0000000001030076
AUTHOR
Cosme Gay-escoda
Compliance of postoperative instructions following the surgical extraction of impacted lower third molars: A randomized clinical trial
Objectives: The understanding and adherence to postoperative care instructions are factors that influence the recuperation process after any surgical procedure. The aim of this study was to determine the percentage of patients who strictly follow the postoperative instructions after the extraction of an impacted lower third molar in relation to sociocultural level, preoperative anxiety scores and how postoperative information is provided to the patient. Study Design: Patients were randomly assigned to one of three different test groups according to how the postoperative instructions were presented: verbal, written and a group that received additional information. Before surgery, patients we…
Therapeutic management of the odontogenic keratocyst. An energetic approach with a conservative perspective and review of the current therapeutic options
Background Odontogenic keratocysts (OKC) are cystic lesions appearing in the jaws, usually asymptomatic with a progressive growth into the bone. Many of them are diagnosed by a routine radiological examination. Material and methods This study reports a 12-year-old girl that presented an asymptomatic large radiolucent unilocular lesion associated to the crown of 3.8 that caused displacement of the molar and the inferior alveolar canal. Differential diagnosis included OKC, unicystic ameloblastoma, ameloblastic fibroma, dentigerous cyst and orthokeratinized odontogenic cyst. Two surgical interventions were performed; first, a marsupialization, and 10 months after, the third molar extraction pl…
A retrospective radiographic evaluation of the anterior loop of the mental nerve: Comparison between panoramic radiography and cone beam computerized tomography
Objectives: To compare the prevalence and the length of mental loop, measured with panoramic radiography (PR) and cone beam computerized tomography (CBCT). Material and Methods: PG and CBCT images where analyzed by a single calibrated examiner to determine the presence and the position of the mental foramen (MF), its distance to the lower mandible border, the anterior length of the mental loop (ML) and the bone quality in 82 PR and 82 CBCT. Results: ML was identified in 36.6 % of PR and 48.8 % of CBCT. PR showed a magnification of 1.87 when compared to CBCT. The mean of anterior extension of the inferior alveolar nerve and the distance to the inferior border of the mandible was higher for P…
Odontogenic maxillary sinusitis and fungus ball development secondary to a dental root retained for more than 25 years. A case report
The displacement of a dental root fragment into the maxillary sinus is a serious complication of tooth extraction that can give rise to maxillary sinusitis. The condition can become chronic if the intrasinusal foreign body is not promptly removed, and Asp
Clinical significance of interleukin-1 genotype in smoking patients as a predictor of peri-implantitis: A case-control study
Background: Interleukin-1 (IL-1) is a proinflammatory cytokine that plays an important role in the pathogenesis of periodontitis, and so it might be useful to detect high-risk cases of peri-implantitis. It has been reported that IL-1 polymorphisms and smoking habit have a synergic effect, increasing the incidence of peri-implantitis. The aim of the present study was to evaluate the relationship between IL-1 gene polymorphisms and peri-implantitis in smoking patients. Material and Methods: A case-control study was performed in 27 patients with peri-implantitis and 27 patients with healthy implants. All patients included were smokers. IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C were identifie…
Recurrence rate of oral squamous cell papilloma after excision with surgical scalpel or laser therapy : a retrospective cohort study
Background The aim was to describe the recurrence rates of Oral Squamous Cell Papilloma (OSCP) following surgical treatment with surgical scalpel and two different lasers (CO2 or Er,Cr;YSGG) and to determine the clinical and histopathologic features of these lesions. Material and Methods A retrospective cohort study covering a period of 12 years (1997-2009) that included patients diagnosed of OSCP treated with surgical excision was performed. Data was processed using SPSS 22.0 (SPPS Inc. Chicago, USA) and a descriptive and bivariate analysis were conducted. Results A total of 37 histopathologically confirmed OSCP in 36 patients, 19 women (52.7%) and 17 men (47.2%) with an average age of 33.…
Analyses of odontogenic tumours : the most recent classification proposed by the World Health Organization (2017)
Background The fourth edition of the ‘’WHO Classification of Head and Neck Tumours’’ was published in January 2017 and includes a classification of odontogenic tumours. This review aims to examine the changes made in this new classification in comparison with the previous classification of 2005. Material and Methods An electronic search was conducted in the PubMed, Scopus and Cochrane databases with the keywords “odontogenic tumor”, “WHO classification” and “update”. Studies published from January 2009 to April 2019 with a high level of scientific evidence were included, but studies not published in English, epidemiological studies and studies with a low level of evidence were excluded. Res…
Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series
Background: The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods: A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and…
Antibacterial suture vs silk for the surgical removal of impacted lower third molars. A randomized clinical study.
