerdan con diferentes teorías sobre la reducción del tamaño dental como una característica evolutiva de los himínidos.

The Oral Health of Patients with DiGeorge Syndrome (22q11) Microdeletion: A Case Report.

BACKGROUND: DiGeorge syndrome (DG) is a genetic disorder associated with 22q11 deletion. It involves various phenotypes, including craniofacial abnormalities, congenital heart disorders, endocrine dysfunction, cognitive deficits, and psychiatric disorders. Cases commonly involve multiple anomalies. However, little is known about the condition of the oral cavity in this disorder, although palate fissure, abnormal mandible, malocclusion, and tooth hypoplasia have been identified. We aimed to determine the odontological features of patients with 22q11.2 microdeletion, in relation to gingival health and oral hygiene. We report the systemic manifestations of nine patients and results of oral evaluation of two patients. In the oral examination, oral hygiene and gingivitis were evaluated. CASE PRESENTATION: In terms of the systemic manifestations, we found high frequencies of low weight and height at birth. In terms of the oral manifestations, both examined patients presented malocclusion, enamel hypoplasia, dental crowding, anodontia, and healthy periodontium. CONCLUSION: Although DG has been documented to involve periodontium disease, the patients in this study exhibited more dental manifestations such as enamel defects, misalignment between the teeth and the two dental arches, anodontia, and dental crowding. As such, a multidisciplinary approach combining dentistry and healthcare is recommended in this case.

Acercamiento multifactorial a la fisiopatología de la obesidad. Modelo de abordaje COD2 / A multi-factor approach to the physiopathology of obesity: COD2 model

La obesidad en este momento representa una de las peores amenazas del sector salud. El acelerado aumento de la prevalencia y mortalidad a causa de enfermedades cardiovasculares establece un precedente histórico como problema de salud pública mundial. La elevada incidencia de obesidad y enfermedades crónicas ha llevado a múltiples áreas de la salud a entender y buscar un detonante claro que explique esta patología. Existen numerosas causas que explican su comportamiento agresivo, progresivo y crónico. Sin embargo, ninguna de ellas satisface como el solo factor desencadenante que ofrezca un tratamiento único que genere una reducción de su rápida expansión. En este artículo se buscan explicar las principales causas relacionadas con esta entidad así como los mecanismos que lo demuestran, para lograr entender el abordaje adecuado de los pacientes que acuden buscando el manejo de la obesidad (modelo COD2).

Obesity is currently considered as one of the major life-threatening conditions affecting the healthcare system. The accelerated increase in prevalence and mortality due to cardiovascular diseases establishes an historical precedent as a global public health issue. The increased incidence of obesity and chronic diseases, has led multiple health researchers to try to identify a clear triggering factor contributing to obesity. There are numerous causes which explain its aggressive, progressive and chronic behavior. However, they do not satisfactorily elucidate a unique triggering factor which would determine a unique treatment to help decelerate its rapid expansion. This article seeks to explain the major causal factors and mechanisms leading to obesity, in order to find the most appropriate approach for obese patients seeking treatment options (COD2 model).

Estilo de vida de estudiantes en primer semestre de odontología de una universidad privada, Cali 2016 / Lifestyles in first semester students of a private university, in Cali 2016

RESUMEN Objetivo: Identificar los estilos de vida de los estudiantes de primer semestre de Odontología en una universidad privada en el año 2016. Material y métodos: Estudio descriptivo, transversal, cuantitativo, con una muestra de 58 estudiantes de primer semestre de una universidad privada de Cali. Se diligenció de manera virtual y anónima el cuestionario Fantástico que consta de 25 preguntas cerradas de escala Likert, que mide varios dominios físicos, psicológicos y sociales relacionados con el estilo de vida. Se realizó análisis estadístico uni- y bivariado con el programa Stata 13®, buscando asociación entre cada ítem y el resultado final con el sexo del estudiante, mediante la prueba χ2 con un alfa de 0.05. Resultados: Las categorías en las que se obtuvo un bajo puntaje fueron actividad física, alimentación, fumar, consumo de alcohol, hábitos de sueño y estrés. Hubo diferencias significativas en el consumo de cigarrillo, siendo mayor en hombres. Conclusión: El estilo de vida en la mayoría de los estudiantes fue excelente y bueno.

ABSTRACT Objective: To identify the lifestyle of first semester students of Dentistry at a private university in 2016. Material and methods: Descriptive, cross-sectional, quantitative study with a sample of 58 first semester students from a private university in Cali. The questionnaire "FANTASTIC" consisting of 25 items Likert scale questionnaire which measures various physical, psychological and social domains related to lifestyle was digitally and anonymously filled out. Statistical analysis was performed with univariate and bivariate analysis with the program Stata 13®, seeking association between each item and the fi nal result with the student's sex, using the chi2 test with an alpha of 0.05. Results: The categories in which a low score were obtained were physical activity, feeding habits, smoking, alcohol consumption, sleep habits and stress. There were significant differences in cigarette smoking, being higher in men. Conclusion: The lifestyle in most students was excellent and good.

Association of metabolic syndrome and chronic periodontitis in Colombians.

