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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2006. Vol. 11, no. 1
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- Digital diagnosis records in orthodontics : An overview(2006) Paredes Gallardo, Vanessa; Gandía Franco, José Luis; Cibrián Ortiz de Anda, Rosa MaríaActualmente la tecnología digital es una realidad que cada vez se impone más en todos los ámbitos clínicos y, por tanto, existe una incorporación también de los ortodoncistas a la digitalización de los registros ortodóncicos diagnósticos. En este trabajo queremos hacer una valoración sobre las ventajas y desventajas, del uso de la radiografía digital, la fotografía digital así como de la última incorporación, los modelos de estudio digitalizados. Basados en encuestas previas, mostraremos la situación actual en nuestro país en cuanto al número de profesionales que utilizan estos registros digitales de manera sistemática.
- Colon adenocarcinoma with metastasis to the gingiva(2006) Álvarez Álvarez, Carlos; Iglesias Rodríguez, B.; Pazo Irazu, Susana; Delgado Sánchez Gracián, CarlosLa cavidad oral es lugar de asiento de tumores metastásicos, sobre todo con origen en mama y pulmón. La mayoría de los casos afectan por este orden a los huesos mandibular y maxilar, aunque en ocasiones se desarrollan sobre las partes blandas intraorales. Presentamos el caso de un paciente de 62 años diagnosticado de adenocarcinoma de colon sigmoide con metástasis ganglionares y hepáticas, que 6 meses después presenta una lesión vegetante en la encía, interpretada inicialmente como neoplasia primaria de encía, que tras ser biopsiada fue diagnosticada como adenocarcinoma intestinal metastásico. El estudio histológico es obligatorio para diferenciar un adenocarcinoma de los carcinomas de células escamosas, habituales en la zona, y las técnicas inmunohistoquímicas permiten diferenciar entre un tumor metastásico, sea intestinal o de otro origen, y un adenocarcinoma primario originado en glándulas salivares menores de la zona. La presencia de un tumor diseminado con extensión intraoral acarrea un pronóstico ominoso, aunque si se trata de una metástasis única es posible un tratamiento quirúrgico radical con una supervivencia mayor.
- At-home vital bleaching : a comparison of hydrogen peroxide and carbamide peroxide treatments(2006) Berga Caballero, A.; Forner Navarro, Leopoldo; Amengual Lorenzo, JoséEl blanqueamiento de los dientes vitales que realiza el/la paciente domiciliariamente con férulas bajo supervisión del/de la dentista es una alternativa interesante entre las que integran este tipo de terapéutica odontológica, ya sea, de forma aislada o combinada con alguna de las modalidades de tratamiento en la consulta. En este procedimiento blanqueador se usan peróxidos de baja concentración que se aplican sobre el esmalte dentario mediante una cubeta individualizada especialmente diseñada para ello. El objetivo del presente trabajo es analizar y comparar dos productos blanqueadores comerciales de diferente concentración indicados para esta técnica, VivaStyle (Vivadent) y FKD (Kin); el primero de ellos es un peróxido de carbamida al 10%, mientras que el segundo es un peróxido de hidrógeno al 3,5%. Se analizan los parámetros que deben ser controlados durante la puesta en práctica de este tipo de procedimiento y se presentan 6 casos (3 de ellos tratados con uno de los productos mencionados y los otros 3 con el otro) en los que se constata su capacidad blanqueadora y la aparición y la intensidad de hipersensibilidad postoperatoria. Los resultados obtenidos muestran que ambos productos son eficaces para la función para la que han sido desarrollados. En general, la hipersensibilidad dentaria es mínima.
- Parotid sialolithiasis in Stensen´s duct(2006) Torres-Lagares, Daniel; Barranco Piedra, Sebastián; Serrera Figallo, María Angeles; Hita Iglesias, Pilar; Martínez-Sahuquillo Márquez, A.; Gutiérrez Pérez, José LuisSalivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths resulting in salivary ectasia and even provoking the subsequent dilation of the salivary gland. Sialolithiasis accounts for 30% of salivary diseases and most commonly involves the submaxillary gland (83 to 94%) and less frequently the parotid (4 to 10%) and sublingual glands (1 to 7%). The present study reports the case of a 45-year-old male patient complaining of bad breath and foul-tasting mouth at meal times and presenting with a salivary calculus in left Stensen´s duct. Once the patient was diagnosed, the sialolith was surgically removed using local anesthesia. In this paper we have also updated a series of concepts related to the etiology, diagnosis and treatment of sialolithiasis.