Background The aim of this study was to evaluate the clinical and microbiological impact of an antibacterial suture (Monocryl® Plus) in the surgical removal of I3M. Material and Methods A “split-mouth”, prospective pilot clinical study was designed involving 20 patients programmed for the surgical removal of I3M. Each side was randomly sutured with Monocryl® Plus or silk suture and removed for microbiological study 72 hours and 7 days after surgery. Presence of SSI, wound bleeding and the degree of discomfort associated with each type of suture material (scored by means of a visual analog scale) were evaluated. The level of contamination of each material was observed under the scanning elec…
Retrospective clinicopathological study of 418 odontogenic cysts
Objectives: To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona (Spain). Study design: A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration,…
Simple bone cyst : a case report
Background Simple bone cysts (SBC) are intraosseous cysts devoid of an epithelial lining, asymptomatic and appearing in the jaw. In general, SBCs are discovered incidentally and tooth displacement or pathological fractures are very unusual. Material and methods This study reports a 16 years old man that presented an asymtomatic radiolucent unilocular lesion in the right ascending ramus. Differencial diagnosis included odontogenic keratocyst and dentigerous cyst. One surgical intervention was performed and consisted in the curettage of the bone walls. The lesion and some small samples of the bone wall were sent for the anatomopathological study. Results The anatomopathological exam confirmed…
Association between marfan syndrome and oral health status : a systematic review and meta-analysis
Background: The purpose was to identify and assess the existing scientific evidence from epidemiologic, non-experimental, observational studies of associations between Marfan’s syndrome and oral diseases. Material and Methods: Electronic literature searches in MEDLINE (OVID), The Cochrane Library, Scopus and the Web of Science were conducted to identify all relevant articles. Eligibility was based on inclusion criteria, and quality assessments were conducted. The outcome variables were probing depth, gingival margin, clinical attachment level, bleeding on probing, gingival status, periodontal status, tooth mobility, furcation involvement and decayed, missing and filled teeth index. After ex…
Thermal increment due to ErCr: YSGG and CO2 laser irradiation of different implant surfaces. A pilot study
Podeu consultar la versió en castellà http://hdl.handle.net/2445/118903
Periodontal health and esthetic results in impacted teeth exposed by apically positioned flap technique.
Objectives: This study evaluates the periodontal health status and the esthetic results of teeth subjected to orthodontic traction, after their exposure by an apically positioned flap. Study design: Fifteen patients were included in the study, ages between 11 and 28 years old. The fenestrated teeth and their homologous contralateral normally erupted teeth, used as control, were evaluated. Results: Statistically significant differences were found in the position of the gingival margin (p = 0.005), with an average distance between cemento-enamel junction (CEJ) and gingival margin of 2.47 mm (SD 1.19) in control teeth and of 1 mm (SD 1.31) in the operated teeth, and in the depth of palatal pro…
CBCT assessment of radicular volume loss after rapid maxillary expansion : a systematic review
Background The present systematic review analyzed the current literature to investigate whether rapid maxillary expansion (RME) causes radicular resorption, assessed by cone-beam computed tomography (CBCT). Material and methods Eighteen electronic databases and reference lists of studies were searched up to November 2017. Grey literature was also screened. To be included, articles must be human studies on growing subjects with transversal maxillary deficiency treated with maxillary expansion protocol and with 3-D radiographic assessment of radicular volume by CBCT images. Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics…
Pilomatrixoma. Review of 205 cases.
Podeu consultar la versió en castellà del document a: http://hdl.handle.net/2445/153543
Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. A crossover randomized controlled trial.