BACKGROUND: Metabolic syndrome (MetS) is a common chronic condition that increases the cardiovascular disease risk and is also linked to periodontitis. The study aim was to determine if a relationship exists between MetS and chronic periodontitis in adult Colombians. METHODS: Participants were 220 healthy-gingivitis subjects and 431 periodontitis patients coming from the three largest Colombian cities. Periodontal status and MetS were determined in subjects. Univariate analysis and odds ratio were calculated within the 95 % confidence intervals and chi2 test compared the groups. Variables were compared among the clinical periodontal groups and MetS by Wilcoxon and multivariate analysis, and logistic regression was performed for MetS and periodontitis. RESULTS: MetS had higher prevalence in periodontitis group (6.3 %) versus controls (3.2 %). In multivariate analysis, periodontitis was associated with MetS (adjusted OR = 2.72, 95 % CI 1.09-6.79), glucose intolerance with another component of MetS (adjusted OR = 1.78, 1.16 to 2.72), glucose resistance (adjusted OR = 11.46, 95 % CI 1.41-92.88), smoking (OR = 1.72, 95 % CI 1.09-2.71), and city of origin (2.69, 95 % CI 1.79-4.04). CONCLUSION: The study confirmed the positive association between MetS and periodontitis, being glucose sensitivity the strongly associated component. CLINICAL RELEVANCE: MetS must be taken into account by the dentist when evaluating risk factors for periodontitis, being useful for dentists to evaluate glycemia, lipidic profile, central obesity, and high blood pressure in patients. Interdisciplinary treatment must be recommended when a patient with MetS and periodontitis is being treated.

Determinación de los cambios en altura y densidad ósea después de un proceso de preservación con un sustituto óseo sintético / Determination of changes in height and bone density after process preservation with synthetic bone substitute

Objetivo: Determinar los niveles de altura y densidad osea alcanzada en alvéolos pos - texodoncia, 15 dias y tres meses despues de ser injertados con un sustituto óseo experimental. Materiales y Métodos: Se distribuyeron aleatoriamente 37 alvéolos postexodoncia en dos grupos, uno experimental (n=21) y otro control (n=16). En el grupo expe- rimental se utilizó un material compuesto por ß-Fosfato tricalcico y quitosano, en el grupo control se empleó un producto co- mercial compuesto por una mezcla bifásica de hidroxiapatita (HA) y fosfato tricalcico (TCP). Se realizaron tomografías a los 15 días y 3 meses postquirúrgicos determi - nando niveles óseos (altura y anchura en la zona injertada); también se determinó la densidad ósea utilizando unidades Houns- field. La información obtenida se procesó con la aplicación STATA versión 13. Se calcularon frecuencias para el sexo, tipo de alvéolo y tipo de injerto utilizado, y para las variables numéricas de edad, densidad ósea, altura ósea, grosor crestal, se establecieron promedios y desviación estándar. El nivel de confianza se estableció en 95% y el nivel de significancia en 5%. Resultados: Al comparar la densidad y altura ósea en los dos grupos no se encon- traron diferencias estadísticamente signifi - cativas, pero si al comparar el ancho en la zona de la cresta ( p <0.05). Conclusiones: El biocompuesto cerámico con quitosano mostró ser útil en preservar niveles óseos en los alvéolos postexodoncia y presentó diferencias estadísticamente significas en el ancho del reborde

Aim: Determine bone density and height reached fifteen (15) days and three (3) months after being grafted an sockets with a synthetic bone substitute and compared with experimental ceramic biocomposite. Materials and Methods: Thirty-seven sockets (37) selected randomly were gra - fted in clinics of the University of Valle, sixteen sockets (16) for control group and twenty (21) for the experimental group. CT scans were performed at 15 days and 3 months post-surgery determining bone levels: vertical height and width in the gra - fted area; bone density is also determined by analyzing Hounsfield units. The infor - mation obtained was processed with the STATA version 13 application frequencies for gender, type of socket and type of graft used, and for numeric variables of age, bone density, bone height, thickness crestal, averages were established and deviation were calculated standard. The confidence level was set at 95% and the significance level of 5%. Results: Bone density and height, no statis - tically significant differences between the intervention group (group 1) and control (group 2). For peak thickness statistically significant differences ( p <0.05). The va - riation or change between start and end of follow within each group found that there is no statistically significant difference. Conclusions: The ceramic biocomposite with chitosan and graft tricalcium phospha - te and hydroxyapatite no statistically significant differences in density and height in the scans at 15 and 90 days. The bone width showed statistically significant differences

Porphyromonas gingivalis Fim-A genotype distribution among Colombians.

