Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2014. Vol. 19, no. 2

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    Efficacy of platelet-rich plasma applied to post-extraction retained lower third molar alveoli. A systematic review
    (2014) Barona Dorado, Cristina; González Regueiro, Iria; Martín Ares, María; Arias Irimia, Óscar; Martínez González, José María
    Dental retentions have a high prevalence among the general population and their removal can involve multiple complications. The use of platelet rich plasma has been proposed in an attempt to avoid these complications, as it contains high growth factors and stimulates diverse biological functions that facilitate the healing of soft and hard tissues. Objectives: To evaluate the available scientific evidence related to the application of platelet-rich plasma in the post-extraction alveoli of a retained lower third molars. Material and Methods: A systematic review of published literature registered in the Medline, EMBASE, Cochrane and NIH databases. The following categories were included: human randomized clinical studies. Key search words were: platelet rich plasma; platelet rich plasma and oral surgery; platelet rich in growth factors and third molar. Results: Of 101 potentially valid articles, seven were selected, of which four were rejected as they failed to meet quality criteria. Three studies fulfilled all selection and quality criteria: Ogundipe et al.; Rutkowski et al.; Haraji et al. The studies all measured osteoblast activity by means of sintigraphy, and also registered pain, bleeding, inflammation, temperature, numbness as perceived by the patients, radiological bone density and the incidence of alveolar osteitis. Conclusions: Scientific evidence for the use of PRP in retained third molar surgery is poor. For this reason rando - mized clinical trials are needed before recommendations for the clinical application of PRP can be made.
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    Hospital dental practice in special patients
    (2014) Silvestre Rangil, Javier; Silvestre Donat, Francisco Javier; Espín Gálvez, Fernando
    Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physi - cal and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Be - fore starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind
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    Epidemiology of pediatric facial trauma in Chile: a retrospective study of 7,617 cases in 3 years
    (2014) Collao González, Carolina; Carrasco-Labra, Alonso; Sung-Hsieh, Hsiao-Hsin; Cortés Araya, Juan
    Objectives: To describe the epidemiology of facial trauma injuries in a group of Chilean children aged 15 years or less. Study Design: Retrospective study of case series. Between 2006 and 2009, clinical records of 293,090 patients were reviewed. Data of patients with trauma injuries to the face were collected and evaluated for: age, sex, day and month of hospital admission, cause of injury, anatomical location, type of injury and presence of associated injuries. Results: A total of 7,617 patients with 8,944 injuries were found. Boy to girl ratio was 1,7:1. Preschool age children were most frequently affected. Main cause of injury were falls, soft tissue injuries the most common type of injury. Associated injuries occurred in 11% of cases. Conclusions: Facial trauma presents a significant frequency in the group of Chilean children studied. Preeschool age boys were prone to present facial trauma of mild severity associated to falls.
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    A clinical-pathological and survival study of oral squamous cell carcinomas from a population of the north of Portugal
    (2014) Monteiro, Luís Silva; Amaral, José Barbas do; Vizcaíno, José Ramón; Lopes, Carlos Alberto; Torres, Fernando Oliveira
    Objectives: Our aim was to analyze the clinical, pathological, and outcome characteristics of oral squamous cell carcinomas (OSCC) from a population of the north of Portugal. Material and Methods: We conducted a descriptive study of 128 OSCC diagnosed between the years of 2000 and 2010 in the Centro Hospitalar do Porto. Through of the review of the clinical records we studied several clinical, pathological, and outcome variables. The overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method and log-rank test. Cox regression method was used for multivariate analysis. Results: Of 128 patients with OSCC, 83 (64.8%) were male and 45 (35.2%) were female, (mean age of 62.13±15.57 years). The most affected location was the tongue (n=52; 40.6%). The most common cause of reference was a nonhealing ulcer (n=35; 28.9%) followed by oral pain (n=27; 22.3%). Sixty (60.6%) patients were tobacco consumers and 55 (57.3%) alcohol consumers. The cumulative 3-years OS rate was 58.6% and DFS was 55.4%. In multivariable analysis for OS, we found an adverse independent prognostic value for advanced tumour size (p<0.001) and for the presence of perineural permeation (p=0.012). For DFS, advanced stage tumours presented adverse independent prognostic value (p<0.001). Conclusions: OSCC occurred most frequently in males, in older patients, and in patients with tobacco and/or alcohol habits. TNM and tumour stage additionally to the perineural permeation were the most important prognostic factors for the survival of these patients, contributing to identify high-risk subgroups and to guide therapy.
