Oral cancer awareness among dental students in a private university setting.

INTRODUCTION: There is a great deal of research on the awareness of students and professionals regarding oral cancer. The aim of this study was to find out students' opinions in their final years of dental school training who have clinic time about the importance of correct mucosal examination of the oral cavity. MATERIALS AND METHODS: A cross-sectional study was carried out and a questionnaire was designed and distributed to fourth- and fifth-year dental students. The questionnaire included demographic aspects of the participants and five closed questions related to the importance given to the exploration of the soft tissues during patient visits, the importance of the university training received, their interest in continuing education on this subject, their role as dentists in early diagnosis and whether they consider themselves prepared to diagnose oral cancer. RESULTS: A total of 214 undergraduate dental students participated in the study, 24.3% fourth year and 75.7% fifth year. Moreover, 97.7% of the students considered soft tissue examination to be important or very important, 90.2% of the students surveyed considered the university training received to be important or very important and 66.4% of the students considered that the most qualified professional to diagnose an oral lesion is the dentist. CONCLUSION: In this study, most of the students felt that graduate training in oral cancer is important, as well as soft tissue examination. In addition, the majority considered that the professional most indicated to diagnose oral lesions is the dentist. However, a very small percentage felt prepared to diagnose oral cancer themselves.

Complicaciones tras exodoncias de terceros molares erupcionados realizadas en una clínica universitaria / Complications after erupted third molar extractions performed at the university clinic

La extracción dental es uno de los ejercicios más practicado entre dentistas y maxilofaciales. Actualmente en España la prevalencia de extracciones realizadas es del 32,1%, de los cuales el 23,6% son cordales. La extracción de un tercer molar puede ser muy variada, desde un acto de pocos minutos y gran simplicidad a una complicada y extensa cirugía. Son diver sas las complicaciones que pueden de rivar de ello, las inmediatas que ocurran intraquirúrgicamente o las mediatas, a las horas o días. La aparición de dichas complicaciones está influenciada por diversos factores como edad, sexo, medicación, hábitos, enfermedades y diente extraído. El objetivo de este estudio fue describir la tasa de complicaciones en las exodoncias de terceros molares erupcionados a priori sin necesidad de abordaje quirúrgico, realizadas por los alumnos del grado en Odontología de la de la Universidad Europea de Madrid. Un total de 311 extracciones de terceros molares erupcionados, realizadas entre los años 2018-2020 por alumnos de la Policlínica de la Universidad Europea de Madrid fueron analizadas. Se registraron la edad, sexo, diente extraído, hábitos, enfermedades, medicación habitual, medicación pautada por el operador, motivo de extracción, estado periodontal y complicaciones. El análisis de los datos se realizó con el paquete estadístico Stata IC v. 15.La edad media de los pacientes fue 48,3 (DE: 14,01) años, habiendo una equidad en el género. El molar extraído con mayor frecuencia fue el 2.8. La tasa de complicaciones fue del 4,5% (IC95%: 2,04% – 6,97%), un dato inferior al encontrado en la literatura, prevaleciendo la frac tura de corona o raíz (4,5%) y la alveolitis con un 1,93%.La tasa de complicaciones reflejada en este estudio es in ferior a la publicada por otros autores; posiblemente debi do a la elección de casos más sencillos para ser realizados por aquellos con menor experiencia (AU)

Dental extraction is one of the most practiced exercises among dentists and maxillofacial surgeons. Currently in Spain the prevalence of extractions performed is 32.1%, of which 23.6% are wisdom teeth. The extraction of a wisdom tooth can be very varied, from an act of a few minutes and great simplicity to a complicated and extensive surgery. There are several complications that can derive from it, the immediate ones occurring intraoperatively or the mediate ones, after hours or days. The appearance of these complications is nfluenced by various factors such as age, sex, medication, habits, diseases and extracted tooth. The aim of this study was to describe the rate of complications in extractions of erupted third molars initially without the need for surgical approach, performed by students of the bachelor in Dentistry of the European University of Madrid. A total of 311 extractions of erupted third molars performed between the years 2018-2020 by students of the polyclinic of the European University of Madrid were analyzed. Age, sex, extracted tooth, habits, diseases, regular medication, medication prescribed by the operator, reason for extraction, periodontal status and complications were recorded. Data analysis was performed with the Stata IC v. 15 statistical package. The mean age of the patients was 48.3 (SD: 14.01) years, with gender equality. The rate of complications was 4.5% (95%CI: 2.04% – 6.97%), lower than that found in the literature, with a prevalence of tooth fracture (crown or root) (4,5%) and dry socket (1.93%). The rate of complications reflected in this study is lower than that published by other authors; possibly due to the choice of simpler cases to be performed by those with less experience (AU)

Evaluation of the diagnostic ability of oral lesions on clinical images among undergraduate dental students.