INTRODUCTION: Porphyromonas gingivalis is associated with periodontitis and exhibit a wide array of virulence factors, including fimbriae which is encoded by the FimA gene representing six known genotypes. OBJETIVE: To identify FimA genotypes of P. gingivalis in subjects from Cali-Colombia, including the co-infection with Aggregatibacter actinomycetemcomitans, Treponema denticola, and Tannerella forsythia. METHODS: Subgingival samples were collected from 151 people exhibiting diverse periodontal condition. The occurrence of P. gingivalis, FimA genotypes and other bacteria was determined by PCR. RESULTS: P. gingivalis was positive in 85 patients. Genotype FimA II was more prevalent without reach significant differences among study groups (54.3%), FimA IV was also prevalent in gingivitis (13.0%). A high correlation (p= 0.000) was found among P. gingivalis, T. denticola, and T. forsythia co-infection. The FimA II genotype correlated with concomitant detection of T. denticola and T. forsythia. CONCLUSIONS: Porphyromonas gingivalis was high even in the healthy group at the study population. A trend toward a greater frequency of FimA II genotype in patients with moderate and severe periodontitis was determined. The FimA II genotype was also associated with increased pocket depth, greater loss of attachment level, and patients co-infected with T. denticola and T. forsythia.

INTRODUCCIÓN: Porphyromonas gingivalis es una bacteria asociada con la periodontitis. Expresa una amplia gama de factores de virulencia, incluyendo las fimbrias, las cuales están codificadas por el gen FimA que representa seis genotipos conocidos. OBJETIVO: Identificar los genotipos de FimA de P. gingivalis en pacientes de Cali - Colombia, incluyendo la co -infección con Aggregatibacter actinomycetemcomitans, Treponema denticola y Tannerella forsythia . MÉTODOS: Se obtuvieron muestras subgingivales de 151 individuos con diferentes diagnósticos periodontales. La ocurrencia de P. gingivalis, los genotipos de FimA y otras bacterias se determinó por PCR. RESULTADOS: Porphyromonas gingivalis fue positiva en 85 pacientes. El genotipo FimA II fue más prevalente, pero no hubo diferencias significativas entre los grupos de estudio (54.3%) , FimA IV fue el más frecuente en la gingivitis (13.0%). Una alta correlación (p= 0.000 ) se encontró entre P. gingivalis , T. denticola y T. forsythia. El genotipo FimA II estuvo correlacionado con la detección de T. denticola y T. forsythia . CONCLUSIONES: Porphyromonas gingivalis tuvo una alta frecuencia incluso en el grupo de individuos sanos. Se encontró una tendencia hacia una mayor frecuencia de FimA II en pacientes con periodontitis moderada y severa. El genotipo FimA II también se asoció con una mayor profundidad de la bolsa, una mayor pérdida de nivel de inserción, y con los pacientes en los que se detectó co - infección con T. denticola y T. forsythia.

Porphyromonas gingivalis Fim-A genotype distribution among Colombians / Distribución del genotipo Fim-A de Porphyromonas gingivalis entre la población colombiana

Introduction: Porphyromonas gingivalis is associated with periodontitis and exhibit a wide array of virulence factors, including fimbriae which is encoded by the FimA gene representing six known genotypes. Objetive: To identify FimA genotypes of P. gingivalis in subjects from Cali-Colombia, including the co-infection with Aggregatibacter actinomycetemcomitans, Treponema denticola, and Tannerella forsythia. Methods: Subgingival samples were collected from 151 people exhibiting diverse periodontal condition. The occurrence of P. gingivalis, FimA genotypes and other bacteria was determined by PCR. Results: Porphyromonas gingivalis was positive in 85 patients. Genotype FimA II was more prevalent without reach significant differences among study groups (54.3%), FimA IV was also prevalent in gingivitis (13.0%). A high correlation (p= 0.000) was found among P. gingivalis, T. denticola, and T. forsythia co-infection. The FimA II genotype correlated with concomitant detection of T. denticola and T. forsythia. Conclusions: Porphyromonas gingivalis was high even in the healthy group at the study population. A trend toward a greater frequency of FimA II genotype in patients with moderate and severe periodontitis was determined. The FimA II genotype was also associated with increased pocket depth, greater loss of attachment level, and patients co-infected with T. denticola and T. forsythia.

Introducción: Porphyromonas gingivalis es una bacteria asociada con la periodontitis. Expresa una amplia gama de factores de virulencia, incluyendo las fimbrias, las cuales están codificadas por el gen FimA que representa seis genotipos conocidos. Objetivo: Identificar los genotipos de FimA de P. gingivalis en pacientes de Cali - Colombia, incluyendo la co -infección con Aggregatibacter actinomycetemcomitans, Treponema denticola y Tannerella forsythia. Métodos: Se obtuvieron muestras subgingivales de 151 individuos con diferentes diagnósticos periodontales. La ocurrencia de P. gingivalis, los genotipos de FimA y otras bacterias se determinó por PCR. Resultados: Porphyromonas gingivalis fue positiva en 85 pacientes. El genotipo FimA II fue más prevalente, pero no hubo diferencias significativas entre los grupos de estudio (54.3%), FimA IV fue el más frecuente en la gingivitis (13.0%). Una alta correlación (p= 0.000) se encontró entre P. gingivalis , T. denticola y T. forsythia. El genotipo FimA II estuvo correlacionado con la detección de T. denticola y T. forsythia. Conclusiones: Porphyromonas gingivalis tuvo una alta frecuencia incluso en el grupo de individuos sanos. Se encontró una tendencia hacia una mayor frecuencia de FimA II en pacientes con periodontitis moderada y severa. El genotipo FimA II también se asoció con una mayor profundidad de la bolsa, una mayor pérdida de nivel de inserción, y con los pacientes en los que se detectó co-infección con T. denticola y T. forsythia.

