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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2014. Vol. 19, no. 3
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- Influence of the usual motivation for dental attendance on dental status and oral health-related quality of life(2014) Montero, Javier; Albaladejo Martínez, Alberto; Zalba, José IgnacioObjectives: To evaluate the influence of dental visiting patterns on the dental status and Oral Health-related Qua- lity of Life (OHQoL) of patients visiting the University Clinic of Salamanca (Spain). Study Design: This cross-sectional study consisted of a clinical oral examination and a questionnaire-based inter - view in a consecutive sample of patients seeking a dental examination. Patients were classified as problem-based dental attendees (PB) and regular dental attendees (RB). Clinical and OHQoL (OHIP-14 & OIDP) data were compared between groups. Pair-wise comparisons were performed and a Logistic Regression Model was fitted for predicting the Odds Ratio (OR) of being a PB patient. Results: The sample was composed of 255 patients aged 18 to 87 years (mean age: 63.1 ± 12.7; women: 51.8%). The PB patients had a poorer dental status (i.e. caries, periodontal and prosthetic needs), brushed their teeth less,and were significantly more impaired in their OHQoL according to both instruments. The logistic regression coef - ficients demonstrated that on average the OR of being a PB patient was high in this dental patient sample, but this OR increased significantly if the patient was a male (OR= 1.1-5.0) or referred pain-related impacts according to the OHIP and, additionally, the OR decreased significantly as a function of the number of healthy fillings and the number of sextants coded as CPI=0. Conclusions: Regular dental check-ups are associated with better dental status and a better OHQoL after control - ling for potentially related confounding factors.
- Influence of occlusal loading on peri-implant clinical parameters. A pilot study(2014) Pellicer Chover, Hilario; Viña Almunia, José; Romero Millán, Javier; Peñarrocha Oltra, David; García Mira, Berta; Peñarrocha Diago, MaríaObjectives: To investigate the relation between occlusal loading and peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, width of keratinized mucosa, and crevicular fluid volume) in pa - tients with implant-supported complete fixed prostheses in both arches. Material and Methods: This clinical study took place at the University of Valencia (Spain) dental clinic. It included patients attending the clinic for regular check-ups during at least 12 months after rehabilitation of both arches with implant-supported complete fixed ceramo-metallic prostheses. One study implant and one control implant were established for each patient using the T-Scan®III computerized system (Tesco, South Boston, USA). The maxil - lary implant closest to the point of maximum occlusal loading was taken as the study implant and the farthest (with least loading) as the control. Occlusal forces were registered with the T-Scan® III and then occlusal adjust - ment was performed to distribute occlusal forces correctly. Peri-implant clinical parameters were analyzed in both implants before and two and twelve months after occlusal adjustment. Results: Before occlusal adjustment, study group implants presented a higher mean volume of crevicular fluid (51.3±7.4 UP) than the control group (25.8±5.5 UP), with statistically significant difference. Two months after occlusal adjustment, there were no significant differences between groups (24.6±3.8 UP and 26±4.5 UP respec - tively) ( p =0.977). After twelve months, no significant differences were found between groups (24.4±11.1 UP and 22.5±8.9 UP respectively) ( p =0.323). For the other clinical parameters, no significant differences were identified between study and control implants at any of the study times ( p >0.05). Conclusions: Study group implants receiving higher occlusal loading presented significantly higher volumes of crevicular fluid than control implants. Crevicular fluid volumes were similar in both groups two and twelve months after occlusal adjustment.
- Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement support(2014) Pellicer Chover, Hilario; Peñarrocha Oltra, David; Bagán Debón, Leticia; Fichy Fernandez, Antonio J.; Canullo, Luigi; Peñarrocha Diago, MiguelPurpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extrac - tion and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in im - mediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants ( p =0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant dif - ferences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up.
- Inherited, congenital and acquired disorders by hemostasis (vascular, platelet & plasmatic phases) with repercussions(2014) Arrieta Blanco, Juan José; Oñate Sánchez, Ricardo Elías; Martínez López, Federico; Oñate Cabrerizo, Daniel; Cabrerizo Merino, María del CarmenThe hemostasis alterations, either congenital or hereditary origin, and acquired, are circumstances that hinder oral care to patients who suffer them and also generates in the professional who has to attend, high stress. Bleeding control once established and dental treatment planning, both in the aspect of preparation, as the realization of the odonto-stomatological therapeutic, has suffered updates that do need to remember certain aspects of the care of these patients. But we must not forget that the hematologist or internist who controls the patient's medical condition, is a cornerstone for the planning and implementation of treatment plans. We must also remember that, in certain circumstances, treatment should be performed in a hospital setting. In this review, we aim to provide the odonto-stomatologist guidance on how to address the problem and provide simple and updated guidelines to apply in the treatment of these people.