INTRODUCTION: The dentist should be able to carry out systematic oral examinations of the mucosa of patients in order to diagnose any alterations at an early stage. MATERIALS AND METHODS: An observational, analytical, prospective, and longitudinal study was carried out. 161 students were evaluated at the beginning of their clinical practice in their 4th year of dental school (September 2019), at the beginning and at the end of their 5th year of dental school (June 2021). Thirty oral lesions were projected, and the students were asked to provide an answer; if the lesions were benign, malignant, or potentially malignant, whether they should be biopsied and/or treated and a presumptive diagnosis. RESULTS: Significant improvement (p < .001) was obtained between the 2019 and 2021 results, in relation to the classification, need for biopsy and treatment of lesions. For differential diagnosis, no significant difference (p = .985) was obtained between the 2019 and 2021 responses. Malignant lesions and PMD obtained mixed results, with the best results corresponding to OSCC. DISCUSSION: In this study, a correct lesion classification by the students was over 50%. As for the OSCC, the results were superior to the rest of the images, reaching more than 95% correct. CONCLUSION: Theoretical-practical training from universities and continuing education for graduates in relation to oral mucosal pathologies should be further promoted.

The Objective Structured Clinical Examination (OSCE) in Periodontology with Simulated Patient: The Most Realistic Approach to Clinical Practice in Dentistry.

The objective structured clinical examination (OSCE) is becoming an increasingly established assessment test in dental schools. The use of simulated patients in the OSCE makes the stations more similar to clinical practice. Therefore, the student can show their technical and clinical knowledge, and certainly, their ability to manage the patient. These sorts of tests, in which simulated patients can be included, would be used before the student started clinical practice with patients and/or at the end of the degree. The objective of this work was to describe how the periodontology station was developed using a simulated patient for students of a fifth year dentistry degree taking an OSCE test. Furthermore, a questionnaire was created to learn the perception of the students about this station and its characteristics. The fifth year students at the European University of Madrid positively evaluated this station in their examination. In addition, it was recorded that they preferred a simulated patient in their tests, rather than stations with clinical cases, images, X-rays, and presentations. It is essential that once the OSCE has been completed, the student receives a feedback to learn where they have failed and, therefore, be able to improve any of the aspects evaluated in the station.

Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition.

The aim of this study was to determine the optimum dimensions of a radiographic plate to allow correct visualization of dental tissues and correct fit in the oral cavity of children with deciduous dentition. A quasi-experimental clinical study was carried out in children of both sexes aged between 3 and 5 years. The study variables were the complete visualization of the dental structures, the surveillance of ischemia on soft tissues, stimulation of the gag reflex, and acceptance of the radiographic plate by the pediatric patient through a validated visual analogue scale that measures anxiety. The data obtained were subjected to a descriptive and comparative statistical analysis carried out for both study phases. A total of 80 children participated in the study. The optimal dimensions obtained for the radiographic plate were 19.5 mm in height and 27.3 mm in width. Visualization of the dental tissues during both phases was not statistically significant (p = 0.412). However, there were statistically significant differences regarding the presence of ischemia, gag reflex, and child rejection (p < 0.001). A smaller radiographic plate allows correct visualization of the coronal dental tissues without causing rejection, ischemia, or gag reflex in patients in the deciduous dentition.

Assessment of Clinical Parameters of Dental Anxiety during Noninvasive Treatments in Dentistry.