Objective: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed. Study Design: Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests. Results: Both solutions exhibited similar latency times and intraoperative effic…
A prospective, randomized, triple-blind comparison of articaine and bupivacaine for maxillary infiltrations
Objectives: To compare the clinical anesthetic efficacy of 0.5% bupivacaine and 4% articaine (both with 1:200.000 adrenaline) for anterior maxillary infiltration in healthy volunteers. Material and methods: A triple-blind split-mouth randomized clinical trial was carried out in 20 volunteers. A supraperiosteal buccal injection of 0.9 ml of either solution at the apex of the lateral incisor was done in 2 appointments separated 2 weeks apart. The following outcome variables were measured: latency time, anesthetic efficacy (dental pulp, keratinized gingiva, alveolar mucosa and upper lip mucosa and tissue) and the duration of anesthetic effect. Hemodynamic parameters were monitored during the p…
Periapical Microsurgery with an Endoscope and Microscope of Two Upper Central Incisors Already Subjected to Periapical Surgery 25 Years Ago
Introduction. The present clinical case describes periapical microsurgery with an endoscope and microscope in a patient already treated 25 years ago due to persistent periapical disease of the two central upper incisors, restored with poorly adapted crowns. Clinical Case. The first periapical surgery had been performed with silver amalgam as a retrograde filler material, causing grayish staining of the buccal mucosa. Periapical surgery was performed raising a submarginal flap with ostectomy and apicoectomy, retrograde cavity preparation with ultrasound tips, and filling with mineral trioxide aggregate (MTA). After soft tissue healing and complete bone regeneration of the lesion, retreatment…
Evaluation of the effectiveness of the photobiomodulation in the treatment of dentin hypersensitivity after basic therapy. A randomized clinical trial
Background: Dentin hypersensitivity (DH) in one of the most common causes of patient discomfort in the general population and its prevalence is higher in patients who have received basic or surgical periodontal treatment. Efficiency of the diode laser with different wavelengths has been studied by several authors, showing an improvement rate of the DH between 60-98%. The aim of the present study was to evaluate the effect of photobiomodulation (PBM) treatment on the reduction of DH after non surgical periodontal treatment. Material and methods: A randomized split mouth clinical trial was performed involving 30 patients (120 teeth) diagnosed with DH after scaling and root planning. Two teeth…
Scientific evidence on the usefulness of intraarticular hyaluronic acid injection in the management of temporomandibular dysfunction
Abstract Hyaluronic acid (HA) is found in high concentrations in cartilage and synovial fluid, and is an important component of the extracellular matrixes ? exerting joint lubrication and buffering actions thanks to its viscoelastic properties. The present study examines the scientific evidence found in the current literature on the usefulness of the intraarticular injection of HA in patients with temporomandibular dysfunction. A literature search was made up until May 2008 in the following databases: PubMed / MEDLINE. Of the articles found in the literature, the present review included 18 relevant studies on the application of HA in the temporomandibular joint (TMJ). The quality, level of …
Use of autologous conditioned serum (Orthokine) for the treatment of the degenerative osteoarthritis of the temporomandibular joint. Review of the literature
Objectives: Treatment of osteoarthritis (OA) using autologous conditioned serum (ACS) has become in recent years an alternative to consider in the approach of the degenerative joint disease of the knee. There is no support in the literature for the use of ACS for the treatment of OA of the temporomandibular joint (TMJ), although the promising results obtained in human patients with knee joint disease as well as in animal studies are opening the way for its use at the TMJ. The aim of this paper is to conduct a review of the published literature regarding the use of the ACS for the treatment of OA in humans, considering the level of scientific evidence, and following the principles of the evi…
Documento de consenso sobre el tratamiento antimicrobiano de las infecciones bacterianas odontogénicas
Las infecciones de la cavidad bucal son un problema de salud pública frecuente y motivo constante de prescripción antibiótica; el 10% de los antibióticos se emplean para tratar este problema. Sin embargo, hasta la fecha son pocos los estudios realizados para determinar su incidencia. Asímismo, su relación con ciertas enfermedades sistémicas (cardiacas, endocrinas, etc...) confiere a estas patologías una importancia vital. A pesar de la reconocida frecuencia e importancia de las infecciones odontogénicas, llama la atención la actual dispersión de criterio en varios aspectos referentes a su clasificación, terminología y recomendaciones terapéuticas. El objetivo principal de este documento, re…
Immediate implants placed in fresh sockets associated to periapical infectious processes: a systematic review
