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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2007. Vol. 12, no. 4
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- Recommendations for the prevention, diagnosis, and treatment of osteonecrosis of the jaw (ONJ) in cancer patients treated with bisphosphonates(2007) Bagán Sebastián, José Vicente; Blade, Juan; Cózar Olmo, José Manuel; Constenla, M.; García Sanz, R.; Gómez Veiga, Francisco; Lahuerta Palacios, Juan José; Lluch Hernández, Ana; Massuti Sureda, Bartomeu; Morote Robles, Juan; San Miguel, Jesús F.; Solsona Narbón, Eduardo
- Infections in implantology : from prophylaxis to treatment(2007) Bowen Antolín, Antonio; Pascua García, Mª Teresa; Nasimi, AbdulSince the introduction of osseointegrated implant treatment, odontology, and in particular the area of prosthodontic replacement of lost teeth, has evolved in an unimaginable way, to the extent that the age-old idea of ?restitutio ad integrum? has almost become possible. Implant treatment has a high success rate that has been rated as high as 95 to 99%, according to different casuists, but there is another group of cases in which implants fail, and in fact it is hard to know the causes of such failures. The microbiological component plays an important role in encouraging and facilitating implant infection during implant placement, and also later when the implant is in function in the mouth, which is a septic medium. In this paper we will study infections in implantology, classified according to the treatment phase: Infection prior to the implant; Peri-surgical infection; Severe post-surgical infection; Peri-implant disease.
- Reparative giant cell granuloma in a pediatric patient(2007) Duarte Ruiz, B.; Riba García, F.; Navarro Cuéllar, C.; Bucci, Tommaso; Cuesta Gil, Matías; Navarro Vila, C.Reparative giant cell granulomas are benign, infrequent tumors, of non-odontogenic origin, that develop at central or peripheral level. Peripherally located lesions are frequently denominated ?giant cell epulis?, and never correspond to true neoplasia, but rather to inflammatory reactions secondary to another lesion (hemorrhage, etc.). It should be taken into account, that in general, head and neck tumors of infancy usually demonstrate an atypical biological behaviour. Furthermore, the anatomicopathologic diagnosis is often compromised in this type of lesion. We present the case of a 6-year-old boy, who, three weeks after suffering a slight facial trauma, developed a painless, exophytic swelling of approximately 4 cm, with bleeding on palpation, in the ipsilateral hemimaxilla. The lesion demonstrated rapid, progressive and continuous growth. The facial CT and incisional biopsy confirmed the suspected diagnosis of reparative giant cell granuloma. The patient was surgically treated, carrying out a left marginal maxillectomy associated with the extirpation of the soft-tissue lesion. The resultant defect was reconstructed with a Bichat fat-pad providing the patient with optimal esthetic and functional results. The definitive anatomicopathologic report of the surgical piece is compatible with reparative giant cell granuloma.
- Pharmacological treatment of burning mouth syndrome : a review and update(2007) Mínguez Serra, María Paz; Salort Llorca, Cesar; Silvestre Donat, Francisco JavierBurning mouth syndrome (BMS) is defined as a burning sensation in the tongue or in any other region of the oral mucosa, in the absence of specific oral lesions. The present study reviews the pharmacological treatments used in the last 10 years to reduce the symptoms of BMS, and assesses the efficacy and safety of pharmacological interventions destined to alleviate the symptoms of BMS. To this effect, searches were made in the following databases: Micromedex®, Cochrane Database® and PubMed®, crossing the following key words: drug, treatment, clinical trial, pain management, and burning mouth syndrome. The searches were limited to articles published in the last 10 years in English or Spanish, and involving human subjects. The searches were conducted in November 2006. The literature contains clinical studies in which BMS has been treated with drugs belonging to different pharmacological groups: antidepressants, antipsychotics, antiepileptic drugs, analgesics and mucosal protectors, among others. Although effective therapies have been identified in concrete cases, a treatment modality offering efficacy in most cases of BMS remains to be established. It is essential to gain further insight to the physiopathological mechanisms of BMS, and to establish differential diagnostic criteria to develop drugs with improved efficacy and safety profiles in the treatment of BMS.
- Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve(2007) Almendros Marqués, Nieves; Delgado Molina, Esther; Tamarit Borrás, Meritxell; Berini Aytés, Leonardo; Gay Escoda, CosmeObjetivos: Evaluar las posibles diferencias existentes en cuanto a la deformación del bisel de dos tipos de aguja de igual longitud y calibre externo, pero de distinto diámetro interno, durante el bloqueo troncal del nervio dentario inferior. Diseño del estudio: Cuatro operadores de similar formación quirúrgica realizaron el bloqueo troncal del nervio dentario inferior y la anestesia infiltrativa del nervio bucal para proceder a la extracción quirúrgica o convencional del tercer molar inferior en 266 pacientes. Para efectuar el bloqueo troncal se utilizó en todos los casos un sistema de jeringa no auto-aspirante (Uniject K®; Hoechst AG, Frankfurt, Alemania) y dos tipos de aguja: una aguja Monoprotect® de 27G x 35 mm con un calibre interno de 0.215 mm (Sofic SA, Mazamet, Francia) o una aguja XL Monoprotect® de 27G x 35 mm con un calibre interno de 0.265 mm (Sofic SA, Mazamet, Francia). Para hacer la anestesia infiltrativa del nervio bucal se utilizó el mismo tipo de jeringa y otros dos tipos de aguja: la Monoprotect®o la XL Monoprotect®, ambas con un calibre de 30G y 25 mm de longitud, diferenciándose en su calibre interno (0.215 y 0.265 mm, respectivamente) (Sofic SA, Mazamet, Francia). En cada paciente fue recopilada de forma sistemática la siguiente información: el tipo de aguja, la técnica anestésica utilizada (troncular directa o indirecta) y el número de veces que se había contactado con el hueso durante ésta, el lado de trabajo del operador, el lado del diente a extraer, el operador que hizo la intervención quirúrgica, así como la presencia o ausencia de deformación del bisel tras la técnica anestésica. Resultados: Para la técnica troncular, sólo se observó una asociación estadísticamente significativa entre la deformación de los biseles de las agujas y el operador que efectuó la técnica anestésica, mientras que para la técnica infiltrativa, se encontró una asociación estadísticamente significativa (p<0,05) entre la deformación de los biseles de las agujas y el operador que efectuó la técnica anestésica, el calibre interno de la aguja y el número de contactos óseos. Conclusiones: No existen diferencias entre las agujas Monoprotect® y las agujas XL Monoprotect® en cuanto a la deformación de su bisel, sino que la existencia de esta deformación obedece a aspectos físico-mecánicos como la fuerza con la que el operador introduce la aguja en los tejidos, que a su vez condicionará la intensidad del impacto de la aguja sobre el hueso.
- Review of temporomandibular joint pathology. Part I : classification, epidemiology and risk factors(2007) Poveda Roda, Rafael; Bagán Sebastián, José Vicente; Díaz Fernández, José María; Hernández Bazán, Sergio; Jiménez Soriano, YolandaPathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14- 44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD.
- Gingival neurofibroma in a neurofibromatosis type 1 patient : case report(2007) García de Marcos, J.A.; Dean Ferrer, Alicia; Alamillos Granados, Francisco; Ruiz Masera, J.J.; García de Marcos, M.J.; Vidal Jiménez, A.; Valenzuela Salas, B.; García Lainez, AnaNeurofibroma is a benign peripheral nerve sheath tumour. It is one of the most frequent tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of type 1 neurofibromatosis (NF-I). Neurofibromatosis type 1 is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (café au lait spots and neurofibromas) as well as bone malformations and central nervous system tumours. Diagnosis is based on a series of clinical criteria. Gingival neurofibroma in NF-I is uncommon. Treatment of neurofibromas is surgical resection. The aim of this paper is to report a case of NF-I with gingival involvement and to review the literature.
