Marginal Bone Loss in Implants Placed in Grafted Maxillary Sinus
Purpose The purpose of this study is to evaluate the vertical and horizontal graft bone resorption (GR) in grafted maxillary sinuses and the marginal bone loss (MBL) around implants placed in the sinuses with different prosthetic connections and to determine the effect of other clinical factors on these tissue responses at 6 and 18 months postloading. Material and Method A total of 254 implants were placed in 150 grafted maxillary sinuses of 101 patients (51.5% female) with mean age of 52.2 years (range, 32–82 years). GR and MBL measurements were made in implants placed with two different prosthetic connections (internal and external) at 6 and 18 months postloading. The complex samples gene…
Post-extraction mesio-distal gap reduction assessment by confocal laser scanning microscopy - a clinical 3-month follow-up study
[EN] AimThe aim of this 3-month follow-up study is to quantify the reduction in the mesio-distal gap dimension (MDGD) that occurs after tooth extraction through image analysis of three-dimensional images obtained with the confocal laser scanning microscopy (CLSM) technique. Materials and MethodsFollowing tooth extraction, impressions of 79 patients 1month and 72 patients 3months after tooth extraction were obtained. Cast models were processed by CLSM, and MDGD changes between time points were measured. ResultsThe mean mesio-distal gap reduction 1month after tooth extraction was 343.4m and 3months after tooth extraction was 672.3m. The daily mean gap reduction rate during the first term (bet…
Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: a systematic review
Background: Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods: A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment . Re…
Drug-induced burning mouth syndrome: a new etiological diagnosis
Burning mouth syndrome (BMS) is defined as a burning sensation of the oral mucosa, in the absence of specific oral lesions. The underlying etiology remains unclear. Peripheral alterations may be related to the density or reactive capacity of the oral mucosal membrane receptors - these being largely influenced by BMS-related risk factors such as stress, anxiety, the female gender, climacterium and advanced age. The present study compiles the cases of BMS induced by drugs reported in the literature, and attempts to draw a series of conclusions. A search was conducted in the PubMed® database using the following key words: burning mouth syndrome, drug-induced, antihypertensive and chemically-in…
Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross-sectional study
Aim We explored the association between obesity and periodontitis with the aim of determining the possible role of insulin resistance (IR) in this relationship. Materials and Methods A total of 212 subjects –110 obese and 102 lean individuals– were evaluated for periodontal disease and divided according to IR: a lean group without IR (LWIR); an obese group without IR (OWIR); and an obese group with IR (OIR). Anthropometric, metabolic, inflammatory and periodontal parameters were evaluated. Results Periodontitis was more prevalent in obese (80.9%) than in lean subjects (41.2%), with the former group showing a risk of periodontitis six-fold that of the latter. Obese subjects as a whole displa…
Marginal bone loss around implants placed in maxillary native bone or grafted sinuses: a retrospective cohort study
Objectives To assess differences in marginal bone loss around implants placed in maxillary pristine bone and implants placed following maxillary sinus augmentation over a period of 3 years after functional loading. Material and methods Two cohorts of subjects (Group 1: Subjects who received sinus augmentation with simultaneous implant placement; Group 2: Subjects who underwent conventional implant placement in posterior maxillary pristine bone) were included in this retrospective study. Radiographic marginal bone loss was measured around one implant per patient on digitized panoramic radiographs that were obtained at the time of prosthesis delivery (baseline) and 12, 24, and 36 months later…
Clinico-therapeutic management of osteoradionecrosis: A literature review and update
In the management of head and neck cancer, radiotherapy is usually a coadjuvant to surgery, or is applied on a palliative basis. The most important complication of such radiotherapy is osteoradionecrosis, which manifests as an area of exposed necrotic bone in the maxillae or mandible that fails to heal during at least three months. In most cases osteoradionecrosis gradually progresses, becoming more extensive and painful, and its late manifestations comprise infection and pathological fracture. The present study provides a literature review and update on the risk factors underlying osteoradionecrosis, its clinical and diagnostic particulars, prevention, and most widely accepted treatment op…
Salivary flow and xerostomia in patients with type 2 diabetes
Background: Saliva is secreted by the major and minor salivary glands. There are a number of physiological factors that can reduce this secretion such as age, sex, body weight, number of teeth present in the mouth or time of day. This decrease may also be caused by the use of certain drugs, radiotherapy for head and neck cancer, chronic rheumatic diseases such as Sjögren's syndrome and other systemic disorders such as diabetes mellitus (DM). Objective of this study was to investigate the effect of type 2 DM on salivary secretion and its relation to the sensation of xerostomia. Methods: Forty-seven patients with type 2 DM and 46 healthy individuals, aged 40-80, participated in the study. Sam…
COVID-19 and Periodontitis: A Dangerous Association?
Manejo odontológico en el paciente cirrótico
Resumen The present article provides a brief review of dental management in patients with cirrhosis. It focusses on problems related to infections, haemorrhagic events, and treatment with commonly used drugs in odontology.