Identificación de bacterias periodontopáticas en cepillos dentales con y sin agente antibacterial / Identification of periodontopathic bacteria on toothbrushes with and without antibacterial agent

Resumen Introducción y objetivo: Los cepillos dentales pueden servir como reservorio para la translocación de bacterias periodontopáticas. El objetivo fue determinar la contaminación por bacterias periodontopatógenas en dos tipos de cepillos dentales, con y sin antibacterial. Materiales y métodos: Participaron 20 pacientes con periodontitis, que cepillaron 2 cuadrantes al azar con un cepillo antibacterial y los 2 cuadrantes contralaterales con cepillo normal, con la técnica de Bass modificado. Los cepillos se lavaron con agua por 10 segundos y se almacenaron individualmente en bolsas estériles a temperatura ambiente. A las 0, 4 y 24 h se cortaron 4 cerdas de cada cepillo y se suspendieron en el medio de dilución VMGA I, se sembraron en 3 medios de cultivo en anaerobiosis y CO2, se identificaron de acuerdo a la morfología de las colonias y pruebas adicionales con el sistema de identificación RAPID ANA II. Se evaluó la normalidad de las variables cuantitativas, se comparó el número de UFC/ml en los medios de cultivo a los diferentes tiempos de siembra, mediante la prueba U de Mann Whitney, con un alfa de 0,05. Resultados: Hubo diferencias significativas en el número de UFC/ml en agar sangre a las 24 horas de cultivo (p=0,011). Se identificaron a partir de los cultivos en los 3 tiempos bacterias como Porphyromonas gingivalis,Prevotella intermedia/nigrescens, Fusobacterium spp y Eikenella corrodens, mientras que Tannerella forsythia, Eubacterium spp y bacilos entéricos se recuperaron solo en la siembra inmediata. Conclusión:Ambos tipos de cepillos tuvieron contaminación bacteriana en los distintos medios de cultivo.

Abstract Introduction and objective: Dental toothbrushes can serve as reservoir to translocation of periodontopathic bacteria. The aim was to determine periodontal bacterial contamination in both types of toothbrushes, with and without antibacterial bristles. Materials and methods:We included 20 patients with periodontitis, which brushed two randomly selected quadrants with antibacterial brush and the 2 contralateral quadrants with normal toothbrush with modified Bass technique, and thereafter, the brushes were washed with water for 10 seconds and stored in sterile bags at room temperature. At 0, 4 and 24 h bristles were cut from each brush 4 and suspended in the dilution medium VMGA I. These were plated on 3 culture media in anaerobiosis and CO2 and identified according to the colony morphology and further tests such as UV fluorescence, catalase and identification system RAPID ANA II. Normality of the quantitative variables was assessed and compared the number of CFU/ ml in the culture media to different culturing times, by the nonparametric Mann Whitney U test with a significance level of p <0.05. Results: There were significant differences in the number of CFU / ml in blood agar at 24 hours of culture (p = 0.011). Were identified from cultures at 3 times bacteria like Porphyromonas gingivalis, Prevotella intermedia/ nigrescens, Fusobacterium spp and Eikenella corrodens, while Tannerella forsythia, Eubacterium spp and enteric bacilli were recovered only in the immediate culturing. Conclusion: Both types of brushes had bacterial contamination in the different culture media tested.

Metástasis endometrial por cáncer de mama durante hormonoterapia adyuvante: reporte de caso / Endometrial metastasis for breast cancer during adjuvant hormone therapy: case report

Introducción: el cáncer de mama es el tumor más frecuente en las mujeres y la primera causa de muerte en este grupo con cerca de 230.000 casos nuevos al año en los Estados Unidos. En el tratamiento adyuvante del cáncer de mama con receptores hormonales positivos el tamoxifeno cumple un papel fundamental sin embargo es bien conocido que su uso incrementa el riesgo de cáncer endometrial. Las metástasis del cáncer de mama hacia el útero son poco comunes aunque existen algunos casos reportados en la literatura. El diagnóstico diferencial entre tumor primario y metástasis distantes de cáncer de mama hacia el útero determina el tipo de tratamiento que se deberá realizar. Caso: nosotros reportamos un caso de cáncer de mama que se presenta con metástasis uterina durante el tratamiento con tamoxifeno y demostramos la utilidad del estudio histopatológico con inmunohistoquimica para llegar al diagnóstico.

Introduction: breast cancer is the most common tumor in women and the leading cause of cancer death in this group with about 230,000 new cases per year in the United States. Adjuvant treatment of breast cancer with hormone receptor-positive tamoxifen plays a critical role but is nevertheless well known the increased risk of endometrial cancer with its use. Metastases of breast cancer to the uterus are rare but there are some cases reported in the literature. The differential diagnosis between primary tumor and distant metastases to the uterus from breast cancer determines the type of treatment that should be administered. Case: we report a case of breast cancer that presented uterine metastases during treatment with tamoxifen and demonstrate the usefulness of histopathology with immunohistochemistry to reach the diagnosis.

