Imaging Evaluation of Platelet-Rich Fibrin in Post-Exodontic Bone Regeneration: A Systematic Review.

Tooth extraction is the most common procedure in dental practice. However, in the long term, it may cause alveolar ridge atrophy. This systematic review aimed to evaluate the role of platelet-rich fibrin (PRF) in post-exodontic alveolar ridge preservation in terms of its effectiveness in the regeneration of bone tissue as assessed by imaging and its efficacy compared to physiological bone healing. The study is presented in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. This systematic review was conducted using electronic databases such as PubMed, Scopus, Web of Science, and Science Direct. The gray literature search was conducted in the New York Academy of Medicine Grey Literature Report. All the studies in this systematic review were randomized controlled trials (RCTs). The risk of bias was performed according to the Cochrane Handbook for Systematic Reviews of Interventions 6.2 (RevMan 6.2). Considering the inclusion and exclusion criteria, we included 17 randomized clinical trials published up to 2022 investigating the efficacy of PRF in post-exodontic bone regeneration. Based on the results of clinical studies, it can be stated that despite not being statistically significant, PRF promotes neoformation and prevents bone loss between three and four months post-extraction.

Granuloma ulcerativo traumático con eosinoflia estromal: lesión simuladora de difícil diagnóstico. Presentación de caso / Traumatic ulcerative granuloma with stromal eosinophilia: Simulator lesión of difcult diagnosis. Presentation of a case

Introducción: el granuloma ulcerativo traumático con eosinofilia estromal es una afección benigna, crónica y autolimitante, que por su evolución clínica puede estar sujeta a confusión diagnóstica. Por ello, el caso que aquí se comparte expone particularidades de esta afección y su respuesta al tratamiento para permitir un mejor conocimiento de esta lesión. Se describen las características clínicas e histopatológicas y su evolución ante la terapéutica empleada. Se presenta una paciente femenina de seis años, con antecedentes de salud y de dientes neonatales, que hace tres meses manifiesta dos úlceras en mucosa sublingual que no cicatrizan ni mejoran al tratamiento anterior. Se indicaron estudios hematológicos, se realizó biopsia incisional de la lesión con su estudio histopatológico e inmunohistoquímico. Se obtuvo eosinofilia estromal y ausencia de linfocitos anómalos CD30. El tratamiento incluyó aplicación de corticosteroides tópicos e intralesionales, experimentando remisión de la lesión. Se mantiene la paciente bajo seguimiento clínico, sin recidiva de lesión. Conclusiones: el granuloma ulcerativo traumático con eosinofilia estromal es una lesión autolimitante que puede ser confundida con otras lesiones ulcerativas de la cavidad bucal, por lo que su estudio histopatológico resulta imprescindible para su diagnóstico. Asimismo, su análisis inmunohistoquímico es indispensable para precisar su naturaleza y probable evolución. El adecuado y exhaustivo proceso diagnóstico constituye una herramienta vital para lograr su identificación.

Background: Traumatic ulcerative granuloma with stromal eosinophilia is a benign, chronicle and self-healing lesion, which can be misdiagnosed for its clinical evolution, for this reason, this case report is carried out, showing particularities of this disease and its response in front to the treatment, giving a better identifcation of the lesion, were described the clinical and histopathological fndings of a case. A feminine patient, six years old, with neonatal health and dental history. She has presented during three months two ulcerative lesions in sublingual mucosa, which do not improve with the previous treatment. Hematological studies and biopsy were carried out, the incisional biopsy was analyzed with immunohistochemical test, the results were stromal eosinophilia and absence of anomalous lymphocytes CD30. She was treated with topical and intralesional corticosteroids, experiencing remission of the lesion. The patient had a long clinical follow up without recidive. Traumatic ulcerative granuloma with stromal eosinophilia is a self-healed lesion that needs a histopathological and inmunohistochemical analysis for an adequate diagnosis. The correct diagnostic sequence is a vital tool to achieve its identification.

Effect of low-speed drilling without irrigation on osseointegration: an experimental study in dogs.

OBJECTIVE: To study the early phases of osseointegration at implants installed in sites prepared with either high rotational speed with irrigation or low rotational speed without irrigation. MATERIAL AND METHODS: After 3 months from tooth extraction, two implants were installed in one side of the mandible of twelve dogs. The osteotomies were prepared either at 60 rpm without irrigation or at 750 rpm with refrigeration. Biopsies were obtained after 4 and 8 weeks of healing, six animals each period for histological analyses. RESULTS: After 4 weeks of healing, new bone percentage in contact with the implant surface (BIC%) was 46.6 ± 7.3% and 43.1 ± 6.8% at the low- and high-speed sites, respectively (p = 0.345). After 8 weeks of healing, the fractions increased to 60.0 ± 11.1% and 60.2 ± 6.2%, respectively (p = 0.753). CONCLUSIONS: Implants installed in sites prepared using either low-rotational drilling without irrigation or high speed with irrigation presented similar amounts of osseointegration.

Healing at implants installed from ~ 70- to < 10-Ncm insertion torques: an experimental study in dogs.