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    Dental treatment for handicapped patients: sedation vs general anesthesia and update of dental treatment in patients with different diseases
    (2014) Corcuera Flores, José Ramón; Delgado Muñoz, José María; Ruiz Villandiego, José Cruz; Maura Solivellas, Isabel; Machuca Portillo, Guillermo
    Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. Ac - cording to this situation we can opt for an outpatient treatment without any kind of previous medication, a treat - ment under conscious or deep sedation or a under general anesthesia treatment. With this systematic review is intended to help clarify in which cases patients should be treated under general anesthesia, sedation (conscious or deep) or outpatient clinic without any medication, as well as clarify what kind of treatments can be carried in private dental clinics and which should be carried out in a hospital. It will also discuss the most common diseases among this group of patients and the special care to be taken for their dental treatment.
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    Soft tissue cell adhesion to titanium abutments after different cleaning procedures: preliminary results of a randomized clinical trial
    (2014) Canullo, Luigi; Peñarrocha Oltra, David; Marchionni, Silvia; Bagán Debón, Leticia; Peñarrocha Diago, María; Micarelli, Costanza
    Objectives: A randomized controlled trial was performed to assess soft tissue cell adhesion to implant titanium abutments subjected to different cleaning procedures and test if plasma cleaning can enhance cell adhesion at an early healing time. Study Design: Eighteen patients with osseointegrated and submerged implants were included. Before re-opening, 18 abutments were divided in 3 groups corresponding to different clinical conditions with different cleaning processes: no treatment (G1), laboratory customization and cleaning by steam (G2), cleaning by plasma of Argon (G3). Abutments were removed after 1 week and scanning electron microscopy was used to analyze cell adhesion to the abutment surface quantitatively (percentage of area occupied by cells) and qualitatively (aspect of adhered cells and presence of contaminants). Results: Mean percentages of area occupied by cells were 17.6 ± 22.7%, 16.5 ± 12.9% and 46.3 ± 27.9% for G1, G2 and G3 respectively. Differences were statistically significant between G1 and G3 (p=0.030), close to significance between G2 and G3 (p=0.056), and non-significant between G1 and G2 (p=0.530). The proportion of samples presenting adhered cells was homogeneous among the 3 groups (p-valor = 1.000). In all cases cells presented a flattened aspect; in 2 cases cells were less efficiently adhered and in 1 case cells presented filipodia. Three cases showed contamination with cocobacteria. Conclusions: Within the limits of the present study, plasma of Argon may enhance cell adhesion to titanium abutments, even at the early stage of soft tissue healing. Further studies with greater samples are necessary to confirm these findings.
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    Anesthetic efficacy of Oraqix® versus Hurricaine® and placebo for pain control during non-surgical periodontal treatment
    (2014) Mayor Subirana, Gemma; Yagüe García, José; Valmaseda Castellón, E.; Arnabat Domínguez, Josep; Berini Aytés, Leonardo; Gay Escoda, Cosme
    Objectives: To evaluate the efficacy of Oraqix® during scaling and root planing (SRP) in comparison with 20% benzocaine and placebo. Study Design: 15 patients requiring 4 sessions of SRP were enrolled. For each patient, Oraqix®, Hurricaine®, vaseline or no anesthetic product were randomly assigned each to a quadrant. Treatment pain was evaluated on a 100 mm Visual Analog Scale (VAS) and on a Verbal Rating Scale (VRS). The amount of product administered, the need to re-anesthetise, patient and operator satisfaction and the onset of side-effects were also recorded. Results: Oraqix® was significantly better than nothing, with a reduction of VAS score to 13.3 units, but without significant differences with Vaseline or Hurricaine®. Oraqix® was better in VRS reduction than not using any anesthetic (p=0.001) or using vaseline (p=0.024), but similar to Hurricaine® (p=0.232). Conclusions: Oraqix® effectively controls pain in SRP procedures, with few side-effects and a good acceptance on the part of patients and clinicians.