Objetives: The development of treated implant surfaces, added to the increase of the aesthetic requirements by the patients has led to a change in the treatment protocols as well as the development of techniques such as the onefase implants and the immediate prosthetic loading. One of the usual contraindications of the implant treatment is the presence of periapical disease associated to the tooth to be replaced. The aim of this paper is to review the published literature on immediate implant placement in extraction sockets of teeth with periapical pathology, considering the level of scientific evidence, and following the principles of medicine and evidence-based Dentistry. Material and Met…
Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr:YSGG laser
Objectives: To compare upper lip frenulum reinsertion, bleeding, surgical time and surgical wound healing in frenectomies performed with the CO2 laser versus the Er, Cr:YSGG laser. Study design: A prospective study was carried out on 50 randomized pediatric patients who underwent rhomboidal resection of the upper lip frenulum with either the CO2 laser or the Er,Cr:YSGG laser. Twenty-five patients were assigned to each laser system. All patients were examined at 7, 14, 21 days and 4 months after the operation in order to assess the surgical wound healing. Results: Insertion of the frenulum, which was preoperatively located between the upper central incisors, migrated to the mucogingival junc…
Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study
Objectives: To determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal. Study Design: Prospective cohort study with intra-subject measures of 16 patients undergoing lower third molar extractions. Sensibility and gustatory functions were evaluated in each subject preoperatively, one week and one month after the extraction, using Semmes-Weinstein monofilaments and 5 different concentrations of NaCl, respectively. Additionally, all patients filled a questionnaire to assess subjective perceptions. Results: Although patients did not perceive any sensibility impairments, a statistically significant decrease was detected …
Endoluminal sclerosis with diode laser in the treatment of orofacial venous malformations
Introduction: The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations. Traditional treatment approach, such as surgery and chemical sclerosis has been given way to a few less-invasive options, as the use of the 810nm diode laser to induce the sclerosis of the venous malformation by intralesional photocoagulation. Objectives: The objective of this study was to determine the efficacy of the diode laser in the intralesional treatment of the orofacial venous malformations (OFVM), describing the recommended surgical approach, as well as to report the main associated complications. Patients and Methods: 10 cases of OFVM, …
Surgical treatment vs. conservative treatment in intravenous bisphosphonate-related osteonecrosis of the jaws. Systematic review
AIMS To determine the success rates of the surgical and non-surgical treatments in the management of bisphosphonate-related osteonecrosis of the jaws (BRONJ). MATERIAL AND METHODS A systematic review of the literature was made. A PubMed Medline database search was performed in order to include clinical studies published in English,between2004 and 2014 with the following key-words: "BRONJ AND treatment" and "NOT osteoporosis". The following data was gathered: authors, title, year of publication, aim of study, level of evidence, sample size, treatment performed, treatment outcomes and follow-up. Studies including more than 20 patients with at least 6 months of follow-up, and that specify the …
Inverted ductal papilloma of the oral cavity secondary to lower lip trauma. A case report and literature review
Inverted ductal papilloma of the oral cavity is an infrequent benign neoplasm of papillary appearance that originates in the secretory duct of a salivary gland. The etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection. We present the case of a 40-year-old woman with a tumor of the lower lip mucosa. Histopathological study of the lesion diagnosed inverted ductal papilloma of the oral cavity. Human papillomavirus DNA detection and typing based on tumor lesion DNA amplification and posterior hybridization, revealed no presence of viral DNA. The antecedents of trauma reported by the patient could have played an important role in the development of thi…
Complications of guided surgery and immediate loading in oral implantology: a report of 12 cases.
Objectives: The growing interest in minimally invasive surgery, together with the possibility of fitting prostheses with immediate function, have led to the development of software capable of planning and manufacturing a surgical guide and prosthesis that can be placed upon conclusion of the implant surgery step. The present study evaluates the surgical and prosthetic complications of implant treatment with the guided surgery technique, together with patient comfort during and after treatment. Patients and methods: A retrospective observational study was made of 19 patients with partially or totally edentulous upper and/or lower maxillae, involving the placement of a total of 122 implants. …
Complications following an accidental sodium hypochlorite extrusion: A report of two cases
Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae. This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it s…
Impacted lower third molars and distal caries in the mandibular second molar. Is prophylactic removal of lower third molars justified?
Background The objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar. Material and methods A retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master's Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies. Results The sample included 203 patients, 94 males (46…
Use of Bichat's buccal fat pad for the sealing of orosinusal communications. A presentation of 8 cases.