- Safety and efficacy of an intra-oral electrostimulator for the relief of dry mouth in patients with chronic graft versus host disease: case Series(2014) Zadik, Yehuda; Zeevi, Itai; Luboshitz Shon, Noa; Dakwar, Nasri; Wolff, Andy; Shapira, Michael Y.; Or, Reuven; Elad, SharonObjectives: Patients with chronic graft-versus-host disease (cGVHD) often suffer from dry mouth and oral mu - cosal lesions. The primary objective of this study was to investigate the safety of an intra-oral electrostimulator (GenNarino) in symptomatic cGVHD patients. The secondary objective was to study the impact on the salivary gland involvement of cGVHD patients. Study Design: This paper presents a case series. The study included patients treated for 4 weeks, randomly as - signed to the active device and then crossed-over to a sham-device or vice versa. The patients and clinicians were blind to the treatment delivered. Data regarding oral mucosal and salivary gland involvement were collected. Results: Six patients were included in this series. Most of the intraoral areas with manifestations of cGVHD were not in contact with the GenNarino device. Two patients developed mild mucosal lesions in areas in contact with the GenNarino during the study. However, only one of them had a change in the National Institutes of Health (NIH) score for oral cGVHD. The unstimulated and stimulated salivary flow rate increased in 4 out of the 5 pa - tients included in this analysis. Symptoms of dry mouth and general oral comfort improved. Conclusion: This study suggests that GenNarino is safe in cGVHD patients with respect to oral tissues. Furthermore the use of GenNarino resulted in subjective and objective improvements in dry mouth symptoms. A large scale study is needed to confirm the impact and safety of GenNarino on systemic cGVHD.
- Nitric oxide synthase 2 (NOS2) expression in histologically normal margins of oral squamous cell carcinoma(2014) Morelatto, Rosana; Itoiz, María-Elina; Guiñazú, Natalia; Piccini, Daniel; Gea, Susana; López de Blanc, Silvia AdrianaThe activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcino - mas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. Study Design: Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were ana - lyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by im - munohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. Results: Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative ( p =0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. Conclusions: NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes.
- Oral lichen planus - retrospective study of 563 Croatian patients(2014) Budimir, Vice; Richter, Ivica; Andabak-Rogulj, Ana; Vucicevic Boras, Vanja; Budimir, Jozo; Brailo, VlahoObjectives: To investigate the epidemiological and clinical characteristics of oral lichen planus (OLP) in a group of Croatian patients seen between 2006 and 2012. Study D esign: A group of 563 patients with a diagnosis of OLP was retrospectively reviewed in our clinic. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, his - tology, treatment and malignant transformation were registered. Results: Of the 563 patients, 414 were females and 149 were males. The average age at the diagnosis was 58 (range 11-94). The most common site was buccal mucosa (82.4%). Most of our patients did not smoke (72.5%) or consume alcohol (69.6%). Patients reported oral soreness (43.3%), mucosal roughness (7%), xerostomia (3%), gingival bleeding (2%) and altered taste (0.5%) as the chief complaint, while almost half of them were asympto - matic (44.2%). The most common types of OLP were reticular (64.8%) and erosive (22.9%). Plaque-like (5.7%) atrophic/erythemtous (4.3%) and bullous (2.3%) type were also observed. Malignant transformation rate of 0.7% was recorded. Conclusions: OLP mostly affects non-smoking middle-aged women. Buccal mucosa is the most commonly af - fected site. In almost half of the cases patients are asymptomatic. In spite of the small risk for malignant transfor - mation all patients should be regularly monitored.
- Clinical and laboratorial profile and histological features on minor salivary glands from patients under investigation for Sjögren's syndrome(2014) Pereira, Débora-Lima; Vilela, Verônica-Silva; dos-Santos, Teresa-Cristina-Ribeiro-Bartholomeu; Pires, Fábio-RamôaDiagnosis of Sjögren's syndrome (SS) is complex and the usefulness of labial minor salivary glands biopsy in this process remains controversial. Objectives: to evaluate the clinical and laboratorial profile and histological features on labial minor salivary glands from patients under investigation of SS. Study D esign: clinical charts from 38 patients under suspicion of SS and submitted to labial minor salivary glands biopsies were reviewed. Clinical and laboratorial data were retrieved from the clinical files and the HE-stained histological slides were reviewed under light microscopy. Results: mean age of the patients was 56.5 years and 97% were females; histological analysis showed that 42% of the cases showed ductal dilatation, lymphocytic foci were found in 52.6% and, from this group, 80% of the cases presented a foci/lobules ratio above 0.8. Acinar/ductal ratio was considered diminished in 39.5% of the samples. Thirty six (95%) and 32 (84%) patients, respectively, complained about xerostomia and xerophthalmia. A study of the time interval of the symptoms that led to SS investigation showed a mean of 116 months. Moreover, sixty-six percent of the patients had already been submitted to immunosuppressive therapy prior to the labial minor salivary gland biopsy. Age of the patients, scintigraphic alterations on salivary function, antinuclear factor (ANF), anti-Ro and anti-La did not show statistical significant association with the histological features. Lobules/foci ratio above 0.8 was the only histological parameter statistically associated with Sjögren's syndrome diagnosis ( p <0.0001). Conclusions: in the studied sample, lymphocytic foci on salivary glands were the only histological parameter as - sociated to the diagnosis of SS. Early indication of labial minor salivary gland biopsy to patients under investiga - tion of SS could limit the effects of immunosuppressive therapy on the histological features associated with the evolution of salivary gland involvement in SS.