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    Genetic basis of dental agenesis - molecular genetics patterning clinical dentistry
    (2014) Chhabra, Nidhi; Goswami, Mridula; Chhabra, Anuj
    Tooth agenesis is one of the most common congenital malformations in humans. Hypodontia can either occur as an isolated condition (non-syndromic hypodontia) or can be associated with a syndrome (syndromic hypodontia), highlighting the heterogeneity of the condition. Though much progress has been made to identify the developmental basis of tooth formation, knowledge of the etiological basis of inherited tooth loss is still lacking. To date, the mutation spectra of non-syndromic form of familial and sporadic tooth agenesis in humans have revealed defects in various such genes that encode transcription factors, MSX1 and PAX9 or genes that code for a protein involved in canonical Wnt signaling (AXIN2), and a transmembrane receptor of fibroblast growth factors (FGFR1). The aim of this paper is to review the current literature on the molecular mechanisms responsible for selective hypodontia in humans and to present a detailed overview of causative genes and syndromes associated with hypodontia.
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    Application of an oral health-related quality of life questionnaire in primary care patients with orofacial pain and temporomandibular disorders
    (2014) Blanco Aguilera, Antonio; Blanco Hungría, Antonio; Biedma Velázquez, Lourdes; Serrano del Rosal, Rafael; González López, Laura; Blanco Aguilera, Elena; Segura Saint Gerons, Rafael
    Objectives: To examine whether patients who report orofacial pain (OP) and temporomandibular disorders (TMD) have a poorer perception of their oral health-related quality of life and, if so, to what extent, and to analyze the association between oral health perception, sociodemographic variables and reported pain duration. Study Design: 407 patients treated at the OP and TMD units in the Healthcare District of Cordoba, Spain, diag - nosed following the standard criteria accepted by the scientific community - the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - were administered the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14). Bivariate and logistic regression analyses were performed to determine the de - gree of association between the patients` OHIP-14 score and pain duration, pain intensity, and various sociode - mographic variables. Results: The observed distribution was 89.4% women and 10.6% men. The mean OHIP-14 score was 20.57 ± 10.73 (mean ± standard deviation). A significant association (p<0.05) was found for gender, age, marital status, chronic pain grade, self-perceived oral health status and pain duration. Conclusions: The analysis of self-perceived oral health status in patients with OP and TMD, as measured by the OHIP-14, showed that oral health is perceived more negatively by women. Moreover, a one-point increase in the Chronic Pain Grade indicator increases the OHIP-14 indicator by 4.6 points, while chronic pain, defined as pain suf - fered by patients for one year or more, increases the OHIP-14 indicator by 3.2 points.
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    Alendronate-associated osteonecrosis of the jaws: a review of the main topics
    (2014) Paiva Fonseca, Felipe; Santos Silva, Alan Roger; Della Coletta, Ricardo; Vargas, Pablo Agustín; Lopes, Márcio Ajudarte
    Bisphosphonates is a group of inorganic pyrophosphates analogues that suppress bone resorption by inducing osteoclast inactivation, being frequently used for management of diseases affecting bone metabolism, bone metastases and bone tumors. However, since 2003 many cases describing the presence of necrotic bone exposures in the jaws have been described in patients receiving these drugs, what represent a significant complication of bisphosphonates treatment. The overall incidence of bisphosphonate-related osteonecrosis of the jaws is low, ranging from 0.7% to 12%, mainly observed in those patients receiving intravenously treatment. Osteonecrosis of the jaws associated to oral bisphosphonate, particularly alendronate, has also been reported by a number of authors. Considering that alendronate is one of the most used drugs worldwide, specially for treatment of osteoporosis, a better understanding of osteonecrosis of the jaws related to its use and how to manage these patients is extremely important. Therefore, in the current manuscript the authors aim to review the most important topics related to this pathological presentation.