Oral implants in patients receiving bisphosphonates : a review and update
This rewiew was mad to establish the convenience of dental implant treatment in patients receiving bisphosphonates or programmed to receive such drugs, with a description of their mechanisms of action and the way in which they can affect the mandibular or maxillary bone of dental implant candidates. In turn, a description is provided of the key elements for evaluating the benefit-risk ratio in patients treated with bisphosphonates who require oral surgery. Clinicians must be aware of the potential risk of osteonecrosis in patients treated with bisphosphonates via the oral or intravenous route. When bisphosphonates are administered via the intravenous route, all invasive oral procedures (inc…
Chronic periodontitis impairs polymorphonuclear leucocyte-endothelium cell interactions and oxidative stress in humans.
Aim To evaluate the relationship between oxidative stress parameters in polymorphonuclear leucocytes (PMNs) and PMN-endothelial cell interactions in patients with chronic periodontitis (CP) according to different degrees of severity of the disease. Materials and methods For this cross-sectional study, 182 subjects were divided into four groups according to degree of CP: without CP (n = 37), mild CP (n = 59), moderate CP (n = 51), and severe CP (n = 35). We determined anthropometric and biochemical variables, periodontal parameters, inflammatory markers, oxidative stress parameters (superoxide and mitochondrial membrane potential), and PMN-endothelium cell interactions (rolling flux, velocit…
Training adults and children with an autism spectrum disorder to be compliant with a clinical dental assessment using a TEACCH-based approach
The specific neuropsychological and sensory profile found in persons with autism spectrum disorders complicate dental procedures and as a result of this, most are treated under general anesthesia or unnecessary sedation. The main goal of the present study was to evaluate the effectiveness of a short treatment and education of autistic and related communication-handicapped children-based intervention program (five sessions) to facilitate a 10-component oral assessment in children (n = 38, aged 4¿9 years) and adults (n = 34, aged 19¿41) with autism spectrum disorder (with or without associated intellectual disability). The assessment ranges from entering into the examination room to the evalu…
Clinical prevalence of drooling in infant cerebral palsy
Objective: To determine the prevalence and severity of drooling in infant cerebral palsy (ICP) and analyze the possible surgical, pharmacological, myofunctional and novel alternative approaches to treatment of this disorder. Methods: A clinical study is made of a group of patients with ICP (cohort) and aged between 4 and 34 years, visiting a dental clinic for disabled patients. The classification of Thomas-Stonell and Greenberg was used to assess the presence and severity of drooling. Results: Of the total of 50 patients evaluated (52% males and 48% females), 58% presented drooling (mild in 44.4% and moderate to severe in 27.7%). Conclusion: Over half of the patients with ICP presented droo…
Levels of serum retinol-binding protein 4 before and after non-surgical periodontal treatment in lean and obese subjects: An interventional study
AimWe aimed to evaluate serum RBP4 levels before and after periodontal therapy in lean and obese subjects with chronic periodontitis (CP) in order to determine its possible association with periodontitis. Materials and MethodsThis is an interventional study for which a total of 112 lean and 119 obese subjects were recruited. Patients with CP were evaluated before and after three months of non-surgical periodontal treatment. Periodontal, anthropometric, biochemical parameters and serum levels of TNF-, IL-6, hs-CRP and RBP4 were assessed. ResultsSerum RBP4 levels were associated with an increased probability of periodontitis (OR=1.60; 95% CI: 1.02-2.50), showing patients with CP to have highe…
Confocal laser scanning microscopy for the study of the morphological changes of the postextraction sites
A better understanding of the remodeling process of postextraction sockets is essential in dental treatment planning. The aim of this study was to evaluate whether confocal laser scanning microscopy (CLSM) can be applied to imaging contour changes of postextraction sites, as well as to its quantification with image analysis of obtained three-dimensional images. This work describes a new application of the CLSM technique. The system used was the OLS3100-USS, LEXT model (Olympus((R))). CLSM was used for the surface analysis of the extraction site. The measurements taken with CLSM were: (1) mesio-distal distance, (2) alveolar ridge thickness, and (3) vestibular and lingual alveolar ridge heigh…
Chlorhexidine in the prevention of dry socket: Effectiveness of different dosage forms and regimens
Dry socket (DS) is a potential postoperative complication of dental extractions. It is clinically diagnosed by the presence of a denuded socket secondary to premature loss of the blood clot, and manifests as slight discomfort for the patient, followed by sudden worsening with intense or lancing pain.Since the underlying etiology is not clear, the best treatment is prevention. Chlorhexidine (CHX) is an antiseptic that acts upon the bacteria of the oral cavity, and is widely used in dental practice.Objectives: A metaanalysis is made of the different CHX treatment regimens used for the prevention of DS, with the proposal of a management protocol designed to maximize the efficacy of such treatm…
Cocaine-related oronasal communication and hard palate destruction
Four cases of midpalatal perforation in cocaine abusers are presented. Other potential etiological processes are discussed to establish an adequate differential diagnosis. These patients were treated at our department, due to the drawback promoted by the establishment of oronasal communication that was provided after an accurate diagnosis. Histopathological evaluation of the lesion margins were conducted in two of the four cases, and yielded no evidence of vasculitis or active cocaine abuse. Therapeutic approach consisted of reconstructive surgeries and/or sealing prostheses. Histological assessment of oronasal communication margins could be useful in establishing the persistence of active …
Relationship Between Surgical Difficulty of Third Molar Extraction Under Local Anesthesia and the Postoperative Evolution of Clinical and Blood Parameters.