- Burnout, depression and suicidal ideation in dental students(2014) Galán, Fernando; Ríos Santos, José Vicente; Polo Padillo, Juan; Rios Carrasco, Blanca; Bullón, PedroObjectives: To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. Study Design: A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the "Patient Health Questionnaire-2", and the "Questions about Suicidal Ideation and Attempted Suicide". Results: The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year ( p = 0.059 and p = 0.003, respectively). Depression prevalence in the fourth year approached significance ( p = 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation ( p < 0.001), but no association was found between burnout and suicidal ideation. Conclusions: This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years.
- Plasma variations in stress markers: clinical trial of two anesthetics used in regional block in the extraction of impacted inferior third molars(2014) Arteagoitia Calvo, María Iciar; Zumárraga, Mercedes; Dávila, Ricardo; Barbier Herrero, Luis; Santamaría Arrieta, Gorka; Santamaría Zuazua, Joseba AndoniObjectives: Was to evaluate the effect of different regional anesthetics (articaine with epinephrine versus prilo - caine with felypressin) on stress in the extraction of impacted lower third molars in healthy subjects. Sutdy Desing: A prospective single-blind, split-mouth cross-over randomized study was designed, with a control group. The experimental group consisted of 24 otherwise healthy male volunteers, with two impacted lower third molars which were surgically extracted after inferior alveolar nerve block (regional anesthesia), with a fortnight's interval: the right using 4% articaine with 1:100.000 epinephrine, and the left 3% prilocaine with 1:1.850.000 fely - pressin. Patients were randomized for the first surgical procedure. To analyze the variation in four stress markers, homovanillic acid, 3-methoxy-4-hydroxyphenylglycol, prolactin and cortisol, 10-mL blood samples were obtained at t = 0, 5, 60, and 120 minutes. The control group consisted of 12 healthy volunteers, who did not undergo either extrac - tions or anesthetic procedures but from whom blood samples were collected and analyzed in the same way. Results: Plasma cortisol increased in the experimental group (multiple range test, P <0.05), the levels being sig - nificantly higher in the group receiving 3% prilocaine with 1:1.850,000 felypressin (signed rank test, p <0.0007). There was a significant reduction in homovanillic acid over time in both groups (multiple range test, P <0.05). No significant differences were observed in homovanillic acid, 3-methoxy-4-hydroxyphenylglycol or prolactin con - centrations between the experimental and control groups. Conclusions: The effect of regional anesthesia on stress is lower when 4% articaine with 1:100,000 epinephrine is used in this surgical procedure.
- The effects of informed consent format on preoperative anxiety in patients undergoing inferior third molar surgery(2014) Torres Lagares, Daniel; Heras Meseguer, Marisa; Azcárate Velázquez, Francisco; Hita Iglesias, Pilar; Ruiz de León, Gonzalo; Hernández Pacheco, Esther; Gutiérrez Pérez, José LuisObjectives: To evaluate the effect of informed consent format on preoperative anxiety of patients. Material and Methods: We performed a prospective study (91 patients) undergoing lower third molar extraction. Patients were distributed into three groups. Informed consent for surgery was obtained through a written docu - ment, an oral interview or a video recording. Afterwards, patients were asked about their anxiety level and the effect the informed consent had had on it. Results: Whereas the information conveyed both in oral and written formats relieved the patient to some extent (in a scale of -3 to +3) 0.97±1.21 and 0.29±0.97, respectively), the video recording increased patient's anxiety in a sta - tistically significant way (in a scale of -3 to +3, -0.57±1.43). The difference obtained between the values obtained in oral and written information was not statistically significant. Discussion: The most adequate format, according to our study, would be the oral format.