- Oral health status in patients with moderate-severe and terminal renal failure(2007) Sobrado Marinho, Jorge Serafín; Tomás Carmona, Inmaculada; Loureiro, Alfredo; Limeres Posse, Jacobo; García Caballero, Lucía; Diz Dios, PedroObjetivos. Evaluar el estado de salud oral de pacientes con insuficiencia renal crónica moderada/severa (IRC-MD) y con fallo renal terminal (FRT). Diseño. El grupo de estudio lo constituyeron 50 pacientes: 22 (44%) con IRC-MD y 28 (56%) con FRT incluidos en un programa de hemodiálisis. Los controles (n= 64) tenían características similares en relación al sexo, edad, peso y nivel educacional. Se realizó una exploración intraoral a todos los participantes recogiendo información acerca de: número de dientes cariados, ausentes y obturados; acúmulo de placa supragingival; acúmulo de cálculo; profundidad de bolsas periodontales en los dientes de Ramfjord; y pérdida de inserción. Resultados. No se detectaron diferencias significativas en los valores del índice CAO entre pacientes y controles. El número medio de dientes cariados fue inferior en los pacientes que en los controles (p= 0,052). En los pacientes, el nú- mero medio de dientes ausentes fue mayor que en los controles (p= 0,002). Había 12 pacientes y 7 controles totalmente edéntulos. El número medio de dientes obturados fue significativamente inferior en los pacientes que en los controles (p< 0,001). El acúmulo de placa supragingival y la pérdida de inserción fue significativamente mayor en los pacientes que en los controles (p= 0,006 y p< 0,001, respectivamente). No se encontraron diferencias significativas en relación al acúmulo de cálculo ni a la presencia de bolsas periodontales entre ambos grupos. El valor del índice CAO, el número medio de dientes cariados y el de obturados fue significativamente superior en los pacientes IRC-MD que en los pacientes FRT (p= 0,004, p= 0,030 y p= 0,006, respectivamente). Conclusión. Los pacientes con IRC tienen menor prevalencia de caries, más placa supragingival, más dientes con pérdida de inserción y más ausencias dentarias, que los controles sanos. La prevalencia de caries está condicionada por la severidad de la insuficiencia y/o por el tratamiento de hemodiálisis.
- The application of microscopic surgery in dentistry(2007) García Calderón, Manuel; Torres-Lagares, Daniel; Calles Vázquez, Carmen; Usón Gargallo, J.; Gutiérrez Pérez, José LuisThe use of the microscope as a tool for practising Medicine, especially in surgical specialisations, has been established for decades. The microscope was first used in OdontologyDentistry back to the 1970s and 1980s, and was introduced more widely (although it was still far from being in general use) during 1990s. The purpose of this article is to describe the main applications of the microscope in OdontologyDentistry today, as well as providing odontologists and stomatologists, whether specialists or in general practice, with information about microscopic OdontologyDentistry for better patient care. This work also gives particular importance to matters needed to achieve the necessary manual dexterity to work in a magnified operating field using a surgical microscope (SM).
- Localized leishmaniasis of the oral mucosa. A report of three cases(2007) García de Marcos, J.A.; Dean Ferrer, Alicia; Alamillos Granados, Francisco; Ruiz Masera, J.J.; Cortés Rodríguez, Begoña; Vidal Jiménez, A.; García Lainez, Ana; Lozano Rodríguez Mancheño, AquilesEl término leishmaniasis comprende un grupo de enfermedades causadas por diferentes especies de un protozoo llamado Leishmania. La leishmaniasis se produce en todo el mundo, considerándose endémica en 88 países. Existen tres formas clínicas principales de leishmaniasis: leishmaniasis visceral, leishmaniasis cutánea y leishmaniasis mucocutánea. La afectación de la mucosa, de manera exclusiva, por la Leishmania es muy rara. Presentamos una serie de tres casos de leishmaniasis mucosa localizados en la cavidad oral. El hecho de que todos los casos se produjeran en España, área endémica de L infantum, nos hace presuponer que éste fue el agente causal. La única manifestación de enfermedad de leishmaniasis en los casos descritos, fue la aparición de una lesión oral. Se administró tratamiento con antimoniato de meglumina en dos de ellos, respondiendo favorablemente. Uno de los pacientes abandonó el hospital tras el diagnóstico sin recibir tratamiento y se desconoce la evolución. Realizamos también una revisión de la literatura.