OBJECTIVE: To evaluate histologically the early healing at implants installed with different insertion torques MATERIAL AND METHODS: Three months after the extraction of the mandibular premolars and of the first molars, two implants were installed monolaterally in the premolar and two in the molar regions of the edentulous alveolar ridge of twelve dogs. The recipient sites were prepared using drills of different diameter to obtain insertion torque of different values, i.e., 30 Ncm (control) or ~ 70 Ncm (test) in the premolar region, and < 10 Ncm (test) or ~ 50 Ncm (control) in the molar region. Six animals were euthanized after 4 weeks and six after 8 weeks of healing. Histological analyses were performed, and the Wilcoxon test was applied for statistical analyses. RESULTS: After 4 weeks of healing, in the premolar region, the new bone in contact with the implant surface was 65.0 ± 4.6% and 53.9 ± 13.5% at the ~ 30-Ncm and ~ 70-Ncm sites, respectively (p = 0.075). In the premolar region, new bone proportions were 51.4 ± 17.0% and 67.3 ± 7.0% at the < 10-Ncm and ~ 50-Ncm sites, respectively (p = 0.046). After 8 weeks of healing, in the premolar region, new bone reached fractions of 77.7 ± 16.2% at the ~ 30-Ncm sites, and 68.3 ± 12.1% at the ~ 70-Ncm sites (p = 0.028). In the molar region, new bone presented proportions of 70.2 ± 6.4% at the < 10-Ncm sites and 76.2 ± 9.4% at the ~ 50-Ncm sites (p = 0.173). CONCLUSIONS: The insertion torque influenced the osseointegration of implants. Higher values of bone-to-implant contact percentages were registered for insertion torques of ~ 30 Ncm and ~ 50 Ncm. Implants inserted with torque < 10 Ncm became integrated with an optimal osseointegration.

Healing at implants installed in osteotomies prepared either with a piezoelectric device or drills: an experimental study in dogs.

OBJECTIVE: To compare osseointegration and marginal bone level at implants placed in osteotomies prepared with either conventional drills or a piezoelectric device. MATERIAL AND METHODS: Three months after the extraction of all mandibular premolars and first molars, two recipient sites were selected. The osteotomies were randomly prepared with either conventional drills (drill sites) or a piezoelectric device (piezoelectric sites). Implants were installed and a submerged healing was allowed. The animals were euthanized in groups of six after 4 and 8 weeks of healing. Biopsies were obtained for histological preparation. Coronal level of osseointegration (bone level) and bone-to-implant contact percentage (BIC%) were evaluated. RESULTS: After 4 weeks of healing, the bone level was 0.6 ± 0.9 mm for the piezoelectric sites and 1.6 ± 0.7 mm for the drill sites (p = 0.173). After 8 weeks, the respective measures were 0.9 ± 0.3 mm and 1.0 ± 1.1 mm (p = 0.917). After 4 weeks of healing, a new bone apposed onto the implant surface was found at fractions of 54.9 ± 6.7% and 55.1 ± 16.6% for the piezoelectric and the drill sites, respectively (p = 0.674). The respective total bone fractions, including new and old bone, was 64.0 ± 4.8% and 63.4 ± 20.4% (p = 0.917). After 8 weeks, a new bone increased to 67.4 ± 6.7% and 62.9 ± 12.5% for the piezoelectric and the drill sites, respectively (p = 0.463). The respective total bone fractions were 70.4 ± 5.5% and 67.8 ± 12.1% (p = 0.753). CONCLUSIONS: The use of a piezoelectric device for implant site preparation is a safe procedure that allows a proper integration since the early periods of healing similar to that observed using conventional drills.

Bone healing at collagenated bicortically installed implants: an experimental study in rabbits.

PURPOSE: To study the healing at collagenated bicortically installed implants. METHODS: Twenty albino New Zealand rabbits were used for implant installation. Two implants with a double acid etched surface, coated with a collagen type I or left uncoated, were installed bicortically in the metaphysis and in the diaphysis of each tibia. Ten rabbits were euthanized after 2 weeks and ten after 6 weeks after installation. Ground sections were prepared for histological analyses that were performed both in the cortical layers and in the marrow regions. RESULTS: After 2 weeks of healing, highest amounts of new bone were found at the collagenated implants (43.2 ± 6.0%) compared to the standard implants (33.9 ± 6.1%; p = 0.022). After 6 weeks of healing, similar percentages of new bone were observed, being 51.8 ± 7.3% and 50.9 ± 9.6% (p = 0.678) for the standard and collagenated surfaces, respectively. CONCLUSIONS: A coated surface with collagen type I promoted bone apposition in the earliest periods of healing. However, the effect vanished over time so that similar results were obtained after 6 weeks of healing.

