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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2008. Vol. 13, no. 7
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- Periodontal status and treatment needs among spanish military personnel(2008) Mombiedro Sandoval, Rafael; Llena Puy, María CarmenIntroduction: Problems arising from poor gingival and periodontal health in military personnel account for around 10% of the emergencies of oral origin during deployments and manoeuvres. Consequently, it is important to ascertain the prior oral health situation among Spanish military personnel. Objective: To assess the periodontal health status and treatment needs of a population of Spanish Army personnel at the General Almirante Base at Marines, in the province of Valencia, and calculate the time required to cover the treatment needs of this population. Materials and methods: Observational cross-sectional study of periodontal health status in a representative sample of the population in question. The community periodontal index (CPI) was used in accordance with WHO criteria. The sample comprised 387 subjects, selected by systematically sampling those attending the sick bay at the base for different reasons. The examinations were carried out by a single examiner; the intra-observer Kappa index was 0.83. Data collection began in December 2003 and ended in July 2004. Results: All sextants were healthy in 7,2% of the sample. The most prevalent condition was the presence of calculus, especially in the younger population. 7.8% had 4-5 mm periodontal pockets and 2.3% had pockets of 6 mm or more, all in the over-25 age group. The women below 25 years of age were significantly more healthy than the men. The healthy sextants mean was 2.38, without differences by rank. Privates presented a significantly higher mean figure for sextants with bleeding, while officers and non-commissioned officers presented a higher average number of sextants with pockets. Practically every subject needed oral hygiene instructions and scaling and root planing but only 2.3%, all over 25 years old, required complex treatments. The estimated treatment time need is 1 hour per person per year.
- Nasopalatine duct cyst : report of 22 cases and review of the literature(2008) Escoda Francolí, Jaume; Almendros Marqués, Nieves; Berini Aytés, Leonardo; Gay Escoda, CosmeObjectives: Nasopalatine duct cysts (NPDCs) are the most common developmental, epithelial and non-odontogenic cysts of the maxillae. The present study describes the clinicopathological characteristics of 22 NPDCs and discusses their etiology, incidence, treatment and prognosis, with a review of the literature on the subject. Study design: A retrospective observational study was made comprising a period of 36 years (1970-2006), and yielding a series of 22 patients with histopathological confirmation of NPDC. Surgical treatment was carried out under local anesthesia and comprised the dissection and removal of the cyst adopting a usually palatine approach, with the preparation of an enveloping flap from 1.4 to 2.4. Results: No statistically significant correlation was observed between the size of the lesion and patient age, although the size of the cyst differed according to patient gender, with a mean NPDC diameter of 16 mm in males and 12 mm in females. In no case did we observe root reabsorption or loss of vitality of the upper incisors following surgery. The X-ray image was rounded in 15 cases and heart-shaped in the remaining 7 cases. In the majority of cases panoramic X-rays and periapical and occlusal X-rays sufficed to identify the lesion, though computed tomography was used in cases of doubt. Conclusions: The etiology of NPDC is unclear. Simple surgical resection is recommended, followed by clinical and radiological control to ensure correct resolution of the case.
- Papillary cystadenoma and cystadenocarcinoma of salivary glands : two unusual entities(2008) Gallego, Lorena; Junquera Gutiérrez, Luis Manuel; Fresno Forcelledo, Manuel Florentino; Vicente Rodríguez, Juan Carlos deCystadenoma and cystadenocarcinoma are rare salivary gland tumours histologically characterized by prominent cystic and frequently papillary growth. We present two cases of cystadenoma of a minor salivary gland (upper lip) and parotid cystadenocarcinoma respectively, captured between 834 salivary gland tumors studied in our hospital from 1980 to 2004. The authors review the clinical, histological, and biological features of these two unusual tumours, and differential diagnosis with other salivary glands neoplasms. Both entities usually reveal papillary proliferation of the epithelial lining and are composed of cells that possess bland cytomorphologic features. Differentiation of tumour types depends largely on the identification of actual infiltration of salivary gland parenchyma or surrounding connective tissue by either cystic or solid epithelium in cystadenocarcinomas. Step sections of a borderline tumour may yield unequivocal evidence of invasion. The authors discuss the problematic diagnosis between these rare neoplasms and with other tumours and compare histological findings of these two entities.