Periodontal disease in children and adolescents of Latin America.

Periodontal diseases are a group of infectious diseases that mainly include gingivitis and periodontitis. Gingivitis is the most prevalent form of periodontal disease in subjects of all ages, including children and adolescents. Less frequent types of periodontal disease include aggressive periodontitis, acute necrotizing ulcerative gingivitis and various diseases of herpesviral and fungal origin. This review aimed to retrieve relevant information from Latin America on the prevalence of periodontal diseases among children and adolescents of the region. Gingivitis was detected in 35% of young Latin American subjects and showed the highest frequencies in Colombia (77%) and Bolivia (73%) and the lowest frequency in Mexico (23%). The frequency of gingivitis in subjects from other Latin American countries was between 31% and 56%. Periodontitis may affect <10% of the young population in Latin America, but the data are based on only a few studies. A more precise assessment of the distribution and severity of periodontal disease in children and adolescents of Latin America may help policy makers and dentists to institute more effective public health measures to prevent and treat the disease at an early age to avoid major damage to the permanent dentition.

Periodontal microbiology in Latin America.

This review article describes the microbiota associated with periodontal disease in Latin America. This vast territory includes 22 nations, which show great ethnic diversity, with large groups of White people, Black people, Mestizo people and Native people. Widespread poverty and limited access to education and health-care services, including periodontal care, are prominent predisposing factors for destructive periodontal disease in Latin America. Black people and Mestizo people seem to have particularly severe periodontal disease and are frequently colonized by the major periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The 'red complex' bacterial pathogens and A. actinomycetemcomitans predominate in chronic and aggressive periodontitis, but gram-negative enteric rods and herpesviruses can also play important periodontopathic roles in Latin America. The key to minimizing the risk of periodontal disease is control of the pathogens, and new low-cost periodontal treatments deserve serious consideration in Latin America.

Contaminación de cepillos dentales denominados antibacteriales. Estudio in vitro / Effectiveness of antibacterial dental brushes. In vitro stud

Introducción: La contaminación del cepi - llo dental es importante para la salud oral y general, puesto que facilita la higiene oral. Como se contamina después del uso, pue- de ser fuente de infecciones. Los cepillos antibacteriales controlan la contaminación. Obtetivo: Se determinó la efectividad de los cepillos dentales antibacteriales en la inhibición del crecimiento de microorga- nismos patogénicos como A. actinomyce - temcomitans y E. cloacae . En este estudio se incluyeron, tres marcas de cepillos dentales que fueron Oral-B® antibacterial y Colgate® antibacterial incluido un cepillo convencional no antibacterial de la marca Colgate. Materiales y métodos: Un total de 48 cepillos fueron inoculados, 24 con A. ac- tinomycetemcomitans y 24 con E.cloacae y la viabilidad microbiana fue establecida después de diversos tiempos así: 24 horas, 4 días, 12 días y 24 días, en un experimento por duplicado al evaluar el crecimiento bacteriano. Resultados: A las 24 horas los cepillos cumplen con su poder antibacterial incluido el cepillo convencional, el cepillo Oral-B® antibacterial y el Colgate®antibacterial inhibieron completamente el crecimiento de las colonias de el A. actinomycete - mcomitans , mientras que el cepillo Oral B antibacterial permitió el crecimiento de E. cloacae . Finalmente se encontró que con el paso de tiempo 24 días, los cepillos dentales perdieron el efecto antibacterial contra ambos organismos. Conclusión: Los cepillos antibacteriales logran inhibir el crecimiento de A. acti - nomycetemcomitans entre las 24 horas y los 4 días, pero su efecto antibacterial se pierde con el tiempo. Un microorganismo súper-infectante como el E. cloacae es más resistente contra antibacteriales presentes en los cepillos dentales...(Au)

Objective: Toothbrush contamination is important to the oral health and the general health. Toothbrush is recommended to the regular elimination of the bacterial plaque; however it is also a potential source infec - tion since it gets contaminated. Antibacte - rial toothbrushes were introduced to control the microbial contamination. Materials and methods: The effectiveness of antibacterial toothbrushes on the growth inhibition of A. actinomycetemcomitans , and E. cloacae were determined. This study included, three brands of dental brushes which were Oral-B® antibacterial Colgate® antibacterial I and as control one conventional dental brush non-antibacterial of Colgate. Materials and methods: A total of 48 dental brushes were inoculated, 24 with A. actinomycetemcomitans and 24 with E. cloacae and the microbial viability was established after diverse times as follows: 24 hours, 4 days, 12 days and 24 days, in an experiment for duplicate, evaluating the bacterial growth. Results: At 24 hours the dental brushes fulfill their antibacterial efficacy including the conventional dental brush, The Oral-B® antibacterial toothbrush and the Colgate® antibacterial controlled completely the growth of the colonies of the A. actinomy- cetemcomitans , while the Oral-B anti - bacterial toothbrush allowed E. cloacae's growth. Finally after 24 days it was found that the inoculation the dental brushes does not inhibited either the A. actinomycete - mcomitans or neither the E. cloacae . Conclusions: The antibacterial brushes are able to inhibit the growth of A. actinomyce - temcomitans between 24 hours to 4 days, but this antibacterial effect is lost over the time. A super-infectious microorganism such as E. cloacae is more resistant to antibacterials present on dental brushes...(Au)