Tumor odontogénico adenomatoide extrafolicular de localización mandibular / Mandibular extrafollicular adenomatoid odontogenic tumor

Introducción: el tumor odontogénico adenomatoide es un tumor odontogénico benigno compuesto por epitelio odontogénico con estroma fibroso maduro sin participación del ectomesénquima. Representa entre el 2 por ciento y el 7 por ciento de estos tumores. Más del 90 por ciento aparecen antes de los 30 años con tres variantes clínicas: folicular, extrafolicular y periférica. Su aspecto clínico-radiográfico varía y puede ser confundido con otras lesiones quísticas o neoplásicas de la cavidad bucal, por lo que es necesario el diagnóstico anatomopatológico. Objetivo: presentar un caso de un tumor odontogénico adenomatoide extrafolicular mandibular. Presentación del caso: paciente femenina de 12 años de edad, con aumento de volumen asintomático en la encía mandibular del lado izquierdo, sin antecedentes patológicos de interés, de tiempo de evolución no precisado. Al examen físico se observó aumento de volumen de forma redondeada de 1,5 cm que desplazaba la encía mandibular izquierda entre incisivo lateral y canino. La radiografía reveló una lesión radiolúcida unilocular entre 42 y 43 que expandía la cortical ósea. Se detectó ausencia de vitalidad pulpar de estos dientes. Con el diagnóstico clínico de quiste periapical se realizó excisión quirúrgica, se envió la muestra al laboratorio de Anatomía Patológica, y se concluyó el diagnóstico de tumor odontogénico adenomatoide extrafolicular. Conclusiones: el tumor odontogénico adenomatoide, más común en la maxila, puede presentarse en la mandíbula. Los hallazgos clínico-radiográficos semejan otras lesiones odontogénicas como quistes dentígeros, otras neoplasias y lesiones periapicales inflamatorias, siendo el diagnóstico anatomopatológico el concluyente(AU)

Introduction: adenomatoid odontogenic tumor is a benign odontogenic tumor composed of odontogenic epithelium with mature fibrous stroma without ectomesenchymal involvement. It represents between 2 percent and 7 percent of these tumors. More than 90 percent appear before age 30, with three clinical variants: follicular, extrafollicular and peripheral. Its clinical-radiographic aspect may vary, and it may be confused with other cystic or neoplastic lesions of the oral cavity, hence the need for an anatomo-pathological diagnosis. Objective: present a case of mandibular extrafollicular adenomatoid odontogenic tumor. Case presentation: afemale 12-year-old patient presents with asymptomatic left mandibular gum swelling, with no pathological antecedents of interest and an imprecise time of evolution. Physical examination found a round 1.5 cm swelling displacing the left mandibular gum between the lateral incisor and the canine. Radiography revealed a unilocular radiolucent lesion between teeth 42 and 43 expanding the cortical bone. The teeth involved showed no pulpal vitality. Upon reaching a clinical diagnosis of periapical cyst, surgical excision was performed and a sample was submitted to the Anatomical Pathology laboratory. The anatomo-pathological diagnosis was extrafollicular adenomatoid odontogenic tumor. Conclusions: though more common in the maxilla, adenomatoid odontogenic tumors may also occur in the mandible. Clinical and radiological features may be similar to those of other odontogenic lesions, such as dentigerous cysts, other neoplasms and periapical inflammatory lesions; therefore, the final diagnosis should be provided by anatomo-pathological evaluation(AU)

Formación de recursos humanos en estomatología, su impacto en la salud bucal de la población / Training of human resources in dentistry, its impact on the population oral health

Introducción: en 1900 comienza la enseñanza universitaria de la Estomatología en Cuba, comenzó así el largo camino de la enseñanza de la profesión. Objetivo: realizar un análisis del desarrollo de la formación de recursos humanos en Estomatología y su impacto en la salud bucal de la población. Desarrollo: se presenta la evolución de la formación de los recursos humanos en Estomatología desde la fundación de la carrera en 1900 y los cambios ocurridos después del triunfo de la Revolución. Se destaca la extensión de la carrera a otras provincias del país y la evolución de los planes de estudio que han respondido a las transformaciones en la salud de la población, el sector salud y la educación superior. Desde 1959 al 2015 se han graduado 23 730 estomatólogos. Se muestra el desarrollo del posgrado destacándose la formación de especialistas y la creación del doctorado en Ciencias Estomatológicas. Se realizaron 15 procesos de evaluación externa de las carreras de Estomatología. Se significa el impacto de la formación de los recursos humanos en los resultados que exhibe Cuba (2015) en indicadores como 13,7 estomatólogos por 100 000, se brindaron 2,5 consultas por habitantes y la evolución del estado de salud bucal ha tenido un comportamiento favorable. Entre los retos más importantes se destaca incrementar la calidad de los procesos universitarios, la atención estomatológica y satisfacción de la población con los servicios, elevar el estado de salud de la población y mantener la cooperación internacional(AU)

ntroduction: In 1900 the university teaching of Dentistry started in Cuba, thus the long path began for the teaching of the profession. Objective: To conduct an analysis of the development of human resources training in Dentistry and its impact on the population oral health. Development: The evolution of the training of human resources in Dentistry since the foundation of the major in 1900 and the changes that came after the triumph of the Revolution. It highlights the outreach of the major to other provinces of the country and the evolution of the curriculums that have responded to the transformations in the population health, the health sector and higher education. From 1959 to 2015, 23 730 dental doctors have graduated. It shows the development of the postgraduate modality, highlighting the training of specialists and the creation of a Ph.D. in Dental Sciences. There were 15 external evaluation processes of the dental majors. The impact of the training of human resources on the results of Cuba (2015) in indicators, such as 13.7 dentistry doctors per 100 000 inhabitants, 2.5 consultations per inhabitants, were given, together with the evolution of the oral health status, which has had a favorable behavior. Among the most important challenges we find to increase the quality of university processes, dental care and the satisfaction of the population with services, raise the population health and maintain international cooperation.(AU)