Dental anxiety is a matter of interest for the dentist since an anxious patient is a potential source of complications in the dental office. The main objectives of this study are to describe the correlation between dental anxiety levels and the values of physiological parameters related to dental anxiety and to study the evolution of blood pressure and heart rate over time during noninvasive dental treatments, i.e., not requiring local anesthesia. A descriptive, longitudinal, and prospective observational study was designed. The study population consisted of 200 patients who attended a university clinic for dental treatment without local anesthesia. The patients were asked to complete the Corah Dental Anxiety Scale. Afterward, blood pressure and heart rate were measured by means of a digital sphygmomanometer. Blood pressure and heart rate were taken throughout the procedure on four occasions. Most of the patients showed mild dental anxiety (5 [IQR: 3] points on Corah Dental Anxiety Scale). Significant but weak correlations were found between the level of dental anxiety and heart rate (Spearman rho: 0.166 and 0.176; p = 0.019 and 0.013; 3 min before and after treatment, respectively), as well as between the level of dental anxiety and the duration of treatment (Spearman rho: 0.191 3 min; p = 0.007). As for the evolution of physiological parameters, all patients showed a progressive decrease in values at different time points during treatment. When the types of treatment were evaluated separately, it was observed that there were statistically significant differences between them with respect to the level of dental anxiety (p = 0.006).

Adaptation of clinical subjects in Dentistry to virtual environments during the COVID-19 pandemic in a Spanish University: A case study.

INTRODUCTION: The evolution of the pandemic has generated a crisis in all areas, also including the faculties of dentistry. We detail how the teaching guides for clinical subjects have been adapted in the Department of Clinical Dentistry at the Universidad Europea of Madrid, moving to a 100% online environment. USUAL DEVELOPMENT OF CLINICAL PRACTICES IN THE DDS DEGREE OF UEM: Students in the fourth and fifth year of DDS degree take the courses "Introduction to Clinical Practice" and "Supervised Practice." Within the framework of continuous assessment, different systems and procedures are used to evaluate knowledge, skills or competences. CURRICULAR ADAPTATION DURING THE PERIOD OF THE COVID-19 PANDEMIC: It was necessary to adapt the practical contents to virtual contents. 35% of the course (12 weeks) was adapted to a 100% online environment. Several activities were carried out that could be evaluated in real time, including lectures, clinical cases and resolution of multidisciplinary dental treatments. DEVELOPMENT OF CLINICAL PRACTICES IN HEALTH EDUCATION IN OTHER INSTITUTIONS DURING THE PANDEMIC: A narrative review was conducted to identify how this situation has been addressed in other institutions and countries; finding that similarly, it has been possible to establish monitoring of clinical practices in a virtual environment. An online questionnaire was conducted to the fourth and fifth year students of DDS degree to stablish the acceptance of the adaptation during the pandemic. CONCLUSION: Despite the limitations of online training for the development of clinical practice, a system has been established to ensure appropriate clinical training for undergraduate students in dentistry. Some of the developments were well accepted by the students.

Valoración de parámetros relacionados con la ansiedad en primeras visitas y revisiones realizadas en clínica universitaria / Assessment of anxiety-related parameters in first visits and check-ups at the university clinic

La ansiedad dental puede considerarse un fenómeno universal con una alta prevalencia a nivel mundial. Esta ansiedad y el dolor dental son las principales causas de urgencias médicas en la consulta odontológica, por lo que su prevención supone una parte esencial para la seguridad del paciente y la calidad general de la atención que este recibe. El objetivo principal del estudio es valorar los niveles de ansiedad y la evolución de los valores de tensión arterial (TA) y frecuencia cardiaca (FC) de un grupo de pacientes durante la primera visita odontológica y las revisiones rutinarias. Además, se describe y compara la evolución de la TA y la FC en pacientes normo e hipertensos controlados, y el posible efecto del sexo y edad del paciente sobre estos parámetros. Se llevó a cabo un estudio observacional analítico prospectivo sobre pacientes que acudieron para realizar primeras visitas y revisiones a la Clínica Universitaria de la Universidad Europea de Madrid entre octubre 2020 y febrero 2021. Los pacientes que cumplieron los criterios de inclusión rellenaron el Test de Corah y fueron sometidos a 4 mediciones diferentes de TA y FC. Se realizaron 48 primeras visitas; el 35,42% eran hombres y el 64,58% mujeres, con una edad de 44,79 ± 16,49 años. La puntuación del test de Corah tiende a ser superior en los pacientes hipertensos en pacientes de primera visita, y la edad es significativamente mayor en hipertensos. En el conjunto de pacientes de primeras visitas, la TAS y el pulso variaron a lo largo del procedimiento, siendo inferiores al final. No se observó esta diferencia en cuanto a la TAD. (AU)