- Immediately restored dental implants for partial-arch applications : a literature update(2008) Carrillo García, Celia; Boronat López, Araceli; Peñarrocha Diago, MiguelThis article carries out a literature update on immediately restored dental implants in partially edentulous patients. A search was made in Medline of all articles published between the year 2000 and February 2007, including all articles published in both English and Spanish, in which immediate restoration of implants was made of partially edentulous areas with a minimum of 12 implants and six months follow-up. Certain decisive factors exist for the success of this technique in partially edentulous patients, such as primary stability, a roughened implant surface, and the absence of parafunctional habits in patients acceptable for this type of treatment. Following the analysis of these studies of immediate restoration of teeth in partially edentulous areas, a weighted mean survival of 95.39% was observed. In spite of the high success rate, major controversy still exists on this subject resulting in few studies and short follow-up periods, making the routine use of this technique questionable.
- Influence of local anesthethics with adrenalina 1:100.000 in basic vital constants during third molar surgery(2008) Vasconcellos, Ricardo José H.; Vasconcelos, Belmiro Cavalcanti; Genú, Paloma RodriguesObjective: The present study consists of a double-blind randomized clinical trial of paired samples. The purpose of the present study was thus to examine the effect of four different local anesthetics of the amida group (2% lidocaine with 1:100.000 adrenaline; 3% prilocaine with 0.30 IU felipressine; 2% mepivacaine with 1:100.000 adrenaline; and 4% articaine with 1:100.100 adrenaline) in patients undergoing extraction of lower third molars and verify the changes in systolic, diastolic and mean blood pressures, heart rate (HR) and oxygen saturation (SpO2 ). Study design: The sample comprised 168 extractions of lower third molars performed on 84 patients, divided into three groups, in whom lidocaine was the control anesthetic. The anesthetic solution applied differed from one side of the mouth to the other (control and experimental) in the same patient at different time periods. Results: The following significant variations were observed: increase in systolic blood pressure with mepivacaine and articaine; decrease in diastolic blood pressure with lidocaine; increase in heart rate with all the anesthetics, but with no statistical significance in the case of prilocaine. The variations in mean blood pressure and oxygen saturation were not statistically significant. All the hemodynamic changes returned to normal with no need for any further treatment. No complications were observed in any of the 168 procedures performed. Conclusion: All the anesthetics studied behaved, in relation to lidocaine, within the parameters of hemodynamic safety, although the best performance was that of prilocaine, followed by lidocaine. The measurement of systolic blood pressure, diastolic blood pressure and heart rate are appropriate monitoring methods for patients under the effects of local anesthetic, even healthy ones.
- pH and salivary sodium bicarbonate in cancer patients : correlation with seric concentration(2008) Rojas de Morales, Thais; Navas, Rita; Viera, Ninoska; Álvarez, Carmen; Chaparro, NeiraObjective: To determine the correlation between pH and bicarbonate of soda in blood and saliva in child and adolescent patients during the administration of 3g/m2 of methotrexate. Method: A controlled clinical test was performed on 23 patients diagnosed with Acute Lymphoblastic Leukemia. Ages ranged from 4 to 18. The Spearman Correlation Coefficient was used to interpret the data. Results: No significant correlation was found between pH levels and seric and salivary sodium bicarbonate. However, there was a significant correlation between the levels of sodium bicarbonate in the body fluids evaluated (rs 0.2576, p=0.0354). Conclusions: Changes modifying the microenvironment of the oral cavity probably do not allow saliva to be used to determine blood pH and seric bicarbonate.