Formación de recursos humanos en estomatología, su impacto en la salud bucal de la población / Training of human resources in dentistry, its impact on the population oral health

Introducción: en 1900 comienza la enseñanza universitaria de la Estomatología en Cuba, comenzó así el largo camino de la enseñanza de la profesión. Objetivo: realizar un análisis del desarrollo de la formación de recursos humanos en Estomatología y su impacto en la salud bucal de la población. Desarrollo: se presenta la evolución de la formación de los recursos humanos en Estomatología desde la fundación de la carrera en 1900 y los cambios ocurridos después del triunfo de la Revolución. Se destaca la extensión de la carrera a otras provincias del país y la evolución de los planes de estudio que han respondido a las transformaciones en la salud de la población, el sector salud y la educación superior. Desde 1959 al 2015 se han graduado 23 730 estomatólogos. Se muestra el desarrollo del posgrado destacándose la formación de especialistas y la creación del doctorado en Ciencias Estomatológicas. Se realizaron 15 procesos de evaluación externa de las carreras de Estomatología. Se significa el impacto de la formación de los recursos humanos en los resultados que exhibe Cuba (2015) en indicadores como 13,7 estomatólogos por 100 000, se brindaron 2,5 consultas por habitantes y la evolución del estado de salud bucal ha tenido un comportamiento favorable. Entre los retos más importantes se destaca incrementar la calidad de los procesos universitarios, la atención estomatológica y satisfacción de la población con los servicios, elevar el estado de salud de la población y mantener la cooperación internacional(AU)

ntroduction: In 1900 the university teaching of Dentistry started in Cuba, thus the long path began for the teaching of the profession. Objective: To conduct an analysis of the development of human resources training in Dentistry and its impact on the population oral health. Development: The evolution of the training of human resources in Dentistry since the foundation of the major in 1900 and the changes that came after the triumph of the Revolution. It highlights the outreach of the major to other provinces of the country and the evolution of the curriculums that have responded to the transformations in the population health, the health sector and higher education. From 1959 to 2015, 23 730 dental doctors have graduated. It shows the development of the postgraduate modality, highlighting the training of specialists and the creation of a Ph.D. in Dental Sciences. There were 15 external evaluation processes of the dental majors. The impact of the training of human resources on the results of Cuba (2015) in indicators, such as 13.7 dentistry doctors per 100 000 inhabitants, 2.5 consultations per inhabitants, were given, together with the evolution of the oral health status, which has had a favorable behavior. Among the most important challenges we find to increase the quality of university processes, dental care and the satisfaction of the population with services, raise the population health and maintain international cooperation.(AU)

Siringoma Condroide. Presentación de un caso / Chondroid syringoma. Case presentation

Introducción: El Siringoma Condroide o tumor mixto es una neoplasia habitualmente benigna que constituye 0,01 por ciento de los tumores primarios de la piel. Es una entidad análoga al tumor mixto (Adenoma Pleomorfo) de glándulas salivales. El diagnóstico es exclusivamente histopatológico. Objetivo: Presentar una paciente con un diagnóstico poco común de Siringoma Condroide benigno, donde se destaca como diagnóstico diferencial entre los tumores de la piel en cabeza y cuello.Presentación de caso: Presentamos el caso de una paciente femenina, de 45 años de edad, quien acude a consulta por presentar un nódulo subcutáneo en la región geniana derecha, que apareció como un pequeño aumento de volumen debajo de la piel, que fue creciendo gradualmente, asintomático, redondeado, bien delimitado, móvil, de consistencia entre suave y firme, de varios meses de evolución, como única lesión. Clínicamente se interpretó como un quiste epidérmico. Su diagnóstico anatomopatológico fue el de Siringoma Condroide benigno o Tumor mixto de la piel. Conclusiones: Resulta un caso interesante debido a la baja frecuencia de presentación de esta lesión. Es importante tener presente esta entidad en el diagnóstico diferencial de los tumores de la piel en cabeza y cuello. A pesar de ser un tumor benigno es necesario el seguimiento del paciente, pues, aunque es muy raro, se han descrito casos con un comportamiento maligno(AU)

Introduction: Chondroid syringoma or mixed tumour is usually a benign neoplasia, constituting 0.01percent of primary tumours of the skin. This is analogous to mixed tumour (Pleomorphic adenoma) of salivary gland. The diagnosis is only histopathologically. Objective: To present a patient with a diagnosis not very common of chondroid syringoma, where it is highlighted as differential diagnosis among the head and neck skin tumours. Case presentation: Is presented a case of a female patient; 45 years old, that arrived to the consulting room showing a subcutaneous nodule on the right genial region, it appeared as an asymptomatic slow-growing small mass, rounded, well bounded, mobile of soft and firm consistence, of several months of evolution, as a single lesion. The diagnosis was a chondroid syringoma or skin mixed tumour. Conclusions: It is an interesting case because it has a low frequency. It is important bear in mind this entity in the differential diagnosis of head and neck skin tumours. Despite being a benign tumour it is necessary to monitor patients, because even though it is uncommon, some cases have been reported with a malignant behaviour(AU)