Dental anxiety can be considered a universal phenomenon with a high prevalence worldwide. Dental anxiety and dental pain are the main causes of medical emergencies in the dental office, so their prevention is an essential part of patient safety and the overall quality of the care received. The main objective of the study is to evaluate the levels of anxiety and the evolution of blood pressure (BP) and heart rate (HR) values in a group of patients during the first dental visit and routine check-ups. In addition, we describe and compare the evolution of BP and HR in controlled normotensive and hypertensive patients, and the possible effect of the patient’s sex and age on these parameters. A prospective analytical observational study was carried out on patients who attended for first visits and check-ups at the University Clinic of the European University of Madrid between October 2020 and February 2021. Patients who met the inclusion criteria filled out the Corah Test and underwent 4 different measurements of BP and HR. Forty-eight first visits were performed;35.42% were men and 64.58% women, with an age of 44.79 ± 16.49 years. The Corah test score tended to be higher in hypertensive patients in first visit patients, and age was significantly higher in hypertensives. In the set of firstvisit patients, the ASR and pulse varied throughout the procedure, being lower at the end. No such difference was observed for DBT. (AU)

Estudio retrospectivo a 5 años sobre la prevalencia de lesiones de la mucosa oral en una clínica universitaria / 5-year retrospective study on the prevalence of oral mucosa lesions in a university clinic

Resumen: El objetivo de este estudio fue determinar la prevalencia y distribución de las lesiones de la mucosa oral en los pacientes que acudieron a la Policlínica Universitaria de la Universidad Europea de Madrid entre 2014 y 2018, así como establecer si existe una relación entre el sexo y la edad con la presencia de lesiones de la mucosa oral. Material y métodos: Al ser un estudio retrospectivo a 5 años, se requería la revisión de 2000 historias clínicas para obtener un nivel de precisión y de confianza aceptable. La recogida de las variables de investigación se llevó a cabo mediante una base de datos diseñada en Access. El análisis de los datos se realizó con el paquete estadístico Stata IC versión 14 (StataCorp LLC., Texas USA). Resultados: En un análisis preliminar de 1536 historias clínicas se determinó que la prevalencia global de lesiones orales era del 29,27%, existiendo una diferencia estadísticamente significativa en cuanto al sexo, y no encontrándose diferencias estadísticamente significativas entre los diferentes grupos de edad. Siendo las lesiones de la mucosa oral más frecuentes la línea alba (9,78%) y el morsicatio buccarum (9,38%). Conclusiones: Este estudio tiene unaprevalencia global similar a otros publicados previamente, destacamos la importancia de la exploración oral para la identificación y prevalencia de lesiones orales. (AU)

Abstract: The objective of this study was to determine the prevalence and distribution of oral mucosa lesions in patients who attended the University Clinic of the European University of Madrid, between the years 2014 and 2018. Secundary objectives were to assess if there is a relationship between sex and age and the presence of lesions in the oral mucosa. Material and methods: Being a 5-year retrospective study, the review of 2000 medical records was required to obtain an acceptable level of precision and confidence level. The collection of all the variables was carried out using a database designed in Access. Data analysis was performed with the Stata IC version 14 statistical package (StataCorp LLC., Texas USA). Results: In a preliminary analysis of 1536 medical records we determined that the global prevalence of oral lesions was 29.27%, with a significant difference regarding sex. No significant differences were found between the different age groups. The most frequent lesions of the oral mucosa were linea alba (9.78%) and morsicatio buccarum (9.38%). Conclusions: Our study has a global prevalence similar to other previously published studies; we highlight the importance of oral examination for the identification and prevalence of oral lesions. (AU)

Estudio piloto sobre el diagnóstico y factores relacionados con la hiposialia en pacientes con xerostomía en una clínica universitaria / Pilot study on diagnosis and related factors to hyposialia in xerostomic patients at a university clinic