- The burnout syndrome and associated personality disturbances : the study in three graduate programs in Dentistry at the University of Barcelona(2008) Alemany Martínez, Aurelia; Berini Aytés, Leonardo; Gay Escoda, CosmeObjective: Determine the presence of ?burnout? syndrome and characteristic personality patterns in the students and faculty of three graduate programs in Dentistry at the University of Barcelona: Department of Oral Surgery and Implantology, Department of Orthodontics and Department of Integrated Dentistry. Materials and Methods: The study was carried out in 78 dentists. The level of ?burnout? was evaluated using the Maslach Burnout Inventory, socio-demographic variables and, finally, the personality test. Results: Oral surgeons constituted the group of highlevel ?burnout?. The profile of an individual with a propensity to ?burn out? is a single man, with a median age of 27, that is in the first years of the graduate program and that combines studies with 30 hours of clinical practice and/or other work (p<0,05). Narcissistic and borderline are the types of personality most frequently found in the individuals that present ?burnout? syndrome (p<0,05). Conclusions: In general, no high levels of ?burnout? were registered in the studied population, only 2-3%, if applying strict definition of ?burnout?, and 10% if these criteria were amplified. We believe it is necessary to identify the individuals with a tendency towards ?burnout?, in order to establish preventive measures and avoid future negative behaviour at work as well as at the personal level.
- A retrospective analysis of gingival biopsied lesions in south indian population : 2001-2006(2008) Shamim, Thorakkal; Varghese, Vengal Ipe; Shameena, Pallikandi Maliyekkal; Sudha, SivasankarObjective: The purpose of the study was to analyze the frequency and distribution of gingival lesions in South Indian population. Study design: A retrospective study of 244 cases of gingival biopsies obtained over a period of 6 years from 1st January 2001 to 31st December 2006 in the Department of Oral Pathology, Government Dental College, Calicut was designed. The lesions were classified into neoplastic lesions and nonneoplastic lesions. Data regarding the age and sex of subjects and the location and type of lesions were obtained from biopsy register for each case. Results: Nonneoplastic lesions accounted for 75.5% of cases with pyogenic granuloma being the most frequent. Neoplasms accounted for 24.5% of biopsies (18% benign, 6.5% malignant). The most frequent benign and malignant neoplasms were peripheral ossifying fibroma and squamous cell carcinoma respectively. Conclusion: This study indicates that there are some differences in the frequency and distribution of gingival lesions in South Indian population. The data presented in this study can be used as a guide for additional multicenter studies in India.
- Dental management in renal failure : patients on dialysis(2008) Jover Cerveró, Alba; Bagán Sebastián, José Vicente; Jiménez Soriano, Yolanda; Poveda Roda, RafaelChronic renal failure is an important health care problem throughout the world, with an incidence of 337, 90, 107 and 95 new cases per million inhabitants/year in the United States, Australia, New Zealand and the United Kingdom, respectively. These figures moreover invariably tend to increase. During the progression of renal damage, clinical manifestations are noted in practically all body organs and systems, and 90% of all affected patients experience oral symptoms. The existing management options range from simple measures based on changes in diet and life style, to different forms of dialysis (hemodialysis and peritoneal dialysis), and also kidney transplantation. Given the multiple oral manifestations of chronic renal failure, and the different repercussions of its treatment upon the oral cavity, these patients require special considerations and precautions in the face of dental treatment. Consultation with the nephrologist is essential before any dental treatment is carried out, in order to determine the condition of the patient, define the best moment for dental treatment, introduce the necessary pharmacological adjustments, or to establish other important aspects for preventing complications in the dental clinic. The present study reviews the characteristics of the disease, the existing therapeutic options, and the considerations of relevance for the dental professional.
- A comparison of injection pain with articaine with adrenaline, prilocaine with phenylpressin and lidocaine with adrenaline(2008) Sumer, Mahmut; Misir, Ferhat; Celebi, Nükhet; Muglali, MehtapObjective: The objective of the present study was to investigate the pain on injection of articaine with adrenaline, prilocaine with phenylpressin , and lidocaine with adrenaline. Study Design: The study sample was comprised of 497 consecutively seen patients received 497 maxillary buccal infiltration injections or inferior alveolar block injections of 4% articaine with 1:200.000 adrenaline, 3% prilocaine with 1.08mcg phenylpressin, or 2% lidocaine with 1:100.000 adrenaline. Immediately after the injection, patients were asked to rate their injection pain on a six-point scale. Results: There were no significant differences among the anesthetic solutions for injection pain. Patients usually reported mild or no injection pain for all of anesthetic administrations. Conclusion: Under the conditions of this study that lidocaine with adrenaline, articaine with adrenaline and prilocaine with phenylpressin seemed to be similar for pain on injection and they could be quite painless.