Association between periodontal disease and plasma levels of cholesterol and triglycerides / Asociación entre enfermedad periodontal y niveles plasmáticos de colesterol y triglicéridos

Objective: Untreated Periodontal Disease Seems To Cause Low Grade Systemic Inflammation And Blood Lipid Alteration Leading To Increased Cardiovascular Disease Risk. To Start Testing This Hypothesis In Colombian Patients, A Multicentre Study Was Conducted Including The Three Main State Capitals: Bogota, Medellin And Cali. Methods: In This Study 192 (28.4%) Advanced And 256 (37.8%) Moderate Periodontitis Patients Were Investigated For Socio-Demographic Variables, City Of Precedence, Periodontal Parameters, Smoking, Red Complex Periodontopathic Bacteria, Serum Antibodies Against Porphyromonas Gingivalis And Aggregatibacter Actinomycetemcomitans And Blood Lipids Including Total Cholesterol, HDL, LDL And Triglycerides (TG). Those Parameters Were Compared To 229 (33.8%) Controls Having Periodontal Health Or Gingivitis. Results: Advanced Periodontitis Had Worst Periodontal Indexes, Than Moderate Periodontitis And Controls. Interestingly, Higher HDL And TG Levels Were Present In Periodontitis. BMI <30 And Smoking Were Associated With Increased HDL, HDL-35, LDL And TG, While Glycemia >100 Mg/Dl Associated With HDL, HDL-35 And TG. Tannerella Forsythia Showed A Significant Association With HDL-35 In Bivariate Analysis And Serum Igg1 Against P. Gingivalis Associated With HDL-35 And Serum Igg1 Against T. Forsythia Associated With TG And Serum Igg2 Against A. Actinomycetemcomitans Correlated With Levels Of HDL Y HDL-35. In Logistic Regression The Periodontitis Patients From Cali Presented Reduced HDL Levels As Compared To Bogota And Medellin Patients. Presence Of Igg1 Antibodies Against P. Gingivalis And A. Actinomycetemcomitans Correlated With Reduced HDL Levels. Conclusion: This Study Confirmed That Untreated Periodontitis Generates Alteration In Serum Lipid Levels And Systemic Bacterial Exposure Against Important Periodontopathic Bacteria Could Be The Biological Link.

Objetivo: La periodontitis no tratada parece causar inflamación sistémica, así como alteración de los niveles sanguíneos de lípidos, lo que conduce a un mayor <<<<<<<<

Association between periodontal disease and plasma levels of cholesterol and triglycerides.

OBJECTIVE: untreated periodontal disease seems to cause low grade systemic inflammation and blood lipid alteration leading to increased cardiovascular disease risk. To start testing this hypothesis in colombian patients, a multicentre study was conducted including the three main state capitals: bogota, medellin and cali. METHODS: in this study 192 (28.4%) advanced and 256 (37.8%) moderate periodontitis patients were investigated for socio-demographic variables, city of precedence, periodontal parameters, smoking, red complex periodontopathic bacteria, serum antibodies against porphyromonas gingivalis and aggregatibacter actinomycetemcomitans and blood lipids including total cholesterol, hdl, ldl and triglycerides (tg). Those parameters were compared to 229 (33.8%) controls having periodontal health or gingivitis. RESULTS: advanced periodontitis had worst periodontal indexes, than moderate periodontitis and controls. Interestingly, higher hdl and tg levels were present in periodontitis. Bmi <30 and smoking were associated with increased hdl, hdl-35, ldl and tg, while glycemia >100 mg/dl associated with hdl, hdl-35 and tg. Tannerella forsythia showed a significant association with hdl-35 in bivariate analysis and serum igg1 against p. Gingivalis associated with hdl-35 and serum igg1 against t. Forsythia associated with tg and serum igg2 against a. Actinomycetemcomitans correlated with levels of hdl y hdl-35. In logistic regression the periodontitis patients from cali presented reduced hdl levels as compared to bogota and medellin patients. Presence of igg1 antibodies against p. Gingivalis and a. Actinomycetemcomitans correlated with reduced hdl levels. CONCLUSION: this study confirmed that untreated periodontitis generates alteration in serum lipid levels and systemic bacterial exposure against important periodontopathic bacteria could be the biological link.