- Osteonecrosis of the jaws and bisphosphonates : Report of three cases(2006) Pastor Zuazaga, Daniel; Garatea Crelgo, J.; Martino Gorbea, Raúl; Etayo Pérez, Amaya; Sebastián López, C.Bisphosphonates are recently acquiring increasing relevance in the treatment of several diseases. In line with the increased use of these compounds, cases of mandibular osteonecrosis, and to a lesser extent, maxillary osteonecrosis, are being reported. This necrosis is difficult to treat in patients who usually have a previously limited quality of life. A surgical performance carried out by oral and maxillofacial surgeons, stomatologists and odontologists might lead to bone exposure. A treatment based on conservation and as harmless as possible seems to be the most advisable way of acting with these patients in order to minimize the incidence and treat the complications, once the lesions have been ascertained. We report three cases treated in our service of osteonecrosis of the jaws after exodontics. This side effect should be remembered before starting any surgical treatment in these patients.
- Antibiotic susceptibility of the bacteria causing odontogenic infections(2006) Brescó Salinas, Miguel; Costa Riu, Noelia; Berini Aytés, Leonardo; Gay Escoda, CosmeObjetivos: Identificar la flora bacteriana y su susceptibilidad a varios antibióticos utilizados en infecciones odontogénicas de localización periapical y en las pericoronaritis del tercer molar inferior, para poder adaptar convenientemente el tratamiento antibiótico a las exigencias de tales infecciones, y evitar así los efectos secundarios y los sobretratamientos con antibióticos. Material y métodos: Se han seleccionado con unos criterios de inclusión y de exclusión a 64 pacientes que presentaban una infección odontogénica. Se recogieron muestras de las lesiones en condiciones de máxima asepsia, evitando la contaminación por flora saprófita bucal. Las muestras se sembraron en medios de cultivo apropiados y se incubaron en condiciones aeróbicas y anaeróbicas; finalmente se procedió a la identificación de los microorganismos aislados y a la determinación de su susceptibilidad antibiótica, los resultados se analizaron estadísticamente mediante la prueba t-Student (para muestras aparejadas y para una muestra). Resultados: Se aislaron un total de 184 cepas bacterianas, incluyendo cocos Gram positivo anaerobios facultativos (68%), bacilos Gram negativo anaerobios estrictos (30%), y bacilos Gram positivo anaerobios facultativos (2%). Independientemente del origen de la infección odontogénica los antibióticos que obtuvieron los mejores resultados en cuanto a mayor sensibilidad y menor resistencia estadísticamente significativos fueron respectivamente la amoxicilina/clavulánico y la amoxicilina (p<0,05). Discusión: Cada vez hay más estudios que indican el alto índice de resistencias a antibióticos en poblaciones bacterianas pató- genas que producen infecciones en territorios no bucodentales. A pesar de ello, los niveles de resistencia a los antibióticos en las infecciones odontogénicas no han seguido la misma tendencia, aunque se ha detectado para ciertos antibióticos un alto índice de resistencia. En nuestro trabajo hemos encontrado que los antibióticos de uso común que han obtenido mayor sensibilidad y menor resistencia han sido la amoxicilina en combinación con ácido clavulánico seguido de la amoxicilina.
- Treatment of temporomandibular joint ankylosis by gap arthroplasty(2006) Cavalcanti do Egito Vasconcelos, Belmiro; Viana Bessa Nogueira, Ricardo; Vago Cypriano, RafaelPurpose: The purpose of this paper is to show that gap arthroplasty improve mouth opening when treating TMJ ankylosis. Patients and methods: Eight patients with TMJ ankylosis were treated by gap arthroplasty. The patients were evaluated by at least twenty-four months (minimum 24 and maximum 48 months). Results: Of the eight patients (eleven joints), five (62.5%) had unilateral involvement and three patients (37.5%) had bilateral involvement. The mean age was 20 years ± 9 (range 3 to 30 years). The mean maximal incisal opening (MIO) in the preoperative period was 9.25 ± 6.41 mm and in the postoperative period it was 29.88± 4.16 mm. The complication of temporary facial nerve paresis was encountered in two patients (25%). No recurrence was observed in our series. Conclusions: Trauma was the major cause of tempomandibular joint ankylosis in our sample. Gap arthroplasty showed good results when treating TMJ ankylosis.