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    Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: an in vivo study
    (2014) Moscoso, Saddy; Pineda, Kenneth; Basilio, Juan; Alvarado, Carlos; Roig Cayón, Miguel; Duran Sindreu, Fernando
    Med Oral Patol Oral Cir Bucal. 2014 Mar 1;19 (2):e202-5. Evaluation of Dentaport ZX and Raypex 6: An in vivo study e202 Journal section: Clinical and Experimental Dentistry Publication Types: Research Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: An in vivo study Saddy Moscoso 1 , Kenneth Pineda 1 , Juan Basilio 1 , Carlos Alvarado 2 , Miguel Roig 2 , Fernando Duran- Sindreu 3 1 MD, Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain 2 MD, DDS, PhD, Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain 3 Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain Correspondence: Dentistry Faculty Universitat Internacional de Catalunya C/Josep Trueta s/n. 08195 Sant Cugat del Vallès, Spain fduranst@hotmail.com Received: 10/02/2013 Accepted: 04/05/2013 Abstract Introduction: Raypex 6 is an electronic apex locator (EAL) that has not yet been tested in vivo. The purpose of this in vivo study was to compare the accuracy of two EALs: the Dentaport ZX and the Raypex 6. Material and Methods: The study involved 36 straight single-rooted teeth. A 10-K file was advanced until the EAL detected the major foramen. The file was fixed in a replaceable pattern of light-cured composite. The apical part of each canal was trimmed to expose the file tip. The distances from the file tips to the major foramen were measured. Results: Wilcoxon's signed Rank test found no significant differences between the Dentaport ZX and Raypex 6 in terms of their abilities to detect the major foramen (P = .52) The Dentaport ZX was accurate 82.35% of the time to ± 0.5 mm and 97.05% of the time to ± 1 mm, whereas the Raypex 6 was accurate 88.22% of the time to ± 0.5 mm and 100% of the time to ± 1 mm. Conclusions: No statistically significant differences were observed between the performance of the Dentaport ZX and Raypex 6 EALs under the in vivo clinical conditions used in this study.
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    Serotypes of Aggregatibacter actinomycetemcomitans in relation to periodontal status and geographic origin of individuals-a review of the literature
    (2014) Brígido, Jandenilson Alves; Silveira, Virginia Régia Sousa da; Rego, Rodrigo Otávio; Nogueira, Nádia-Accioly-Pinto
    Objectives: Several studies have focused on the relationship among serotype distribution, ethnical status and geo - graphic populations, and periodontal conditions. Studies that have investigated the prevalence and the distribution of A. actinomycetemcomitans serotypes and the relation between the different serotypes of the bacterium and periodontal status were reviewed. Material and Methods: A systematic literature search for publications regarding the distribution of A. actinomyc - etemcomitans serotypes in subgingival samples of periodontitis patients and periodontally healthy subjects by employing polymerase chain reaction (PCR) was conducted. Results: From the 85 studies identified in the first analysis, only 12 met all inclusion and exclusion criteria. Clinical isolates from diverse geographic populations with different periodontal conditions were evaluated. Serotypes a, b and c were largely found, and serotype c was the most prevalent. They were isolated from various periodontal conditions, including aggressive periodontitis. Conclusions: The available literature suggests that serotypes a, b, and c are globally dominant, serotypes d and e are rare, and the prevalence of the most recently identified serotype f is still unknown. It is widely accepted that distribution patterns of A. actinomycetemcomitans vary among subjects of different ethnicity and geographic re - gions. The correlation of different serotypes with various periodontal conditions remains unclear.