OBJETIVO: La periodontitis no tratada parece causar inflamación sistémica, así como alteración de los niveles sanguíneos de lípidos, lo que conduce a un mayor riesgo de enfermedades cardiovasculares. Para empezar a probar esta hipótesis en pacientes Colombianos, se realizó un estudio multicéntrico que incluyó las tres ciudades principales: Bogotá, Medellín y Cali. MÉTODOS: Se estudiaron 192 pacientes con periodontitis avanzada (2.,4%) y 256 (37.8%) con periodontitis moderada, para medir variables sociodemográficas, ciudad de procedencia, parámetros periodontales, fumar, presencia de bacterias periodontopáticas, anticuerpos séricos contra Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans, así como niveles de lípidos en sangre incluyendo colesterol total, HDL, LDL y triglicéridos (TG). Estos parámetros se compararon con 229 (33.8%) pacientes controles sanos/gingivitis. RESULTADOS: Los pacientes con periodontitis avanzada tuvieron peores índices periodontales que los de periodontitis moderada y los controles. Mayores niveles de HDL y TG estuvieron presentes en pacientes con periodontitis. El índice de masa corporal >30 y el hábito de fumar se asociaron con aumento de HDL, HDL-35, LDL y TG, mientras la glicemia >100 mg/dL se asoció con HDL, HDL-35 y TG. En el análisis bivariado Tannerella forsythia mostró asociación significativa con HDL-35 e IgG1 sérica contra P. gingivalis estuvo asociada a HDL-35 así como IgG1 contra T. forsythia con TG y la IgG2 contra A. actinomycetemcomitans se correlacionó con los niveles de HDL y HDL-35. En la regresión logística se observó que la región de Cali tuvo niveles menores de HDL en comparación con los pacientes de Bogotá y Medellín. La presencia de anticuerpos IgG1 contra P. gingivalis y A. actinomycetemcomitans se asoció con niveles reducidos de HDL. CONCLUSIÓN: Este estudio confirmó que la periodontitis no tratada genera alteración en los niveles de lípidos séricos y la exposición bacteriana sistémica a las bacterias periodontopáticas podría ser el vínculo biológico.

[Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients]. / Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia.

INTRODUCTION: Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. OBJECTIVE: Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. MATERIALS AND METHODS: In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student's t tests were used, with a significance level of p≤0.05. RESULTS: Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. CONCLUSION: Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia / Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

Introducción. Pocos estudios han descrito la microbiota subgingival en mujeres embarazadas con preeclampsia leve. Objetivo. Identificar cambios periodontales y de la microbiota subgingival en mujeres embarazadas con preeclampsia, después del tratamiento periodontal. Materiales y métodos. En un análisis secundario de un ensayo clínico de asignación aleatoria, se estudiaron 57 pacientes con preeclampsia en el Hospital Universitario del Valle de Cali. Se asignaron al azar 31 al grupo de intervención periodontal (detartraje y alisado subgingival ultrasónico y manual) durante su embarazo y otras 26 al grupo control (profilaxis supragingival). Se determinaron los parámetros clínicos periodontales y la microbiota subgingival a la inclusión al estudio y en el posparto. Se evaluaron 8 bacterias periodontopáticas y 2 virus herpes por reacción en cadena de la polimerasa. Se usaron las pruebas de ji al cuadrado, test de McNemar o t de Student, con un nivel de significancia de p≤ Resultados. Los grupos fueron comparables en las variables clínicas y microbiológicas al inicio del estudio. El tratamiento periodontal redujo el promedio de la profundidad de bolsa en el grupo de intervención de 2,44±0,31 a 2,31±0,24 mm (p=0,000) y en el grupo control de 2,58±0,37 a 2,44±0,39 mm (p=0,000),y el índice de sangrado, de 16,4±1,5 a 7,9±0,7 % en el primero (p=0,000), y de 17,1±1,8 a 10±0,9 %, en el segundo (p=0,002). La frecuencia de detección de microorganismos no varió de manera significativa entre los grupos. Conclusión. El raspaje y alisado radicular, así como la profilaxis supragingival, redujeron de manera significativa la profundidad a la sonda y el índice de sangrado gingival. El tratamiento periodontal no fue más efectivo que la profilaxis para reducir los organismos periodontopáticos o los virus herpes.

Introduction. Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. Objective. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. Materials and methods. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student´s t tests were used, with a significance level of p≤0.05. Results. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. Conclusion. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Tooth and periodontal clinical attachment loss are associated with hyperglycemia in patients with diabetes.

BACKGROUND: Periodontal disease has been associated with diabetes, but there is still controversy on the relationship between periodontal clinical parameters and glycemic control. The purpose of this study is to assess the relationship between blood glucose levels and clinical parameters of periodontal disease in individuals with diabetes. METHODS: A total of 65 individuals with diabetes and 81 individuals without diabetes were included in the study. A full-mouth periodontal examination and preprandial fasting glycemia values were recorded for each individual. Glycosylated hemoglobin was only measured in patients with diabetes. A comparative analysis between groups (Mann-Whitney U test) and a correlation analysis between glycemia and periodontal parameters were performed (Spearman test). RESULTS: Patients without diabetes presented more teeth than individuals with diabetes (P <0.05). Patients with diabetes with periodontitis displayed loss of periodontal clinical attachment compared to patients without diabetes, but the highest value was observed in patients with periodontitis that reported a smoking habit. Furthermore, patients with diabetes with periodontitis presented higher glycemia and glycated hemoglobin values in contrast to patients with gingivitis. Patients with diabetes with hyperglycemia had a higher risk to develop periodontitis (odds ratio = 2.24; 95% confidence interval = 1.02 to 4.93). A positive correlation was observed between glycemia and clinical attachment loss (AL), whereas a negative correlation between glycemia and the number of teeth present was found (P <0.05). CONCLUSIONS: Tooth and periodontal AL were increased by hyperglycemia in individuals with diabetes. This study contributes additional evidence that diabetes could aggravate periodontal disease and affect the systemic health of individuals.