- Primary Intraosseous Carcinoma and Odontogenic Cyst : Three new cases and review of the Literature(2006) Aboul-Hons Centenero, Samir; Marí Roig, Antonio; Piulachs Clapera, Pedro; Juárez Escalona, Inma; Monner Diéguez, A.; Díaz Carandell, Artur; Lluch, José Miguel; Pericot Ayats, JosepIntroduction: The Odontogenic Primary Intraosseous Carcinoma (PIOC) are a rare group of malignant tumours with strict clinic and anatomy pathological diagnosis criteria. The different classification suggested for these tumours and the small amount of cases described in literature makes it hard to know exactly how many of the cases published until now are real. Material and methods: We present three new cases of PIOC originated from a previous cystic lesion that where treated in our Hospital. Two of them in the posterior jaw region where is more frequent, and the third in the upper jaw. We explain the procedure we used in each case and the aesthetic-functional reconstruction used witches are two fibula osseomiocutaneous free flaps and a bone graft of iliac crest and further placing of implants. The classification, the clinical and radiological diagnosis, the treatment and its survival are discussed. Results: in all three cases we were able to see in the anatomy pathological study an epithelial, exclusively without surrounding oral mucosa affectation or tissues near the lesion as well as the lack of tumorous pathology in other parts of the body. One of the patients died because of premature massive cervical recidiva while the other two patients are currently free form illness, for ten years one of them and fifteen months the other. Conclusions: the anatomy pathological study of all of the lesions of cystic characteristics at jaw level is very important because of the risk of coexisting with carcinomatous cells. The treatment of these tumours consists in practising aggressive surgery and, in some cases, radio and/or chemotherapy post intervention.
- Influence of smoking upon the postoperative course of lower third molar surgery(2006) López Carriches, Carmen; Gómez Font, Rafael; Martínez González, José María; Donado Rodríguez, ManuelObjectives: To determine whether smoking influences the postoperative course (pain and trismus) of lower third molar surgery, with a clinical evaluation of surgical wound condition and analysis of the possible differences between smokers and nonsmokers. Design: The study subjects were randomly distributed into two groups (smokers and nonsmokers) and subjected to lower third molar extraction in the Unit of Oral and Maxillofacial Surgery (Madrid Complutense University, Spain). The study variables were trismus after 7 days, the intensity of pain and the need for rescue medication during a period of one week. The surgical wound was also assessed (color, presence of plaque, etc.). Results: Two cases of postoperative infection were documented among the smokers, and postoperative trismus was found to be greater among the latter (p=0.05). Conclusions: There were no statistically significant differences between the two groups in terms of pain, though trismus was greater among the smokers. Smoking did not influence wound condition (color, marginal inflammation, appositioning of the margins, ulceration, etc.).
- Compressive osteotomes for expansion and maxilla sinus floor lifting(2006) Calvo Guirado, José Luis; Saez Yuguero, Rosario; Pardo Zamora, GuillermoAim: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, España) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA). Materials and methods: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson?s inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13 mm. Results: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm ± 1.25 mm was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm ± 0.15 mm. Conclusions: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient
- Physiological bases of bone regeneration I : Histology and physiology of bone tissue(2006) Fernández Tresguerres, Isabel; Alobera Gracia, M.A.; Canto Pingarrón, M. Del; Blanco Jérez, LuisBone is the only body tissue capable of regeneration, allowing the restitutio ad integrum following trauma. In the event of a fracture or bone graft, new bone is formed, which following the remodeling process is identical to the pre-existing. Bone is a dynamic tissue in constant formation and resorption. This balanced phenomena, known as the remodeling process, allows the renovation of 5-15% of the total bone mass per year under normal conditions (1). Bone remodeling consists of the resorption of a certain amount of bone by osteoclasts, likewise the formation of osteoid matrix by osteoblasts, and its subsequent mineralization. This phenomenon occurs in small areas of the cortical bone or the trabecular surface, called ?Basic Multicellular Units? (BMU). Treatment in Traumatology, Orthopedics, Implantology, and Maxillofacial and Oral Surgery, is based on the biologic principals of bone regeneration, in which cells, extracellular matrix, and osteoinductive signals are involved. The aim of this paper is to provide an up date on current knowledge on the biochemical and physiological mechanisms of bone regeneration, paying particular attention to the role played by the cells and proteins of the bone matrix.
- Mucosal varicosities : case report treated with monoethanolamine oleate(2006) Gomes, Carolina Cavalieri; Gomez, Ricardo Santiago; Vieira do Carmo, María Auxiliadora; Castro, Wagner Henriques; Gala García, Alfonso; Mesquita, Ricardo AlvesWe reported a case of varicosities in the buccal mucosa treated with sclerotherapy. The sclerosant agent used was the monoethanolamine oleate. After three sessions the lesions disappeared and the patient is follow-up.