Siringoma Condroide. Presentación de un caso / Chondroid syringoma. Case presentation

Introducción: El Siringoma Condroide o tumor mixto es una neoplasia habitualmente benigna que constituye 0,01 por ciento de los tumores primarios de la piel. Es una entidad análoga al tumor mixto (Adenoma Pleomorfo) de glándulas salivales. El diagnóstico es exclusivamente histopatológico. Objetivo: Presentar una paciente con un diagnóstico poco común de Siringoma Condroide benigno, donde se destaca como diagnóstico diferencial entre los tumores de la piel en cabeza y cuello. Presentación de caso: Presentamos el caso de una paciente femenina, de 45 años de edad, quien acude a consulta por presentar un nódulo subcutáneo en la región geniana derecha, que apareció como un pequeño aumento de volumen debajo de la piel, que fue creciendo gradualmente, asintomático, redondeado, bien delimitado, móvil, de consistencia entre suave y firme, de varios meses de evolución, como única lesión. Clínicamente se interpretó como un quiste epidérmico. Su diagnóstico anatomopatológico fue el de Siringoma Condroide benigno o Tumor mixto de la piel. Conclusiones: Resulta un caso interesante debido a la baja frecuencia de presentación de esta lesión. Es importante tener presente esta entidad en el diagnóstico diferencial de los tumores de la piel en cabeza y cuello. A pesar de ser un tumor benigno es necesario el seguimiento del paciente, pues, aunque es muy raro, se han descrito casos con un comportamiento maligno(AU)

Introduction: Chondroid syringoma or mixed tumour is usually a benign neoplasia, constituting 0.01 percent of primary tumours of the skin. This is analogous to mixed tumour (Pleomorphic adenoma) of salivary gland. The diagnosis is only histopathologically. Objective: To present a patient with a diagnosis not very common of chondroid syringoma, where it is highlighted as differential diagnosis among the head and neck skin tumours. Case presentation: Is presented a case of a female patient; 45 years old, that arrived to the consulting room showing a subcutaneous nodule on the right genial region, it appeared as an asymptomatic slow-growing small mass, rounded, well bounded, mobile of soft and firm consistence, of several months of evolution, as a single lesion. The diagnosis was a chondroid syringoma or skin mixed tumour. Conclusions: It is an interesting case because it has a low frequency. It is important bear in mind this entity in the differential diagnosis of head and neck skin tumours. Despite being a benign tumour it is necessary to monitor patients, because even though it is uncommon, some cases have been reported with a malignant behaviour(AU)

Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep.

OBJECTIVE: To assess the influence of a collagen membrane covering a perforation of the sinus (Schneiderian) membrane on the outcome (bone fill) of a sinus floor elevation. MATERIALS AND METHODS: Eighteen Pelibuey sheep were used. The animals underwent sinus floor elevation on both sides of the upper jaw. A perforation of 5 × 4 mm in dimension of the sinus mucosa was performed on both sides and, at a randomly selected test site, a collagen membrane was placed to cover the perforation. A graft of biphasic calcium phosphate (60% HA/40% beta-TCP) was subsequently placed bilaterally, and the access window was closed with a membrane made of polylactic acid and a citric acid ester acetyl. The sacrifices were performed after 2, 4, and 12 weeks of healing. RESULTS: After 2 weeks of healing, the augmented volume was filled with biomaterial surrounded by connective tissue and minimal new bone was detected. After 4 weeks of healing, new bone was found mainly in connection with the sinus bony walls with percentages of 18.0 ± 12.9% at the test and 12.3 ± 7.9% at the control sites. After 12 weeks of healing, similar amounts of newly formed bone were found compared to the previous healing period, namely 16.7 ± 8.0% and 13.7 ± 10.1% at the test and control sites, respectively, with the highest amount detected in the bottom of the sinus cavity. The newly formed bone was distributed more evenly within the sinus cavity also including the central areas. The differences between test and control sites did not reach statistical significance. CONCLUSION: Even though there were trends for more bone formation when applying a collagen membrane on a sinus mucosal perforation of relatively small dimensions, this study failed to establish the absolute necessity of such a procedure to achieve bone fill in the sinus cavity.

Healing at implant sites prepared conventionally or by means of Sonosurgery ®. An experimental study in dogs.

OBJECTIVE: To compare peri-implant tissue healing at implants installed in sites prepared with conventional drills or a sonic device. MATERIAL AND METHODS: In six Beagle dogs, the mandibular premolars and first molars were extracted bilaterally. After 3 months, full-thickness muco-periosteal flaps were elevated and recipient sites were prepared in both sides of the mandible. In the right side (control), the osteotomies were prepared using conventional drills, while, at the left side (test), a sonic device (Sonosurgery(®)) was used. Two implants were installed in each side of the mandible. After 8 weeks of non-submerged healing, biopsies were harvested and ground sections prepared for histological evaluation. RESULTS: The time consumed for the osteotomies at the test was more than double compared to the conventional control sites. No statistically significant differences were found for any of the histological variables evaluated for hard and soft tissue dimensions. Although not statistically significant, slightly higher mineralized bone-to-implant contact was found at the test (65.4%) compared to the control (58.1) sites. CONCLUSIONS: Similar healing characteristics in osseointegration and marginal hard tissue remodeling resulted at implants installed into osteotomies prepared with conventional drills or with the sonic instrument (Sonosurgery(®)).