La xerostomía es una sensación subjetiva de boca seca que puede acompañarse de disminución de la cantidad de saliva o no. La hiposialia es la disminución del flujo salival medido mediante una sialometría. El objetivo del estudio fue definir el porcentaje total de pacientes con hiposialia real en un grupo de pacientes con xerostomía y analizar las diferencias existentes entre los pacientes con xerostomía asociada a hiposialia y los pacientes con xerostomía subjetiva. 28 pacientes que referían xerostomía formaron parte del estudio entre noviembre y marzo de 2020-2021 en la Policlínica de la Universidad Europea de Madrid. Se completó una exhaustiva historia médica, se cumplimentaron tres cuestionarios: Xerostomy Inventory, Perceived Stress Scale y OHIP-14, y se realizó una sialometría no estimulada durante cinco minutos. El análisis de los datos se realizó con el paquete estadístico Stata IC v. 14. El 82% del total de los pacientes que referían boca seca eran mujeres con una edad media de 59,14 años. Menos de la mitad de los pacientes (46%) presentaban hiposialia objetivada mediante la sialometría. Había más pacientes portadores de prótesis dentales en el grupo que sufría de hiposialia respecto al grupo con flujo salival normal. Ambos grupos mostraron un número similar de enfermedades y medicamentos xerostomizantes. En cuanto a los cuestionarios cumplimentados, no hubo diferencia significativa en los resultados de ambos grupos. (AU)

Xerostomia is a subjective sensation of dry mouth that may or may not be accompanied by a decrease in the amount of saliva. Hyposialia is the reduction in salivary flow measured by a sialometry. The aim of the study was to define the total percentage of patients with true hyposialia in a group of patients with xerostomia and to analyze the differences between patients with xerostomia associated with hyposalia and patients with subjective xerostomia. 28 patients who referred xerostomia were part of the study between November and March 2020-2021 at the Polyclinic of the European University of Madrid. A comprehensive medical history was fulfilled, three questionnaires were completed: Xerostomia Inventory, Perceived Stress Scale, and OHIP14, and unstimulated sialometry was performed for five minutes. Data analysis was performed with the Stata IC v. 14. 82% of the total patients who reported dry mouth were women with a mean age of 59.14 years. Less than half of the patients (46%) had hyposialia as evidenced by sialometry. There were more patients with dental prostheses in the group suffering from hyposialia compared to the group with normal salivary flow. Both groups showed a similar number of xerostomizing diseases and drugs. Regarding the completed questionnaires, there was no significant difference in the results of both groups. (AU)

Pilot study on the diagnosis of and factors related to hyposialia in patients with xerostomia at a university clinic

Xerostomia is a subjective sensation of dry mouth that may or may not be accompanied by a decrease in the amount of saliva. Hyposialia is a reduction in salivary flow, as measured by sialometry. The aims of the study were to establish the total percentage of patients with actual reduced saliva flow (hyposialia) in a group of patients with perceived reduced saliva flow (xerostomia) and analyse the differences between patients with xerostomia associated with hyposalia and patients with subjective xerostomia. 28 patients with xerostomia were part of the study between November and March 2020-2021 at the Polyclinic of the European University of Madrid. A comprehensive medical history was prepared, 3 questionnaires were completed (Xerostomia Inventory, Perceived Stress Scale and OHIP- 14) and unstimulated sialometry was performed for 5 minutes. Data analysis was performed with the Stata IC v 14 statistics program. 82% of the total patients who reported dry mouth were women, with a mean age of 59.14 years. Less than half of the patients (46%) had hyposialia as evidenced by sialometry. There were more patients with dental prostheses in the group suffering from hyposialia compared to the group with normal salivary flow. Both groups showed a similar number of xerostomising disorders and drugs. There were no significant differences between either group regarding the completed questionnaires. (AU)

Osteonecrosis de los maxilares y anticuerpos monoclonales: una revisión bibliográfica / Osteonecrosis of the jaws and monoclonal antibodies: a literature review

El objetivo, establecer si existe una evidencia científica que avale una relación entre la administración de anticuerpos monoclonales y la aparición de osteonecrosis de los maxilares (ONM). En la literatura que revisamos nos muestra determinados casos en los que la ONM está relacionada con los anticuerpos monoclonales (denosumab, sunitib, etc.) siempre y cuando el paciente sea sometido a un tratamiento dental. También se evalúan aquellos artículos en los que se administra anticuerpos monoclonales y bifosfonatos de manera simultánea y se observa que la frecuencia de ONM es más elevada. Como conclusión se establece que no hay evidencia científica suficiente para asegurar una relación entre ONM y anticuerpos monoclonales, aunque sí la hay para demostrar relación entre ONM y anticuerpos monoclonales si se administra junto a los bifosfonatos

