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Language Medicina oral, patología oral y cirugía bucal. 2005. Vol. 10, no. 1
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- Caracterización físico-química de la superficie de 9 implantes dentales con 3 distintos tratamientos de superficie(2005) Rodríguez Rius, Daniel; García Sabán, FranciscoThere are many surface treatments applied to dental implants. The aim of the present investigation is to compare the physicochemical characteristics of titanium dental implant surfaces with different surface treatments. 9 dental implants from the same batch were divided in 3 groups and received 3 different surface treatments: machined, acid etched and a new chemical surface treatment called Avantblast®. Scanning electron microscopy and confocal microscopy were used to image the treated surfaces, and energy-dispersive spectrometry and X-ray photoelectron spectrometry to provide a chemical characterization of the surfaces. Results The acid etched and chemical etched surfaces had an increased roughness over the machined one. Surface chemical composition had differences between processes, as the surface with the new treatment presented a reduced level of impurities and increased thickness of the titanium oxide layer Conclusions Surface roughness of titanium dental implants and thickness of the titanium oxide layer can be increased with a suitable surface treatment.
- Estudio del estado bucodental del paciente trasplantado hepático(2005) Díaz Ortiz, María Luisa; Micó Llorens, José María; Gargallo Albiol, Jordi; Baliellas Comellas, Carmen; Berini Aytés, LeonardoSince the first liver transplantation in Spain was carried out in 1984, advances in surgical technique and immunosuppressive drugs have facilitated an increase in the number of transplants performed. The present study evaluates buccodental health in liver transplant patients. A cross-sectional descriptive study was made of a sample of patients subjected to liver transplantation in Príncipes de España Hospital (Bellvitge University Health Care Complex, L Hospitalet de Llobregat, Barcelona - Spain). Information was collected relating to demographic characteristics, general clinical history, buccodental history and intraoral exploratory findings. A total of 53 individuals were evaluated (28 males and 25 females, with a mean age of 57.6 years). The mean time elapsed from transplantation was 3 years and 9 months. The most frequent indication for liver transplantation was liver cirrhosis due to hepatitis C virus (HCV) infection (49.1% of the global series). The most widely used immunosuppressors were cyclosporine and tacrolimus. The CAOD index of the series was 11.2. In relation to periodontal disease, 22% of the dentate patients showed gingival overgrowth, while half of those with teeth had gingival recessions, and 34% presented some type of dental mobility. The examination of the oral mucosa showed fissured tongue to be the most common disorder (39.6%), followed by saburral tongue (28.3%) and xerostomia (18.9%). Buccodental pathology in these patients is related to the use of immunosuppressor medication and other factors such as a lack of preventive measures. The findings of the present study point to the need for preventive treatments in this population group.
- Granuloma periférico de células gigantes: a propósito de 5 casos y revisión de la literatura(2005) Chaparro Avendaño, Angie Virginia; Berini Aytés, Leonardo; Gay Escoda, CosmePeripheral giant cell granuloma (PGCG) is a relatively frequent benign reactive lesion of the oral cavity, originating from the periosteum or periodontal membrane following local irritation or chronic trauma. PGCG manifests as a red-purple nodule located in the region of the gums or edentulous alveolar margins, fundamentally in the lower jaw. The lesion can develop at any age, though it is more common between the fifth and sixth decades of life, and shows a slight female predilection. PGCG is a soft tissue lesion that very rarely affects the underlying bone, though the latter may suffer superficial erosion. The present study reviews 5 cases of PGCG, involving 3 males and 2 females between 19-66 years of age, and with presentation in the upper jaw in three cases. Two patients showed radiological concave depression images corresponding to bone resorption. Treatment consisted of resection and biopsy, using a carbon dioxide laser in 2 cases and a cold scalpel in the remaining 3. There were no relapses during postoperative follow-up (range 10 months to 4 years). The differential diagnosis of PGCG includes lesions with very similar clinical and histological characteristics, such as central giant cell granuloma, which are located within the jaw itself and exhibit a more aggressive behavior. Only radiological evaluation can establish a distinction. The early and precise diagnosis of these lesions allows conservative management without risk to the adjacent teeth or bone.