Dimensional changes in soft tissues around dental implants following free gingival grafting: an experimental study in dogs.

OBJECTIVE: To study the buccal dimensional tissue changes at oral implants following free gingival grafting, with or without including the keratin layer, performed at the time of implant installation into alveolar mucosa. MATERIAL AND METHODS: The mandibular premolars and first molars were extracted bilaterally in six Beagle dogs. In the right side of the mandible (Test), flaps were first elevated, and the buccal as well as part of the lingual masticatory mucosa was removed. An incision of the periosteum at the buccal aspect was performed to allow the flap to be coronally repositioned. Primary wound closure was obtained. In the left side, the masticatory (keratinized) mucosa was left in situ, and no sutures were applied (Control). After 3 months of healing, absence of keratinized mucosa was confirmed at the test sites. Two recipient sites were prepared at each side of the mandible in the region of the third and fourth premolars. All implants were installed with the shoulder placed flush with the buccal alveolar bony crest, and abutments were connected to allow a non-submerged healing. Two free gingival mucosal grafts were harvested from the buccal region of the maxillary canines. One graft was left intact (gingival mucosal graft), while for the second, the epithelial layer was removed (gingival connective tissue graft). Subsequently, the grafts were fixed around the test implants in position of the third and fourth premolars, respectively. After 3 months, the animals were euthanized and ground sections obtained. RESULTS: Similar bony crest resorption and coronal extension of osseointegration were found at test and control sites. Moreover, similar dimensions of the peri-implant soft tissues were obtained at test and control sites. CONCLUSIONS: The increase in the alveolar mucosal thickness by means of a gingival graft affected the peri-implant marginal bone resorption and soft tissue recession around implants. This resulted in outcomes that were similar to those at implants surrounded by masticatory mucosa, indicating that gingival grafting in the absence of keratinized mucosa around implants may reduce the resorption of the marginal crest and soft tissue recession.

Lesiones blancas de la cavidad bucal. Concordancia Diagnóstica / Diagnostic concordance of white lesions of oral cavity

Introducción: las lesiones bucales resultan un fuerte indicador del estado de salud del individuo, y dentro de estas, las lesiones de apariencia blanquecina están sujetas a errores diagnósticos dada su similitud y variada forma de presentación.Objetivo: determinar la concordancia existente entre el diagnóstico clínico e histopatológico de lesiones bucales blanquecinas, así como caracterizar dichas lesiones socio-demográficamente y distribuirlas topográficamente. Material y Métodos: se realizó un estudio descriptivo retrospectivo de corte transversal en una muestra de 52 pacientes del total con lesiones de apariencia blanquecina en la cavidad bucal sometidos a biopsia para confirmar diagnóstico en el Departamento de Cirugía de la Facultad de Estomatología Raúl González Sánchez, en el período comprendido de enero 2013 a diciembre 2013. Se tomaron datos sociodemográficos y diagnósticos de modelo de solicitud de biopsia, informe histopatológico y registro estadístico de la Institución. La información recogida fue sometida al estadígrafo Índice de Kappa para evaluar concordancia de diagnóstico clínico e histopatológico.Resultados: pacientes con edades entre 40 y 49 años resultaron los más afectados (28,85 por ciento). Predominaron lesiones blanquecinas en pacientes de piel blanca (59,62 por ciento) y femeninas (61,54 por ciento). Un 34,33 por ciento de las lesiones se ubicaron en la mucosa del carrillo. Clínicamente, 50 por ciento de las lesiones clasificaron como leucoplasia e histopatológicamente 42,31 por ciento. Existió muy buena concordancia entre ambos diagnósticos para leucoplasia (k=0,84) liquen plano (k=0,83). La concordancia total del grupo resultó buena (k=0,79). Conclusiones: la concordancia total de la muestra fue buena, aunque la concordancia diagnóstica de leucoplasia y liquen plano clasificó como muy buena(AU)

Introduction: the buccal lesions are a strong indicator of the state of the individual's health, and inside these the white lesions are subject to be misdiagnosed due to their similarity and varied presentation form. Objective: to determine the concordance between the clinical and histopathological diagnosis of buccal white lesions, as well as to characterize these lesions social-demographically and to distribute them topographically. Material and Methods: a cross sectional descriptive retrospective study was conducted in a sample of 52 patients of the total of patients with buccal white lesions to be biopsied in the Department of Surgery of Dentistry College Raúl González Sánchez in the period January 2013 to December 2013. The Sociodemographic and diagnostics data were obtained from the Biopsy request model and histopathological report .The information was subjected to kappa index to evaluate the concordance between clinical and histopathological diagnosis. Results: patients with ages between 40-49 were more affected (28,85 percent).White lesions prevailed in female( 61,54 percent) and white race people (59,62 percent). 34,33 percent was located in the cheek mucous. 50 percent was clinically diagnosed like leukoplakia and confirmed histologically in 42.31 percent. The concordance was very good in the diagnosis of leukoplakia (k=0,84) and lichen planus (K=0,83). The total concordance of the group was good (k=0,79). Conclusions: the total concordance of the studied sample was good, although the diagnostic concordance to leukoplakia and lichen planus were very good(AU)