Prevalencia de diseminación infecciosa de origen odontogénico al complejo bucomaxilofacial / Prevalenceof infectino dissemination from odontogenic origin to the bucomaxillofacial complex

Objective: To establish the prevalence of infectious dissemination of odontogenic origin of the maxillofacial complex in patients attending for emergency consultation and outpatient service of a second level hospital in the city of Cali. Materials and methods: We reviewed 142 medical records of adult patients of any gender and ethnicity, with diagnostic impression of periapical abscess with and without fistula, periodontal abscess, pericoronitis, cellulitis and mouth and face abscesses that had disseminations to maxilla and mandible, who attended the emergency dental service and the outpatient service of a level II hospital in Cali in 2009. Results: One hundred and twenty four of 695 patients who attended the service of dentistry presented any infection of odontogenic origin, equivalent to the 17.8%. The most frequent diagnostics were acute periocoronitis, cellulitis and abscess. Discussion: The dentist must know the prevalence of these infections and the risks of occurrence of a more complicated condition as a mediastinitis by spread from the dental infection, with a high rate of mortality. Infections such as these can put at risk the life of the patient which leads to hospitalization. Conclusions: The anatomical area with greater commitment was the lower maxillary infection spread from the lower molars and premolars. It is important to recommend further promotion and prevention education strategy directed to dentists and vulnerable population, to explain the risks associated with an oral infection and the importance of early treatment and the possibility of generating resistance to antibiotics...(AU)

Objetivo: Determinar la prevalencia de diseminación infecciosa de origen odonto- génico del complejo bucomaxilofacial en pacientes que asisten a consulta de urgen- cias y consulta externa de un hospital de segundo nivel de la ciudad de Cali. Materiales y métodos: Se revisaron 142 historias clínicas de pacientes mayores de edad sin discriminar género ni etnia, con impresión diagnóstica de absceso periapi - cal con y sin fístula, absceso periodontal, pericoronitis, celulitis y absceso de boca y celulitis de cara que presentaron disemina - ciones en maxilar superior e inferior, los cuales acudieron al servicio odontológico en el año 2009. Resultados: De 695 pacientes que asis - tieron al servicio de odontología 124 se presentaron por infección de origen odontogénico, equivalente al 17.8%. Los diagnósticos más frecuentes fueron perico - ronitis aguda, celulitis y absceso. Discusión: El odontólogo debe conocer la prevalencia de estas infecciones y los riesgos que se pueden presentar en casos severos como una mediastinitis por disemi - nación con una tasa elevada de mortalidad. Infecciones como estas pueden poner en riesgo la vida del paciente lo cual conlleva a hospitalización para su manejo. Conclusiones: La zona anatómica con mayor compromiso fue la mandíbula, por infecciones diseminadas desde los molares y premolares inferiores. Se recomienda profundizar en campañas de Promoción y Prevención en la población vulnerable, para dar a conocer el riesgo que conlleva una infección oral y la importancia de realizar el tratamiento oportuno y la posibilidad de generar resistencia a los antibióticos...(AU)

[Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease]. / Bacilos Gram negativos entéricos y no fermentadores de la glucosa en pacientes con enfermedad periimplante.

INTRODUCTION: Implants can be colonized by microorganisms from oral biofilms and may affect peri-implant tissues health. Among these bacteria, pathogens typically associated with periodontitis can be found, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, as well as Gram negative enteric bacilli not typically associated with periodontal diseases. OBJECTIVE: Superinfecting bacteria were characterized from peri-implant lesions in patients with history of periodontitis. MATERIALS AND METHODS: Sixty-eight implants were studied in 55 patients; the average patient age was 56 years. Forty-nine implants had peri-implant lesions and 19 were considered stable. Subgingival samples were obtained in affected and stable implants. The samples were streaked on Mac-Conkey agar and incubated at 37°C for 24 hours. The colonies were identified with the kit-BD BBL Crystal E/NF®. RESULTS: Superinfecting organisms were detected in 20 patients--they were seen more frequently at diseased implants (n=15) than at healthy implants (n=5). The prevalence of superinfecting bacteria on the selected implants was 33.8% (n=23/68). These bacteria were more prevalent among affected implants (n=17 or 25%) than those with stable implants n=6 (8.8%). Klebsiella pneumoniae was the most frequent Gram negative rod detected (n=12). CONCLUSIONS: One-third of the implants had superinfecting organisms. Implants with a peri-implant lesion had a higher frequency of superinfecting bacteria. Klebsiella pneumoniae was the most common superinfecting organism isolated. A multiple infection caused by superinfecting bacteria was present only at diseased implants. These microbial agents potentially affect implant stability.