- Dental audit (I) : exact criteria of dental records; Results of a Phase-III study(2008) Martín García, María del pilar; Ríos Santos, José Vicente; Segura-Egea, Juan J.; Fernández Palacín, Ana; Bullón, PedroObjective: Evaluating the quality of dental records in the Faculty of Dentistry of the University of Seville (Spain). We attempted to collect and/or develop identifiable elements of dental care used to evaluate its appropriateness, as well as to measure its level of filling-in between 1999 and 2004 (Phase III of the record audit). Method: The 46 criteria used to evaluate dental care are shown, measuring ?in 50 dental records randomly chosen within a 5-year-time period? their level of filling-in (Phase III of a health audit). Results: A low level of filling-in was observed in all quality criteria defined. No record was found to be free from errors. A maximum of 36 criteria out of 46 was fulfilled (mean of 20.8). Conclusions: The standard of appropriate filling-in was only met in 12 criteria (75 %), the results being poor, due to the importance which clearly deficient aspects related to diagnosis and treatment plan have in the process of patient care. For such reason, we suggest a remedial action (Phase IV) developing a new model of dental record and its subsequent re-evaluation (Phase V), which will be subject to analysis in the second part of this paper.
- Lichen sclerosus of the oral mucosa : a case report(2008) Jiménez Soriano, Yolanda; Gavaldá Esteve, Carmen; Carbonell Pastor, Enrique; Margaix Muñoz, María; Sarrión Pérez, María GraciaLichen sclerosus or lichen sclerosus et atrophicus is a chronic inflammatory disease predominantly affecting the genital mucosa and skin. Clinically, it is characterized by white atrophic plaques in the anogenital region. The lesions are generally asymptomatic, but may cause discomfort with itching and pain. Extragenital mucosal involvement is very unusual, and lesions limited to the oral mucosa are even less frequent. Knowledge of such lesions is important in order to establish a differential diagnosis with other white oral lesions, and histological confirmation is required. We present the case of a 31-year-old woman with a well delimited, pearly white lesion located in the upper gingival mucosa, lip mucosa and adjacent skin. The lesion had led to loss of periodontal attachment of the affected tooth (2.3), causing pain in response to tooth brushing. The biopsy confirmed lichen sclerosus, and treatment was provided in the form of intralesional corticoid injections, followed by improvement of the mucosal lesion, though without recovery of the periodontal loss.
- Evaluation of clinical dental variables to build classifiers to predict celiac disease(2008) Mina, Silvia; Azcurra, Ana Isabel; Riga, Carolina; Cornejo, Lila Susana; Brunotto, MabelObjective: The aim of this study was to evaluate the use of salivary variables to build statistical models for predicting celiac disease in symptomatic children. Materials and Methods: the study group consisted of 52 children with celiac disease diagnosed by bowel biopsy, grade III or IV (4 to 12 years old, both sexes) and 23 healthy children as a control group. A logistic regression model was applied to evaluate an individual?s belonging to one group or another. The performance of the model was evaluated by the value of area under the ROC curve. The salivary variables included in the model were the concentration of total proteins, calcium, Ca / P molar ratio, buffer capacity and salivary flow. Results: The total proteins (p = 0.0016) and Ca / P molar ratio (p = 0.0237) variables were significantly associated with the celiac condition. The value of the area under the ROC curve, estimated from the probabilities of the logistic model, showed that salivary component values allow the celiac condition of patients to be predicted with 85% accuracy (p <0.0001). Conclusion: Logistic discriminant analysis built with salivary variables shows that these are good for predicting this eating pathology with 85% accuracy.