The aim is establish if there is a scientific evidence to support a relationship between the administration of monoclonal antibodies and the appearance of osteonecrosis of the jaws (ONJ). In the literature we review shows certain cases in which ONJ is related to monoclonal antibodies (denosumab, sunitib, etc.) as long as the patient undergoes dental treatment. Those articles in which monoclonal antibodies and bisphosphonates are administered simultaneously are also evaluated and it is observed that the frequency of ONJ is higher. As conclusión it is established that there is not enough scientific evidence to ensure a relationship between ONJ and monoclonal antibodies, but there is evidence to show that the relationship between ONJ and monoclonal antibodies if administered with bisphosphonates

Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature

BACKGROUND: Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. MATERIAL AND METHODS: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library. We excluded articles dealing with all anticoagulants other than dabigatran, and works about surgical treatments in anatomical locations other than the oral cavity. RESULTS: We included a total of 13 papers of which 1 was a randomized clinical trial, 9 narrative literature reviews, 1 case series, 2 clinical cases and 1 expert opinion. Because we did not obtain any properly designed clinical trials, we were unable to conduct a meta-analysis. CONCLUSIONS: Currently, there is no consensus on the procedure to be followed in patients taking dabigatran. However, all authors agree to treat each case individually in accordance to the risk of embolism, postoperative bleeding and renal function. Also, it is necessary to perform minimally invasive interventions, and take the appropriate local anti-hemolytic measures

Terapia fotodinámica para el tratamiento de lesiones orales potencialmente malignas / Photodynamic therapy for treatment of potentially malignant oral lesions

La terapia fotodinámica (TFD) es un método tópico, no invasivo y selectivo para lesiones orales potencialmente malignas, el objetivo de esta revisión bibliográfica es el de revisar la evidencia científica existente sobre el empleo de la terapia fotodinámica (TFD) en el tratamiento de dichas lesiones orales. Se realizó una búsqueda bibliográfica en Pubmed, limitando la búsqueda a los últimos 20 años. Se incluyeron 24 artículos entre estudios y reportes de casos. Utilizando diferentes fuentes de luz para la activación del fotosensibilizante acumulado en las células a tratar, prácticamente todos los estudios revisados encontraron buenos resultados, clínicos y estéticos, con efectos adversos leves (dolor) y con reducciones tanto de la incidencia como de la gravedad de las lesiones orales encontradas.

Photodynamic therapy (PDT) is a topical, non-invasive and selective method for potentially malignant oral lesions. The aim of this article is to present a literature review of the scientific evidence for the use of photodynamic therapy (PDT) in the treatment of these oral lesions. A literature search was conducted in PubMed, limiting the search to the last 20 years. Finally, 24 articles including studies and case reports were selected. Using different light sources for the activation of the photosensitising agent accumulated in the cells to treat, practically all of the studies reviewed showed good clinical and aesthetic results, with minor adverse effects (pain) and with reductions in both incidence and severity of the oral lesions found.

Diabetes y periodontitis: una relación bidireccional / Diabetes and periodontitis: A bidirectional relationship

La diabetes mellitus es un grupo de enfermedades metabólicas caracterizadas por una hiperglucemia resultante de un defecto en la secreción de insulina, un defecto en la acción de esta, o bien una combinación de ambos. La periodontitis se considera actualmente una infección crónica localizada en la cavidad oral, que puede activar la respuesta inmunitaria inflamatoria del hospedador a nivel local y sistémico, y que además puede ser una fuente de bacteriemia. Hoy en día se sabe que la periodontitis tiene una influencia sobre la patogénesis de ciertas enfermedades sistémicas. La relación biológica entre la diabetes y la enfermedad periodontal está bien documentada. A mediados de la década de 1990 se encontró soporte científico suficiente para la asociación entre la diabetes y la periodontitis, que se comenzó a designar como la sexta complicación de la diabetes. Se han realizado estudios que muestran una mejora tanto en los parámetros clínicos e inmunológicos de la periodontitis como en el control glucémico a largo plazo de la diabetes tras el tratamiento de la enfermedad periodontal. Además, la evidencia científica confirma que un peor control glucémico contribuye a un peor estado periodontal. La interrelación entre ambas afecciones deja constancia de la importancia de la necesidad de una buena comunicación entre el médico internista y el odontólogo de los pacientes diabéticos, teniendo siempre en cuenta la posibilidad de que ambas enfermedades puedan estar ocurriendo simultáneamente, para garantizar el diagnóstico precoz de ambas (AU