Objectives: To determine the efficacy of the pediculate flap with the buccal fat pad in the sealing of orosinusal communications, describe the surgical technique used, and report the main complications. Patients and method: A retrospective study was made of 8 patients seen in the Service of Oral Surgery of the University of Barcelona Dental Clinic (Spain) for the treatment of orosinusal communications between the years 2007 and 2009. In all cases a pediculate flap with the buccal fat pad was used to solve the problem. Results: All of the orosinusal communications were successfully resolved with this technique. The immediate postoperative complications were pain (37.5%), inflammation (37.5%)…
The use of low level laser therapy in the treatment of temporomandibular joint disorders: review of the literature
Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was mad…
Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications
Background In order to choose the appropriate implant size and to prevent complications, an oral surgeon must know the size and shape of the mandible. In the posterior mandibular region, a lingual undercut is often found and could represent a difficulty hard to manage if a lingual or buccal perforation occur. A large series of computed tomography (CT) images of the mandibular first molar was evaluated and the bone morphology, the prevalence and the degree of the lingual concavity in the first molar region were studied. Material and Methods One hundred and fifty-one computed tomography (CT) examinations of patients were retrospectively evaluated to determine anatomical variations in bone mor…
Primary intraosseous squamous cell carcinoma arising in dentigerous cyst: Report of 2 cases and review of the literature
Dentigerous cysts are one of the most common odontogenic cysts of the oral cavity. Odontogenic cysts can give rise to a variety of neoplasms. Carcinoma arising in a dentigerous cyst is extremely rare, with a review of literature showing near 30 cases. The present report describes 2 cases of primary intraosseous squamous cell carcinoma originated from a dentigerous cyst. The first one refers to a 57-year old female with a persistent lesion in the left retromolarregion and diagnosed with squamous cell carcinoma originated fromthe incomplete excision of the lower third molar follicle during its surgical extraction. The second case describes the case of an 18-year old male with an impacted uppe…
Histologic evaluation of thermal damage produced on soft tissues by CO2, Er,Cr:YSGG and diode lasers
Objective: The aim of this in vitro experimental study was to perform histological evaluation of the thermal effect produced on soft tissue irradiated with CO2 , Er,Cr:YSGG or diode lasers. Study design: Porcine oral mucosa samples were irradiated with Er,Cr:YSGG laser at 1 W with and without water / air spray, at 2 W with and without water / air spray, and at 4 W with water / air spray, with CO2 laser at 1 W, 2 W, 10 W, 20 W continuous mode and 20 W pulsed mode and diode laser at 2W, 5W, and 10W pulsed mode. The thermal effect was evaluated measuring the width of damaged tissue adjacent to the incision, stained positively for hyalinized tissue with Hematoxylin-Eosin and Masson Trichrome st…
Critical assessment of the latest classification of jaw cysts proposed by the World Health Organization (2017)
Background The fourth edition of the World Health Organization Classification of Head and Neck Tumors was published in January 2017, and includes a classification of odontogenic tumors and odontogenic cysts. The present review assesses the changes made in this new classification in relation to odontogenic and non-odontogenic jaw cysts. Material and methods An electronic search was conducted in the Cochrane Library, PubMed-MEDLINE and Scopus databases using the search terms: "odontogenic cyst" "WHO classification" "update". Studies written in English and published between January 2005 and April 2020 with a high level of scientific evidence were included, while studies not published in Englis…
Efficacy of different methods used for dry socket management: A systematic review.
Document publicat també en castellà
Stafne's bone cavity: An unusual case with involvement of the buccal and lingual mandibular plates
Lingual mandibular bone defects, also known as Stafne bone cavity (SC), are unilateral asymptomatic radiolucencies, generally seen in the mandibular angle, below the inferior alveolar canal. Although panoramic radiographies normally offer enough information to make a correct diagnosis, additional studies are often required, especially in atypical cases. The present report describes an atypical presentation of a Stafne’s bone cavity in a 78 years-old male patient. In this particular case, an asymptomatic and radiolucid lesion was observed during a routine dental examination. The computed tomography (CT) showed an involvement of both lingual and buccal mandibular plates producing a tunnel-lik…
Clinical features of oral lichen planus. A retrospective study of 65 cases
Objectives: To describe the clinical features of patients diagnosed with oral lichen planus (OLP) and to establish the prevalence of its malignant transformation in our setting. Study design: A retrospective study was made of 65 patients clinically and histologically diagnosed with OLP in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain) in the period 1990-2005. A descriptive and bivariate statistical analysis was made. Results: The mean patient age was 59 years (SD ± 14.9). Most of the patients (61%) were women, and the most frequent location of the lesions was the buccal mucosa (90.8%). White forms of OLP were noted in 66% of the cases, and 46.2% of the pat…