- Anomalía morfológica coronal inusual de un incisivo: diente evaginado anterior(2005) Llena Puy, María Carmen; Forner Navarro, LeopoldoExophytic growth of a portion of the tissue structure is one of the various clinical manifestations of the morphological anomalies that can affect the crown of the anterior teeth. The crown form disorder presented in this paper consists of an asymptomatic bulge on part of the vestibular surface of the tooth, due to enamel and dentine growth, with no radiological evidence of the pulp having extended into the protrusion of mineralised tissues. In this case, it only affects one tooth and is not associated with any other dental morphology or structure disorder, or with any of the syndromes that have been described in association with this anomaly. The term to describe this situation in the anterior teeth is not clearly defined in the relevant literature, which employs various names such as talon cusp, accentuated cingulum (when it affects the lingual or palatal surface) or dens evaginatus (evaginated tooth, evaginated odontome), the term that is always used when it is present in the posterior teeth.
- Valor predictivo de la candidiasis oral como marcador de evolución a SIDA(2005) Fernández Feijoo, Javier; Diz Dios, Pedro; Otero Cepeda, Xosé Luis; Limeres Posse, Jacobo; Fuente Aguado, Javier de laObjective: To determine the validity of oral candidiasis (OC) as a clinical marker of progression in patients with human immunodeficiency virus infection. Study design: In 1992, an oral examination was carried out on a group of 200 HIV-infected patients with a mean age of 36.8 ± 7 years (range 25-46 years) to establish the diagnosis of OC. The following variables were recorded: age, sex, duration of the disease, risk behaviour, CD4 lymphocyte count, clinical stage and antiretroviral treatment. Of the 200 patients in the group evaluated, 157 did not fulfil the criteria for AIDS at the time of the baseline examination; these patients constitute the study group and underwent 6-monthly follow-up until they fulfilled these criteria. The study was concluded at the end of 2001. Results: Of the 157 patients selected, 71 (45.2%) did not present OC and, of these, 28.7% progressed to AIDS during the followup period. Of the 86 (54.8%) patients with OC, 48.2% progressed to AIDS (RR= 2.71). If the start date of the study was taken as 1997, when highly active antiretroviral therapy (HAART) was introduced, no differences were found in the percentage of patients who progressed to AIDS with respect to the presence or absence of OC at the baseline examination. Multivariate analysis demonstrated that the association of the presence of OC with progression to AIDS did not reach a predictive value. Conclusions: The long-term prognostic value of OC has not been established in patients receiving highly active antiretroviral therapy (HAART). The immunological recovery and the reduction in the number of opportunistic diseases observed after the administration of HAART means that many patients who developed AIDS do not currently satisfy these criteria, making a review of the definition of the syndrome itself a necessity in order to be able to evaluate prognostic markers.
- Melanoacantosis oral (melanoacantoma): reporte de un caso y revision de literatura(2005) Contreras, Elisa; Román, CarlosOral melanoacanthosis (MA) is a rare pigmented mucosal lesion that is considered the counterpart of cutaneous melanoacanthoma. Microscopically the superficial epithelium shows mild to moderate acanthosis, spongiosis and prominent dendritic melanin producing melanocytes, which are present throughout the spinous keratinocytes. Reported cases show predilection for black females and the most common locations in decreasing frequency are buccal mucosa, lip, palate and gingiva. Although its pathogenesis remains uncertain, its clinical behavior is sugestive of a reactive origin. The clinical appearance of oral MA is non diagnostic and therefore biopsy is mandatory to differentiate from other melanocytic lesions, including melanoma.
- Expresión proteica de p53 y proliferación celular en leucoplasias orales(2005) Santos García, Antonio; Abad Hernández, M. Mar; Fonseca Sánchez, Emilio; Cruz Hernández, Juan Jesús; Bullón Sopelana, AgustínOBJECTIVES: We intend to know the protein expression of genetic alterations that take place in the early stages in the field cancerization of oral cavity in our means as well as to study the cellular proliferation by means of Ki-67 and the protein product expression of p53 to value if the alterations in the protein products expression of these markers happen in a sequential pathway through the different stages in the field cancerization of oral cavity. MATERIALS AND METHODS: A study was made by immunohistochemistry on 53 patients that presented lesions of oral leukoplaquia, assisted by the ENT service at University Hospital of Salamanca, from 1.990 up to 2000. 11 samples of normal epithelium, 15 mild to moderate dysplasias, 15 in situ carcinomas and 12 microinvasive carcinomas are included in the study. RESULTS: we find an increased cellular proliferation and p53 over-expression as we advance in the grade of severity histopathologic of these lesions. The most early alterations are a significant increase of cell proliferation in mild and moderate dysplasias and an increased p53 over-expression. CONCLUSIONS: Oral leukoplaquia is a precancerous stage that constitutes a canzerisable lesion due to the genetic alterations that mediate in the evolution of lesion. Routine Immunohistochemical and molecular study of these lesions allow us to know the protein expression of genetic alterations that can help in the early diagnosis and treatment of this pathology, having special relevance the study of Ki-67 in early stages and p53 in advanced lesions.