- Relationship between the oral cavity and cardiovascular diseases and metabolic syndrome(2014) Carramolino-Cuéllar, Esther; Tomás Carmona, Inmaculada; Jiménez Soriano, YolandaThe components of the human body are closely interdependent; as a result, disease conditions in some organs or components can influence the development of disease in other body locations. The effect of oral health upon health in general has been investigated for decades by many epidemiological studies. In this context, there appears to be a clear relationship between deficient oral hygiene and different systemic disorders such as cardiovascular disease and metabolic syndrome. The precise relationship between them is the subject of ongoing research, and a variety of theories have been proposed, though most of them postulate the mediation of an inflammatory response. This association between the oral cavity and disease in general requires further study, and health professionals should be made aware of the importance of adopting measures destined to promote correct oral health. The present study conducts a Medline search with the purpose of offering an update on the relationship between oral diseases and cardiovascular diseases, together with an evaluation of the bidirectional relationship between metabolic syndrome and periodontal disease. Most authors effectively describe a moderate association between the oral cavity and cardiovascular diseases, though they also report a lack of scientific evidence that oral alterations constitute an independent cause of cardio - vascular diseases, or that their adequate treatment can contribute to prevent such diseases. In the case of metabolic syndrome, obesity and particularly diabetes mellitus may be associated to an increased susceptibility to periodontitis. However, it is not clear whether periodontal treatment is able to improve the sys - temic conditions of these patients.
- Exclusion of PAX9 and MSX1 mutation in six families affected by tooth agenesis. A genetic study and literature review(2014) Tallón Walton, Victòria; Manzanares Céspedes, María Cristina; Carvalho Lobato, P.; Valdivia Gandur, Ivan; Arte, Sirpa; Nieminen, PekkaObjectives: In the present study, it is described the phenotypical analysis and the mutational screening, for genes PAX9 and MSX1, of six families affected by severe forms of tooth agenesis associated with other dental anomalies and systemic entities. Study Design: Six families affected by severe tooth agenesis associated with other dental anomalies and systemic entities were included. Oral exploration, radiological examination, medical antecedents consideration and muta - tional screening for PAX9 and MSX1 were carried out. Results: No mutations were discovered despite the fact that numerous teeth were missing. An important pheno - typical variability was observed within the probands, not being possible to establish a parallelism with the pat - terns associated to previously described PAX9 and MSX1 mutations. Conclusions: These results bring us to conclude that probably other genes can determine phenotypical patterns of dental agenesis in the families studied, different than the ones described in the mutations of PAX9 and MSX1. Moreover, epigenetic factors can be involved, as those that can reduce gene dosage and other post-transcriptional modulation agents, causing dental agenesis associated or not with systemic anomalies.
- Etiology, distribution, treatment modalities and complications of maxillofacial fractures(2014) Pham-Dang, Nathalie; Barthélémy, Isabelle; Orliaguet, Thierry; Artola, Alain; Mondié, Jean-Michel; Dallel, RadhouanePurpose: This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital. Material and Methods: This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etio- logy, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined. Results: Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible. Conclusions: Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophy - laxis associated with dental hygiene care can be indicated to prevent postoperative infections.
- Parental-caregiver perceptions of child oral health-related quality of life (P-CPQ): psychometric properties for the peruvian spanish language(2014) Albites, Ursula; Abanto, Jenny; Bönecker, Marcelo; Paiva, Saul Martins; Aguilar-Gálvez, Denisse; Castillo, Jorge-LuisObjectives: The aim of the study was to cross-culturally adapt the Parental-Caregiver Perceptions Questionnaire (P-CPQ) to the Peruvian Spanish language and assess its reliability and validity. Study Design: To translate and cross-cultural adapt the instrument, 60 parents answered the P-CPQ in two pilot tests. The final version of the P-CPQ was evaluated in 200 parents of children aged 11 to 14 years, who were clini - cally examined for dental caries. The internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the P-CPQ on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the P-CPQ with global ratings of oral health and clinical groups, respectively. Results: The mean (standard deviation) P-CPQ score was 15.64 (11.89). Internal consistency was confirmed by a Cronbach's alpha of 0.84. Test-retest reliability revealed excellent reproducibility (ICC= 0.94). Construct validity was satisfactory, demonstrating significant correlations between global ratings (oral health and overall well-being) and the total scale and for subscale. Discriminant validity was significant ( p <0.001), supporting its ability to dis - criminate between clinical groups. Conclusions: The Peruvian Spanish P-CPQ has satisfactory psychometric properties to assess parental-caregivers perceptions on their children's oral health-related quality of life.
- Risk factors for temporomandibular disorder: binary logistic regression analysis(2014) Magalhães, Bruno-Gama; Sousa, Stéphanie Trajano de; Mello, Victor Villaça Cardoso de; Silva Barbosa, André-Cavalcante da; Assis-Morais, Mariana-Pacheco-Lima de-; Barbosa-Vasconcelos, Márcia-Maria-Vendiciano; Caldas-Júnior, Arnaldo-de-FrançaObjectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and marital status) on the occurrence of temporomandibular disorder. Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oeste - oarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and Classes D/E (very poor social class). The results were analyzed using Pearson's chi-square test for proportions, Fisher's exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis. Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of ex - hibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems. Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems.