- Adamantiades-Behçet disease : an enigmatic process with oral manifestations(2006) Eguía Del Valle, Asier; Villarroel Dorrego, Mariana; Martínez-Conde Llamosas, Rafael; Echebarria Goicouria, María Ángeles; Aguirre Urízar, José ManuelAdamantiades-Behçet disease (ABD) is a chronic multisystemic vasculitis that is able to affect any human organ or system Recurrent oral ulcers are a very important clinical sign. ABD is a worldwide pathology, which prevalence varies according to the population and geographic location. Although ABD has been known for ages, its aetiology remains an enigma. Genetic, immunological and microbiological factors have been associated. A wide spectrum of clinical manifestations (oral, genital, cutaneous, ocular, neurological, vascular and gastrointestinal) and an unpredictable evolution with repeated periods of exacerbation and remission are the most representative aspects of this pathology. The complex treatment of ABD requires a deep multidisciplinary cooperation; therefore, there is an extensive development of new therapeutic agents that have improved the prognosis of ABD. In this review were analysed the main etiological, clinical and therapeutic aspects of the disease.
- Burning mouth syndrome (BMS) : evaluation of thyroid and taste(2006) Felice, F.; Gombos, Fernando; Esposito, V.; Nunziata, M.; Scully, CrispianBackground Burning mouth syndrome (BMS) is a chronic, intraoral burning sensation seen mainly in middle-aged and post-menopausal females, without identifiable oral lesions or abnormal laboratory findings, but often associated with psychogenic disorders such as depression. The latter can have a range of causes, including hormonal. Objective Since there may be connections between BMS, psychogenic changes, hormonal changes and taste abnormalities , we have examined aspects of taste and thyroid function.. Patients and methods We selected 50 patients with BMS (study group) and 50 healthy subjects (control group) and analysed their ability to taste bitter, acid and spicy substances and analysed their thyroid function and Undertook thyroid echography. Results Taste sensation was normal in all controls. However, 30 of the patients with BMS reported ageusia for bitter taste and 2 had ageusia for acid. The use of pepper sauce ( Tabasco®) (spicy substance) produced a strong burning to the tongue in 28 patients of the BMS group but only in 10 controls. No control patients showed abnormality of thyroid function or echograpic abnormality. Five patients in the BMS group had biochemical evidence of hypothyroidism, 4 patients had raised levels of thyroid autoantibodies and, of the 41 remaining BMS patients, most (34) had thyroid echographic changes indicative of nodularity. Conclusions Hypothyroidism may be responsible for a negative influence on taste and consequent increase in trigeminal sensorial sensation (tactile, thermal and painful sensation).
- Gastroesophageal reflux diagnosed by occlusal splint tintion(2006) Cebrián Carretero, José Luis; López-Arcas Calleja, José MªThe gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.
- Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population(2006) Bravo, Inés María; Correnti de Plata, María; Escalona, Laura; Perrone, Marianella; Brito, Aubert; Tovar, Vilma; Rivera, HelenAim: To determine the prevalence of oral lesions in a HIV + group of patients, related to CD4 cell count and viral load in a Venezuelan population. Materials and methods: In the present study, we evaluated 75 HIV+adult patients, attended at the Center of Infectious Diseases, at the Faculty of Dentistry, Central University of Venezuela. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by flow cytometry, as well as viral load by RT-PCR (Amplicor HIV-RNA, TM test 1.5, Roche) Results: 85% (64/75) of HIV/AIDS patients showed associated HIV lesions. Oral Candidiasis constituted the most common lesion representing a 61% (39/64), followed by Oral Hairy Leukoplakia 53% (34/64); Oral Leukoplakia 34% (22/64), Melanic Hiperpigmentation 38% (18/64); Papilloma 13 (6/64), Lineal Gingival Erithema 8% (5/64); Aphtous Recurrent Stomatitis 5% (4/64) and Kaposi?s Sarcoma 5% (3/64). Only one case of the following lesions were represented by Non Hodgkin Lymphoma, Multifocal Epithelial Hyperplasia, Recurrent Herpes, Histoplasmosis and Molluscum Contagiosum. The patients with a viral load of 30.000 copies/mm3 exhibited oral lesions related with HIV, independent of CD4 cell count, although patients with CD4+ levels of 200 cel/mm3 were more susceptible to develop these lesions. Conclusions: The most common oral lesion was Oral Candidiasis followed by Oral Hairy Leukoplakia, Oral Leukoplakia and Melanic Hyperpigmentation. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+ cell count.