- Alveolitis seca: actualización de conceptos(2005) Torres Lagares, Daniel; Serrera Figallo, María Angeles; Romero Ruiz, Manuel María; Infante Cossío, Pedro; García Calderón, ManuelDry socket is a postoperative complication that occurs after a dental extraction and has been defined as an inflammation of the alveolus. If this inflammation should surpass the alveolar walls, it would result in a located osteitis. The frequency of appearance of dry socket has been reported in a very wide margin, from 1% until 70%. It is generally accepted that most dry sockets appear after extraction of third retained molars, in which the occurrence of this complication is about 20-30% of dental extractions, ten times more than in the rest of dental extractions. In this work we review the forms of clinical appearance, the risk factors related to this affection and the etiopathogenic theories that try to explain its appearance. The treatment management is also examined. Fibrinolitic agents, laundries, antiseptic, and antibiotics have been studied for its prevention, according to the pathogenic theories of dry socket. We analyze and critize the different drugs and their results. In conclusion from the revised data, we think it is possible to defend a pathogenic model in which the bacterial fibrinolytic mechanisms and the microorganism of the own patient may contribute to produce the dry socket.
- Aspectos odontoestomatológicos en oncología infantil(2005) Cabrerizo Merino, María del Carmen; Oñate Sánchez, Ricardo ElíasChildhood neoplasias have become increasingly important in recent years in the ambit of paediatric medicine. This phenomenon has been accompanied by a spectacular improvement in the treatment of childhood cancer, long-term survival rates reaching 90% in the case of some tumours. A corollary of this success is the obligation to provide new and improved medical assistance both as regards the possible prevention of any alterations and, if possible, the avoidance of complications derived from the neoplasm itself and its treatment. Among possible secondary effects are oral manifestations of a chronic or acute nature, which may cause great discomfort, act as foci of sytemic infections or have long-term after effects, all of which will depend on the exact moment of the child s development that treatment is undertaken. The incidence and severity of most oral complications is associated with pre-existent factors, such as caries, gingivitis or generally poor hygiene, which strongly affect the beginning, increase and persistence of the same. It is to be decried that a problem in the buccal cavity is allowed to develop, which a simple preventative measure, simple hygiene or dental conservation treatment could prevent or reduce.
- Tratamiento del carcinoma de labio mediante braquiterapia de alta tasa de dosis(2005) Finestres, Fernando; Guix Melcior, Benjamín; Cloquell Damian, Alberto; Chimenos Küstner, Eduardo; Tello Luque, José IgnacioObjetives: The objetive of the present study is to value the results obtained in the treatment of 28 patients a prospective group, affected of upper lip carcinoma treated through external molds of high dose rate brachytherapy. Design of the study: A total of 28 patients ffected of lip carcinoma were treated through superficial ready ' made molds and high dose rate brachytherapy. The dose of radiation given was 6.000 to 6.500 cGy in 33 to 36 fractions of 180 cGy on tumors up to 4 centimeters of diameter. On the big tumors the dose given was 7.500 to 8.000 cGy in 43 to 46 fractions. The patients were followed every 3 months, evaluating in each visit the local control, regional and at distance of the tumor, the existence of complications or sequels and the aesthetic result obtained. Results: All the patients completed the foreseen treatment. All the cases had complete remission of the tumor. During the period of pursuit local relapses were not detected neither regional or at distance. Patients did not present inmediate or late complications during the treatment. In the observations made 6 and 12 months after the treatment 27/28 patients had excellent or good aesthetic results. Conclusions: Because of the high control of the tumor,good tolerance to therapy, absence of complications and reverts,easy employment of molds, accuracy in positioning the source in the daily repetition of the treatment and the security that offers for radioprotection,we conclude that this therapy will probably be of habitual use the next years.