Evaluación de la calidad de las carreras de Estomatología / Evaluation of the quality of dentistry careers

En Cuba desde el año 2002 se ha ido perfeccionando el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU) con el fin de garantizar la calidad en la formación de los profesionales. Las carreras de Estomatología de 6 provincias han sido sometidas a procesos de evaluación externa alcanzando distintos niveles de acreditación. El objetivo del trabajo es mostrar los resultados más significativos (fortalezas y debilidades), de las carreras en las evaluaciones externas. Los métodos utilizados fueron: revisión documental, entrevistas, procesamiento y análisis de información estadística, tanto de la atención brindada a la población como académica, la cual fue resumida mediante porcentajes, indicadores, entre otros. Las variables e indicadores tomados en cuenta fueron los establecidos por el SEA-CU. Se identificaron como principales fortalezas la pertinencia e impacto social de las carreras en todos los territorios, la presencia de los estudiantes de Estomatología en tareas de impacto social, los profesores se destacaron por sus cualidades como educadores, entre otras. Las debilidades más comunes estuvieron relacionadas con el aseguramiento sistemático de recursos, no fue suficiente el número de doctores en ciencias dentro de los claustros y la producción científica no alcanzó los niveles esperados. De las variables analizadas la de mejores resultados en todas las carreras fue la variable Pertinencia e Impacto Social y la de resultados menos satisfactorios la variable Profesores. El proceso de acreditación permitió un movimiento académico hacia la mejora continua de la calidad de los procesos universitarios(AU)

Since 2002 the university career evaluation and accreditation system has been upgraded with a view to assuring the quality of professional formation. Dentistry careers in 6 provinces have been subjected to external evaluation processes to attain various levels of accreditation. The objective of this paper was to show the most significant results (strengths and weaknesses) of the careers under external evaluation processes. The most used methods were documentary review, interviews, processing and analysis of statistical information both on care rendered to the population and academic work. This information was summarized in percentages, indicators, and others. The variables and indicators taken into account were those set by the university career evaluation and accreditation system. The main strengths were relevance and social impact of the careers in all the territories, the presence of the dentistry students in social impact tasks, the quality of professors as educators, among others. The most common weaknesses were related to systematic assurance of resources, the insufficient number of Ph doctors in the faculties and the scientific production did not reach the expected levels. Out of all the analyzed variables, the best results went to variable Social Relevance and Impact for all the careers, and the less satisfactory results were observed in the variable Professors. The accreditation process allowed developing an academic movement towards the continuous upgrading of the quality of the university processes(AU)

Evaluación de la calidad de las carreras de Estomatología / Evaluation of the quality of dentistry careers

En Cuba desde el año 2002 se ha ido perfeccionando el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU) con el fin de garantizar la calidad en la formación de los profesionales. Las carreras de Estomatología de 6 provincias han sido sometidas a procesos de evaluación externa alcanzando distintos niveles de acreditación. El objetivo del trabajo es mostrar los resultados más significativos (fortalezas y debilidades), de las carreras en las evaluaciones externas. Los métodos utilizados fueron: revisión documental, entrevistas, procesamiento y análisis de información estadística, tanto de la atención brindada a la población como académica, la cual fue resumida mediante porcentajes, indicadores, entre otros. Las variables e indicadores tomados en cuenta fueron los establecidos por el SEA-CU. Se identificaron como principales fortalezas la pertinencia e impacto social de las carreras en todos los territorios, la presencia de los estudiantes de Estomatología en tareas de impacto social, los profesores se destacaron por sus cualidades como educadores, entre otras. Las debilidades más comunes estuvieron relacionadas con el aseguramiento sistemático de recursos, no fue suficiente el número de doctores en ciencias dentro de los claustros y la producción científica no alcanzó los niveles esperados. De las variables analizadas la de mejores resultados en todas las carreras fue la variable Pertinencia e Impacto Social y la de resultados menos satisfactorios la variable Profesores. El proceso de acreditación permitió un movimiento académico hacia la mejora continua de la calidad de los procesos universitarios...

Since 2002 the university career evaluation and accreditation system has been upgraded with a view to assuring the quality of professional formation. Dentistry careers in 6 provinces have been subjected to external evaluation processes to attain various levels of accreditation. The objective of this paper was to show the most significant results (strengths and weaknesses) of the careers under external evaluation processes. The most used methods were documentary review, interviews, processing and analysis of statistical information both on care rendered to the population and academic work. This information was summarized in percentages, indicators, and others. The variables and indicators taken into account were those set by the university career evaluation and accreditation system. The main strengths were relevance and social impact of the careers in all the territories, the presence of the dentistry students in social impact tasks, the quality of professors as educators, among others. The most common weaknesses were related to systematic assurance of resources, the insufficient number of Ph doctors in the faculties and the scientific production did not reach the expected levels. Out of all the analyzed variables, the best results went to variable Social Relevance and Impact for all the careers, and the less satisfactory results were observed in the variable Professors. The accreditation process allowed developing an academic movement towards the continuous upgrading of the quality of the university processes...