- Myositis Ossificans of the temporalis muscle : case report(2007) Manzano Soto de Zaldívar, Damián; Silván, Ángel; Saez, Javier; Moreno García, C.Los autores presentan un caso poco frecuente de miositis osificante del músculo temporal en un paciente varón de 51 años que se manifiesta con limitación de la apertura oral, con masa firme y dura en la fosa temporal derecha. La tomografia axial computerizada (TC) reveló una masa de densidad ósea localizada en la región temporal derecha, que unía el hueso temporal derecho con la apófisis coronoides y una imagen de pseudo-articulación en su porción media. La miositis osificante traumática es un tumor benigno que se localiza frecuentemente en las extremidades de los adolescentes. Los casos en el esqueleto craneofacial son raros. En esta localización, los músculos masetero y esternocleidomastoideo son los más frecuentemente afectados. Las características clínico patológicas de la miositis osificante pueden imitar otros tumores de los tejidos blandos, por lo que se requiere un cuidadoso diagnóstico diferencial. Histológicamente, la actividad osteoblástica asemeja a veces a un osteosarcoma, que requiere establecer el diagnóstico diferencial entre ambas entidades. En nuestro caso, el tratamiento quirúrgico, mediante abordaje combinado retromolar y hemicoronal, fue el elegido.
- Yellowish lesions of the oral cavity : Suggestion for a classification(2007) Gómez, Iria; Varela Centelles, Pablo Ignacio; Romero Méndez, María Amparo; García, María José; Suárez Cunqueiro, María Mercedes; Seoane Lestón, Juan ManuelThe colour of a lesion is due to its nature and to its histological substratum. In order to ease diagnosis, oral cavity lesions have been classified according to their colour in: white, red, white and red, bluish and/or purple, brown, grey and/or black lesions. To the best of our knowledge, there is no such a classification for yellow lesions. So, a suggestion for a classification of yellowish lesions according to their semiology is made with the following headings: diffuse macular lesions, papular, hypertrophic, or pustular lesions, together with cysts and nodes. This interpretation of the lesions by its colour is the first step to diagnosis. It should be taken into account that, as happens with any other classification, the yellowish group of lesions includes items with different prognosis as well as possible markers of systemic disorders.
- Osteonecrosis of the jaws and bisphosphonates : report of fifteen cases: therapeutic recommendations(2007) Heras Rincón, Ignacio; Zubillaga, Ignacio; Castrillo Tambay, M.; Montalvo Moreno, J.J.Recently there have been reports of osteonecrosis of the jaw (ONJ) in patients with chronic therapy with bisphosphonates (Bps). So far three drugs have been linked: Pamidronate of disodium, Zoledronic acid and Alendronate of sodium. It is due to a non detected side effect in clinical trials before commercialization, and reverberates significantly in the quality of life of these patients. Most of the cases are seen in oncology patients that have received long term concurrent antineoplasic therapy and were treated sporadically with steroids, together with Bps endovenous, for treatment of cancer and its symptoms. Among these cases we find the reported by R.E. Marx (1), S.L. Ruggiero (2) and J. V. Bagán (3). In this report fifteen cases diagnosed, treated and followed up at the author´s surgery department are presented and some suggestions are given in order to reduce the incidence in patients with cancer who are going to receive Bps, as well as in patients with established ONJ being treated with these drugs who may need a surgical intervention.