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    Comparison of the effect of naproxen, etodolac and diclofenac on postoperative sequels following third molar surgery: a randomised, double-blind, crossover study
    (2014) Akbulut, Nihat; Üstüner, Evren; Atakan, Cemal
    Objectives: To compare the three non-steroidal anti-inflammatory agents (NSAIDs) diclofenac potassium, etodol - ac and naproxen sodium in relation to pain, swelling and trismus following impacted third molar surgery. Study Design: The study was a randomized and a double-blinded study which included 42 healthy young individu - als with impacted third molars and bone retention. Patients were randomly assigned to 3 groups (n: 14) to which diclofenac potassium, naproxen sodium and etodolac were administered orally an hour before the operation. Im - pacted third molars were surgically extracted with local anaesthesia. Visual analog scales (VAS) were used to assess the pain in the 6 th , 12 th hours and on the 1 st , 2 nd , 3 rd , 5 th , and 7 th days postoperatively. Swelling was evaluated using ultrasound (US) and mouth opening (trismus) was measured with a composing stick pre and post operatively on the 2 nd and 7 th days respectively. Results: Regarding pain alleviation, diclofenac potassium was better than naproxen sodium and naproxen sodium was better than etodolac but these differences were not statistically significant. US measurements showed that the swelling on postoperative 2 nd day was significantly lowest with diclofenac potassium as compared to others (p= 0.027) while naproxen sodium and etodolac acted similarly (p=0.747). No difference was noted regarding trismus in any of the groups. Conclusions: NSAIDs (diclofenac, naproxen and etodolac) are somehow similarly effective for controlling pain and trismus following extraction of mandibular third molars but diclofenac potassium surpasses others in reduc - tion of swelling
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    Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period
    (2014) Barrera Núñez, María del Carmen de la; Yáñez Vico, Rosa María; Batista Cruzado, Antonio; Heurtebise Saavedra, Jean Michel; Castillo de Oyagüe, Raquel; Torres Lagares, Daniel
    Objectives: To evaluate the anti-inflammatory and analgesic effect of Bromelain (pineapple extract) administered orally in the postoperative after extraction of impacted lower molars. Study Design: This is a prospective, placebo-controlled, unicentric, double-blind study; the sample size was 34 patients. The pre and postoperative outcomes, evaluated on the third (D3) and eighth day (D8), included inflam - tion, pain and oral aperture, as well as the need for analgesics. One group received bromelain 150mg per day for three days and 100mg on days 4 to 7. The other group received placebo in the same dosage. All outcomes wer - recorded quantitatively and analyzed with the Mann-Whitney U test for independent samples. Results: Although there were no statistically significant differences between the treatment groups, a trend towards less inflammation and improved oral aperture was observed in the group that received bromelain, compared to the group that received placebo. This trend can be attributed completely to random reasons, since there is no statistical difference in the results. Conclusions: Further studies are necessary to analyze different administration patterns and doses of bromelain for the use in the postoperative of impacted third molars.
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    Identification of the mandibular landmarks in a pediatric population
    (2014) Cantekin, Kenan; Sekerci, Ahmet Ercan; Miloglu, Ozkan; Buyuk, Suleyman-Kutalmis
    Objectives: The aim of this study was to determine and compare the reliability to accomplish of common man - dibular landmarks and to determine the incidence of incisive canals, anterior looping, and lingual foramina in children from panoramic and CBCT images. Study Design: Panoramic and CBCT images from 100 children and adolescent patients were randomly selected. In order to grade the visibility of mandibular anatomical landmarks, a four-point rating scale was used. Results: In panoramic images, the mandibular canal could be observed in 92.5% of cases, with good visibility in 12.0%. The mental foramen could be observed in 44.5% of cases, while none had good visibility. Anterior looping of the mental nerve was present in 16.5% of the cases, and none had good visibility. An incisive canal could be identified in 22.5% of cases, with only 1.5% showing good visibility. The lingual foramen could be visualized in 61.0% of cases, with good visibility in 6%. In CBCT images, the mandibular canal, the mental foramen, and the lingual foramen could be observed in 100% of the cases, with good visibility in 51.0%, 98.5%, and 45.0% of cases, respectively. Anterior looping of the mental nerve was present in 26% of cases, with 2% having good visibility. An incisive canal could be identified in 49.5% of cases, with only 75% showing good visibility. Conclusions: This study confirms the applicability of CBCT images to visualize critical structures in children.