To determine whether the Pederson scale is a good predictor of the surgical difficulty of third molar extraction and establish whether such surgical difficulty is directly related to the postoperative course as assessed from clinical (pain, inflammation, and trismus) and blood (C-reactive protein, interleukin-6 [IL-6], and fibrinogen) parameters.A prospective observational study was conducted of 2 groups of patients who underwent simple or surgical third molar extraction under local anesthesia. Clinical and blood parameters and possible complications were recorded for 1 week after extraction.A total of 118 patients were studied. Surgical difficulty as predicted by the Pederson scale showed …
Dietary therapy and non-surgical periodontal treatment in obese patients with chronic periodontitis.
Aim The effect of dietary weight loss intervention on periodontal therapy is unknown. Therefore, we aimed to evaluate whether weight loss improves the response of obese subjects to non-surgical periodontal treatment. Materials and methods This interventional study in obese patients was conducted at the University Hospital Dr. Peset (Valencia, Spain). Patients were divided into two groups with and without dietary therapy. All participants received non-surgical periodontal treatment. Periodontal, anthropometric and biochemical parameters were assessed at baseline and 12 weeks. Results A total of 78 patients were re-evaluated after intervention. All periodontal parameters improved in both grou…
Association between Periodontal Diseases and Polycystic Ovary Syndrome: A Systematic Review
Background: A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Therefore, the aim of this study was to evaluate the association between periodontal disease—gingivitis and CP—and PCOS. Materials and Methods: The PICO (Participants, Intervention, Control, and Outcomes) question was as follows: “Is there an association between PCOS and CP?” A systematic review of three databases—PubMed, Embase and Scopus—was performed following PRISMA (Preferr…
Vertical guided bone regeneration with bioabsorbable barriers.
Guided bone regeneration (GBR) is a very useful surgical technique to increase limited alveolar bone for implant placement. The use of non-resorbable barriers is well established; however, bioabsorbable collagen membranes may simplify the surgical technique and make it more predictable.Vertical ridge augmentation was performed on 11 patients at the time of implant placement. The part of the implant out of bone was covered with autogenous bone/graft, and a slow-resorption collagen membrane was placed on top. Gingival tissues were closed with horizontal mattress and interrupted sutures. Second-stage surgery was performed 4 to 6 months later, and healing abutments were placed. The length of th…
Treatment of xerostomia and hyposalivation in the elderly: A systematic review
Background: Therapeutic strategies for xerostomia, regardless of etiology, have so far not had definitive or clearly effective results. Objectives. To systematically revise the latest scientific evidence available regarding the treatment of dry mouth, regardless of the cause of the problem. Material and Methods: The literature search was conducted in March 2015, using the Medline and Embase databases. The “Clinical Trial”, from 2006 to March 2015, was carried out in English and only on human cases. The draft of the systematic review and assessment of the methodological quality of the trials was carried out following the criteria of PRISMA (Preferred Reporting Items for Systematic Reviews an…
Effect of non-surgical periodontal treatment with or without doxycycline on the periodontium of type 1 diabetic patients
Aim: The present investigation was performed to study how type 1 diabetics responded to non-surgical periodontal treatment with and without adjunctive doxycycline. Method: Sixty diabetic type 1 patients (mean age 35.3 +/- 9 years) with moderate-to-severe periodontal disease were selected and divided into two groups of 30 patients each. Both groups were sex and age matched and had similar amounts of periodontal destruction. Plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical attachment levels (CAL) were recorded. Group 1 (30 patients) was treated with oral hygiene instruction, scaling and root planing, chlorhexidine rinses twice a day and doxycycline (100 mg/day for…
Interactions between ibuprofen and antihypertensive drugs : Incidence and clinical relevance in dental practice
It has been well documented in the literature that ibuprofen interacts with different groups of antihypertensive drugs (beta-adrenergic blockers, alpha-adrenergic blockers, diuretics and angiotensin-converting enzyme inhibitors), reducing their antihypertensive activity. The mechanism of action of ibuprofen involves inhibition of the enzyme cyclooxygenase, thereby inhibiting the synthesis of inflammatory prostaglandins and vasodilatory prostaglandins that increase renal blood flow and thus favor the excretion of water and sodium. More than five days of treatment with both drugs are normally required for the interaction to manifest. Although the changes in blood pressure resulting from this …
Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study
Aim: The primary objective of this pilot study was to evaluate the effect of non-surgical periodontal treatment. The secondary aim was to evaluate the effect of dietary therapy on both parameters of oxidative stress in leukocytes and leukocyte-endothelial cell interactions in an obese population. Methods: This was a pilot study with a before-and-after design. Forty-nine obese subjects with periodontitis were randomized by means of the minimization method and assigned to one of two groups, one of which underwent dietary therapy while the other did not. All the subjects underwent non-surgical periodontal treatment. We determined periodontal, inflammatory and oxidative stress parameters&mdash