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, a defect in insulin action or a combination of both. Periodontitis is now considered a chronic localized infection of the oral cavity that can trigger inflammatory host immune responses at local and systemic levels, and can also be a source of bacteremia. It is now known that periodontitis has an influence on the pathogenesis of certain systemic diseases. The biological relationship between diabetes and periodontal disease is well documented. In the mid-90s sufficient scientific support for the association between diabetes and periodontitis was published, and periodontitis was designated as the sixth complication of diabetes. There have been studies that show an improvement in both clinical and immunological parameters of periodontitis and glycemic control in long-term diabetes after treatment of periodontal disease. In addition, scientific evidence confirms that poorer glycemic control contributes to a worse periodontal condition. The interplay between the 2 conditions highlights the importance of the need for a good communication between the internist and dentist about diabetic patients, considering always the possibility that the 2 diseases may be occurring simultaneously in order to ensure an early diagnosis of both (AU)

Reacciones adversas a medicamentos en la cavidad oral / Side effects of drugs on the oral cavity

A pesar de que los fármacos son la herramienta terapéutica más potente de la que disponemos para mejorar la calidad de vida de la población, su uso no está exento de efectos adversos. Hoy en día son muchos los pacientes polimedicados, siendo complicado encontrar la causa de los efectos adversos generados por la medicación y aumentando estos de manera exponencial cuando se combinan más de 4 fármacos. Existe un amplio número de fármacos que pueden dar lugar a numerosos efectos adversos en la cavidad bucal. Los más frecuentes son la xerostomía, las alteraciones del gusto, el agrandamiento gingival y las mucositis producidas por el tratamiento oncológico. También se revisan otras alteraciones de las glándulas salivales, las alteraciones de la mucosa oral, las pigmentaciones, la halitosis, la osteonecrosis, las infecciones oportunistas y las diátesis hemorrágicas (AU)

Although drugs are the most powerful therapeutic tools we have for improving the quality of life of the population, their use is not free of adverse effects. Today there are many polymedicated patients, and it is difficult to find the cause of their adverse effects that increase exponentially when more than 4 drugs are combined. There are a large number of drugs that can result in numerous adverse effects in the oral cavity. The most common are xerostomia, altered taste, gingival enlargement and mucositis caused by cancer treatment. We also review other disorders of the salivary glands, oral mucosal changes, pigmentations, halitosis, osteonecrosis, opportunistic infections and bleeding diathesis (AU)

[Side effects of drugs on the oral cavity]. / Reacciones adversas a medicamentos en la cavidad oral.

Although drugs are the most powerful therapeutic tools we have for improving the quality of life of the population, their use is not free of adverse effects. Today there are many polymedicated patients, and it is difficult to find the cause of their adverse effects that increase exponentially when more than 4 drugs are combined. There are a large number of drugs that can result in numerous adverse effects in the oral cavity. The most common are xerostomia, altered taste, gingival enlargement and mucositis caused by cancer treatment. We also review other disorders of the salivary glands, oral mucosal changes, pigmentations, halitosis, osteonecrosis, opportunistic infections and bleeding diathesis.

[Diabetes and periodontitis: A bidirectional relationship]. / Diabetes y periodontitis: una relación bidireccional.

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, a defect in insulin action or a combination of both. Periodontitis is now considered a chronic localized infection of the oral cavity that can trigger inflammatory host immune responses at local and systemic levels, and can also be a source of bacteremia. It is now known that periodontitis has an influence on the pathogenesis of certain systemic diseases. The biological relationship between diabetes and periodontal disease is well documented. In the mid-90s sufficient scientific support for the association between diabetes and periodontitis was published, and periodontitis was designated as the sixth complication of diabetes. There have been studies that show an improvement in both clinical and immunological parameters of periodontitis and glycemic control in long-term diabetes after treatment of periodontal disease. In addition, scientific evidence confirms that poorer glycemic control contributes to a worse periodontal condition. The interplay between the 2 conditions highlights the importance of the need for a good communication between the internist and dentist about diabetic patients, considering always the possibility that the 2 diseases may be occurring simultaneously in order to ensure an early diagnosis of both.