- Aislamiento de Candida dubliniensis en un adolescente con estomatitis protésica(2005) Mosca, Christian Oscar; Moragues Tosantos, María Dolores; Brena Alonso, Sonia; Rosa, Alcira Cristina; Pontón San Emeterio, JoséObjectives: Test several methods that allow the differentiation between Candida albicans and Candida dubliniensis, in an attempt to assess whether C. dubliniensis can be recovered from the oral cavity of teenagers wearing orthopedic oral prostheses. Material and Methods: Twelve Candida strains were isolated from the prosthesis as well as the palatal mucosa in contact with the dental prosthesis from 12 teenager patients wearing orthopedic oral prostheses. Differentiation between C. albicans and C. dubliniensis was achieved by a number of phenotypic tests (carbon assimilation by the commercially available ID 32C test, growth at 45ºC on Sabouraud glucose agar, abundant chlamydospore production on Casein agar, and reactivity with a C. dubliniensis antiserum) and the polymerase chain reaction (PCR). Serotyping of C. albicans was performed with monoclonal antibody B9E. Results: All 12 patients studied presented a Newton's type 2 denture stomatitis and in every patient the same Candida species were isolated from the prosthesis and the palatal mucosa in contact with the dental prosthesis. CHROMagar Candida and the germ tube test allowed the differentiation of isolates giving green colonies and a positive germ tube test from those giving violet colonies and a negative germ tube test. Only the isolate from patient 8 was stained by the C. dubliniensis antiserum and showed abundant chlamydospore production on Casein agar. Eight isolates did not grow at 45 ºC. Identification of all isolates was obtained by the ID 32C test. C. albicans was identified in 75% of patients, C. glabrata in 16,6% and C. dubliniensis in 8,3%. By using specific primers for typing C. dubliniensis, PCR allowed the identification of patient's 8 isolate as C. dubliniensis genotype 1. Conclusion: C. dubliniensis can be isolated from the oral cavity of teenagers wearing orthopedic oral prostheses and it is possible and technically amenable, the differentiation between C. albicans y C. dubliniensis using the ID 32C test, the observation of abundant chlamydospore production on Casein agar, the reactivity with a C. dubliniensis antiserum and the PCR.
- Linfoma angiocéntrico centrofacial(2005) Peral Cagigal, B.; Galdeano Arenas, M.; Crespo Pinilla, J.I.; García Cantera, J. M.; Sánchez Cuéllar, L.A.El linfoma angiocéntrico centrofacial es una neoplasia linfoide rara, con un diagnóstico a menudo difícil, debido al cuadro clínico inespecífico y a que muchas veces son necesarias varias biopsias para llegar a un diagnóstico correcto. Se trata de un linfoma no Hodgkin(LNH) agresivo, de localización preferente en el tracto respiratorio superior (sobre todo en cavidad nasal), y con un pronóstico ominoso, ya que la supervivencia media es de 12-18 meses aproximadamente(1). Predomina en orientales y sudamericanos, entre los 50-60 años de edad, y con ligera preferencia por el sexo masculino (2:1). Se presenta el caso de una paciente ecuatoriana que acude a nuestro servicio con edema hemifacial, rinorrea achocolatada y obstrucción respiratoria nasal de 1 mes de evolución, sin respuesta al tratamiento antibiótico y antiinflamatorio, que tras realizar varias pruebas diagnósticas se evidenció histológicamente la presencia de un linfoma T extranodal de tipo nasal (también llamado linfoma de células T angiocéntrico).
- Adenoma Pleomorfo de Glándula Lagrimal: presentación de un caso clínico(2005) Ostrosky, A.; Klurfan Federico, J.; Gonzalez, Maximiliano Jorge; Camaly, Diego; Villa, DiegoLos tumores de la glándula lagrimal son raros. Se presenta el caso clínico de un paciente masculino de 69 años de edad que consulta por un tumor (Adenoma Pleomorfo) en la región orbitaria derecha, de un año de evolución. Se realizó la escisión quirúrgica del mismo y la recuperación del paciente fue muy satisfactoria, sin recidivas tras un año de seguimiento. Se realiza también una revisión de las características clínicas, radiográficas e histopatológicas de estos tumores.