Influence of presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. An experimental study in dogs.

OBJECTIVE: To investigate the influence of the presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. MATERIAL AND METHODS: In six beagle dogs, the mandibular premolars and first molars were extracted bilaterally. In the right side of the mandible (test), flaps were elevated, and the buccal as well as part of the lingual masticatory mucosa was removed. The flap was released coronally to allow a primary wound closure. In the left side, the wounds were left unsutured with the keratinized mucosa remaining (control). After 3 months of healing, a complete absence of keratinized mucosa was found at the test sites. Two recipient sites were prepared at each side of the mandible, one in the premolar and one in the molar region. A buccal bony ridge width of approximately 1 and 2 mm was obtained at the premolar and molar region, respectively. Implants were installed with the shoulder flush with the buccal alveolar bony crest, and abutments were connected to allow a nonsubmerged healing. At least 2 mm of keratinized mucosa was surrounding the control sites, while at the test sites, the implants were bordered by alveolar mucosa. After 3 months, the animals were euthanized and ground sections obtained. RESULTS: A higher vertical bony crest resorption was observed at the test compared with the control sites both at the premolar and molar regions, the differences being statistically significant. The top of the peri-implant mucosa was located more coronally at the control compared with the test sites. The horizontal resorption measured 1 mm below the implant shoulder was similar at the test and control sites. Only limited differences were found between premolar and molar sites, with the exclusion of the horizontal resorption that was higher at the test compared with the control sites. CONCLUSIONS: A higher alveolar buccal bony crest resorption and a more apical soft tissue marginal position should be expected, when implants are surrounded with thin alveolar mucosa at the time of installation, independently of the thickness of the buccal bony crest.

Liquen plano bucal y displasia epitelial / Oral lichen planus and epithelial dysplasia

Introducción: el liquen plano bucal es una enfermedad inflamatoria, crónica y recurrente considerada como una respuesta inmune anormal mediada por células T. Uno de los aspectos más importantes es su posible carácter premaligno y el papel de la displasia epitelial. Objetivo: describir los desórdenes celulares característicos de la displasia en las lesiones del liquen plano bucal y su relación con las formas clínicas y otras variables histopatológicas. El universo estuvo constituido por el registro de 14,977 pacientes sometidos a estudio anatomopatológico en el Servicio de Anatomía Patológica en el Departamento de Patología de la Facultad de Estomatología de La Habana, en el período comprendido de 1970 al 2008 del que se extrajo una muestra integrada por 115 pacientes con diagnóstico histopatológico de liquen plano de la mucosa bucal. Se revisaron los archivos de biopsias tomándose aquellas solicitudes con suficientes datos clínicos en las cuales estuviera consignada la presencia de lesiones bilaterales o, en su defecto, más de una lesión distribuida en una o en más de una región anatómica. Las variables clínicas fueron: Liquen plano tipo reticular, atrófico erosivo e hipertrófico y las variables histopatológicas: tipo de queratinización, grosor epitelial, presencia de displasia epitelial. Se realizó observación microscópica de las láminas obtenidas del archivo. Se obtuvieron fotomicrografías. Para las variables cualitativas se calculó la frecuencia absoluta y el porcentaje. Para la estadística analítica se utilizó el test de Chi Cuadrado, aplicando la corrección de Yates, cuando esta era necesaria o bien la Prueba exacta de Fisher. Conclusiones: la presencia de displasia ligera es un hallazgo posible en el liquen plano bucal, más frecuente en el tipo erosivo y que, hasta tanto no se demuestre convincentemente lo contrario, el liquen plano bucal debe ser una lesión tributaria de un seguimiento a corto, mediano y largo plazo(AU)

Introduction: oral lichen planus is an inflammatory, chronic and recurrent disease which is considered an abnormal T- cell mediated immune response. One of the most important aspects is its possible pre-malignant character and the role of epithelial dysplasia. Objective: to describe cellular disorders characteristic of dysplasia in lesions in the oral lichen planus and their relation with clinical forms and other histopathological variables Method: the universe was composed of the registration of 14 977 patients who underwent an anatomopathological study in the Department of Pathology of the Faculty of Stomatology of Havana during the period 1970-2008, from which a sample composed of 115 patients with histopathological diagnosis of oral lichen planus was taken. The records of biopsies were reviewed, taking those requests with enough clinical data in which the presence of bilateral lesions were recorded or, in its absence, more than one lesion spread through one or more than one anatomic region. The clinical variables were: reticular, atrophic, erosive and hypertrophic types of lichen planus, and the histopathological variables were: type of keratinization, epithelial thickness, presence of epithelial dysplasia. Microscope observation of the lamina obtained from the records was performed. Photomicrographs were obtained. For qualitative variables, absolute frequency and percentages were calculated. For analytical statistics, the Chi-square test was used, applying, if needed, the Yates´ correction or Fisher's exact test. Conclusions: the presence of mild dysplasia is a possible finding in the oral lichen planus, which is more frequent in the erosive type and, until proven otherwise, the oral lichen planus should have a short-term, medium-term and long-term follow-up(AU)