Aplicación de un gel de ácido tranexámico en pacientes tratados con anticoagulantes orales / Tranexamic acid gel in patients treated with oral anticoagulants

Fundamento y objetivo: Los pacientes en tratamiento con anticoagulantes orales tienen mayor susceptibilidad a la hemorragia y, por tanto, cualquier procedimiento médico quirúrgico, en especial la cirugía bucal, requiere un enfoque terapéutico que minimice los efectos hemorrágicos en estos pacientes y, por lo tanto, sus complicaciones. Material y método: La hipótesis de trabajo se basó en los estudios sobre aplicación local del ácido tranexámico después de las intervenciones maxilofaciales como alternativa terapéutica eficaz para la prevención y control de la hemorragia. El objetivo fue evaluar la eficacia de la aplicación de una solución en gel de ácido tranexámico después de una extracción dental, en pacientes bajo tratamiento anticoagulante, en términos de tiempo de cicatrización y grado de cicatrización. Resultados: Los resultados indican que la aplicación del gel de ácido tranexámico resulta muy efectiva por su consistencia y permanencia en su lugar de acción y, además, demuestra su eficacia como material procoagulante. Conclusiones: La aplicación del ácido tranexámico en gel (Kin Exogel) en pacientes en tratamiento con anticoagulantes orales favorece el grado de cicatrización y la coagulación en las primeras 48-72 h (AU)

Background and objective: Patients treated with oral anticoagulants have increased susceptibility to bleeding, and therefore any surgical medical procedure and especially oral surgery requires a therapeutic approach that minimizes bleeding effects in these patients. Material and method: The working hypothesis was based on studies of local application of tranexamic acid after maxillofacial interventions as effective therapeutic alternative for the prevention and control of bleeding. The aim was to assess the effectiveness of the application of a gel solution tranexamic acid after tooth extraction in anticoagulated patients in terms of healing time and degree of healing. Results: The results indicate that application of tranexamic acid gel is very effective for consistency and maintenance in the place of action and shows its efficacy as a procoagulant material. Conclusions: The application of a gel solution of tranexamic acid in oral anticoagulants patients ameliorates healing time and the bleeding time within the first 48-72 h (AU)

Utilización del láser para la prevención y el tratamiento de la mucositis oral inducida por quimioterapia y radioterapia de cabeza y cuello / Use of laser for the prevention and treatment of oral mucositis induced by radiotherapy and chemotherapy for head and neck cancer

Una de las complicaciones de la radioterapia y la quimioterapia es la mucositis oral. Dado que el láser de baja energía es una de las intervenciones más frecuentemente recomendadas por los autores y las sociedades internacionales, el objetivo de esta revisión bibliográfica es el de revisar la evidencia científica existente sobre el empleo del láser de modo preventivo y terapéutico en la mucositis oral asociada al tratamiento del cáncer. Se realizó una búsqueda bibliográfica en PubMed y en la biblioteca de The Cochrane Collaboration, limitando la búsqueda a los últimos 20 años. Finalmente se incluyeron 29 artículos, que contenían 30 estudios. La fototerapia con láser de baja energía parece una intervención prometedora tanto en la prevención como en el tratamiento de la mucositis oral asociada al tratamiento del cáncer. Prácticamente todos los estudios revisados encontraron buenos resultados, sin efectos adversos y con reducciones tanto de la incidencia como de la gravedad de la mucositis en todos los tipos de tratamientos del cáncer (AU)

One of the complications of radiotherapy and chemotherapy is oral mucositis. Since the low energy laser is one of the mostfrequently recommended interventions by authors and international societies, the aim of this study is to review the scientific evidence on the use of lasers as a preventive and therapeutic in oral mucositis associated with treatment of cancer. We performed a literature search in PubMed and The cochrane Collaboration Library, limiting the search to the last 20 years. We finally included 29 articles that contained 30 studies. Low energy laser phototherapy seems a promising intervention in both the prevention and treatment of oral mucositis associated with cancer treatment. Virtually all studies reviewed showed good results with no adverse effects and reductions in both incidence and severity of mucositis in all types of cancer treatments (AU)