- Cowden?s syndrome : case report, with reference to an affected family(2006) Blanco, Verónica; keochgerián, VerónicaEl síndrome de Cowden es una rara genodermatosis caracterizada por múltiples hamartomas ubicados en tejidos y órganos diversos derivados de las tres hojas embrionarias. Las manifestaciones clínicas de la enfermedad de Cowden se explican especialmente por la mutación de un gen supresor tumoral, el PTEN cuyo cambio induce al crecimiento incoordinado de los tejidos. La importancia de esta enfermedad radica en la tendencia a la malignización de algunas de sus lesiones especialmente las de mama, tiroides y tracto génito-urinario. Esto ha determinado que se la considere como una entidad preneoplásica. A pesar de su variada expresión fenotípica esta entidad es generalmente desconocida. Esto determina que muchos casos pasen desapercibidos o sean diagnosticados tardíamente, de ahí la importancia del diagnóstico precoz de esta enfermedad que lleve al paciente a revisiones periódicas para prevenir enfermedades malignas. Se presenta aquí un caso familiar cuyo diagnóstico surge por los hallazgos clínicos detectados en la cavidad bucal y cuya alteración sistémica mas destacada es la presencia de pólipos hamartomatosos en el tracto digestivo en varios miembros de la familia.
- Clinical evaluation of dental and periodontal status in a group of oncological patients before chemotherapy(2006) López Galindo, Mónica Paula; Bagán Sebastián, José Vicente; Jiménez Soriano, Yolanda; Alpiste Illueca, Francisco M.; Camps Herrero, CarlosObjective: To evaluate the dental status of 88 cancer patients before chemotherapy. Material and methods: Eighty-eight patients with cancer in different body locations were studied and compared with a control group. Dental plaque was assessed by means of the Silness and Löe index, dental status with the DMFT index, and periodontal status with the modified CPI index. Results: In the oncological patients the mean Silness and Löe index was 1.28±0.11. Patients showed multiple missing teeth (mean number 7.55±0.80); the mean number of decayed teeth was 2.10±0.36; and the mean number of filled teeth was 2.27±0.37. As to periodontal status, the mean modified CPI index was 1.45±0.11. In the control group, the mean Silness and Löe index was 0.94±0.00. The mean number of decayed teeth was 1.21±0.25; the mean number of missing teeth was 4.97±0.67; and the mean number of filled teeth was 4.82±0.44. The mean modified CPI index was 1.29±0.10. Conclusions: Oncological patients in our study showed more dental plaque versus healthy patients and more decayed and missing teeth. However, patients in the control group showed more filled teeth than cancer patients. Periodontal status as determined by the modified CPI index was similar in both patient groups.
- Prevalence of the patients with history of hepatitis in a dental faculty(2006) Ilgüy, Dilhan; Ilgüy, Mehmet; Dinçer, Semanur; Bayirh, GündüzObjectives: The aim of the study is to investigate the prevalence of the dental patients who had a history of hepatitis. Study design: A total of 13.527 records of patients who were examined between October 1, 2002 and October 1, 2004 were reviewed retrospectively. The medical histories of patients were taken before routine clinical and radiographic examination. A dental software program was used for the collection of data. The chi-square test was utilized to evaluate correlations between different parameters. Results: The percentage of the patients who had a medical history of hepatitis was 7.9% (n=1065). Within the total patients; history of hepatitis A was found as 3.2% (n=438), hepatitis B was 2.3% (n=308), hepatitis C was 0.1% (n=16). The frequency of the patients who were hepatitis B carriers was 0.8% (n=113) and 17% (n=181) of patients did not know which type of hepatitis they had suffered from. Conclusions: Because dentists are particularly at risk for contacting hepatitis, a strict sterilization procedure is mandatory to prevent the transmission.
- Granulomatous facial reaction to injected cosmetic fillers : a presentation of five cases(2006) Poveda Roda, Rafael; Bagán Sebastián, José Vicente; Murillo Cortés, Judith; Jiménez Soriano, YolandaThe use of substances to augment soft tissues as aesthetic purpose is associated with, among other undesirable effects, the appearance of foreign body granulomas. The improvements made to these substances have reduced the incidence of adverse reactions, but not eliminated them. We present five cases of foreign body reactions to three different products, dimethylpolysiloxane (silicone), bovine collagen, and polylactic acid, which were injected into the subcutaneous cellular tissue of the patients (all five were women), between two and sixteen years before the appearance of the foreign body reaction. All five presented painless, diffuse facial tumefaction, of firm, elastic consistency. The magnetic resonance image (MRI) studies showed signs of intense inflammatory reaction in the affected areas. The histology revealed the presence of foreign body granulomas with giant multi-nucleated cells. The patients were treated with systemically administered corticoids, except in one case which did not require pharmacological treatment.