Role of carnoy’s solution in the treatment of keratocystic odontogenic tumor: A systematic review
Introduction and Objective The keratocystic odontogenic tumor is a benign but aggressive neoplasm. As enucleation alone obtains high recurrence rates, some adjuvant treatments such as Carnoy’s solution have been proposed. The aim of this study is to evaluate the reduction of recurrences with the use of Carnoy’s solution as adjuvant in the treatment of keratocystic odontogenic tumors. Material and Methods An electronic search in Pubmed (MEDLINE), ScienceDirect and Cochrane databases was conducted with the key words “odontogenic keratocyst”, “keratocystic odontogenic tumor”, “carnoy’s solution”, “treatment” and “enucleation”. The inclusion criteria were clinical studies using Carnoy’s solutio…
Central odontogenic fibroma: retrospective study of 8 clinical cases
Introduction and Objectives: The central odontogenic fibroma (COF) is a benign odontogenic tumour derived from the dental mesenchymal tissues. It is a rare tumour and only 70 cases of it have been published. Bearing in mind the rareness of the tumour, 8 new cases of central odontogenic fibroma have been found by analyzing the clinical, radiological and histopathological characteristics of COF. Patients and Method: A retrospective study was carried out on 3011 biopsies in the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008. 85 odontogenic tumours were diagnosed of which 8 were central odontogenic fibroma. The radiolog…
A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction.
Background To evaluate the use of guided bone regeneration with xenograft to prevent periodontal defect in the distal aspect of the second molar after the surgical removal of the mandibular third molar. Material and Methods Three electronic databases (Pubmed, Cochrane Library and Scopus) were searched in April 2020. Randomized clinical trials in non-smokers and healthy patients, with at least six months follow-up, comparing periodontal probing depth, clinical attachment level, alveolar bone level and adverse events were selected by two independent investigators. The risk of bias assessment of the selected studies was evaluated by means of the Cochrane Collaboration’s Tool. Finally, a meta-a…
Pain and swelling after periapical surgery related to the hemostatic agent used: anesthetic solution with vasoconstrictor or aluminum chloride.
Objective: To assess pain and swelling in the first 7 days after periapical surgery and their relationship with the agent used for bleeding control. Study Design: A prospective study was conducted between October 2006 and March 2009. Patients subjected to root surgery, who completed the questionnaire and who consented to the postoperative instructions were included in the study. The subjects were divided into two groups according to the hemostatic agent used: A) gauze impregnated with anesthetic solution with vasoconstrictor; or B) aluminum chloride. The patients were administered a questionnaire, and were asked to record the severity of their pain and swelling on a plain horizontal visual …
Predictive factors of difficulty in lower third molar extraction : a prospective cohort study
Background Several publications have measured the difficulty of third molar removal, trying to establish the main risk factors, however several important preoperative and intraoperative variables are overlooked. Material and Methods A prospective cohort study comprising a total of 130 consecutive lower third molar extractions was performed. The outcome variables used to measure the difficulty of the extraction were operation time and a 100mm visual analogue scale filled by the surgeon at the end of the surgical procedure. The predictors were divided into 4 different groups (demographic, anatomic, radiographic and operative variables). A descriptive, bivariate and multivariate analysis of th…
Sunct syndrome. Report of a case and treatment update
Short-lasting unilateral neuralgiform headache attacks with conjuntival injection and tearing (SUNCT) is considered a rare trigeminal autonomic cephalgias, a group of primary headache disorders characterized by brief episodes of severe unilateral headache in the distribution territory of the trigeminal nerve, accompanied by prominent ipsilateral and cranial parasympathetic autonomic features. The present report describes a SUNCT syndrome in a 64-year-old male who had been diagnosed with trigeminal neuralgia several years ago. The patient reported stabbing pain in the orbital zone and in the left upper maxillary region, of great intensity, brief duration, and a frequency of 20-100 attacks a …
Antibiotic prescription for the prevention and treatment of postoperative complications after routine dental implant placement. A cross-sectional study performed in Spain
Background As there are no established guidelines for antibiotic prescription after dental implant placement a study was made to determine the current prescribing habits of several groups of practitioners regarding antibiotics to prevent and/or treat postoperative complications - early failures and infections - in relation to routine dental implant placement. Material and methods An electronic survey was sent to postgraduate students and professionals with experience in routine dental implant placement who practice in Spain. The questions asked were related to whether antibiotics were routinely prescribed either pre- or postoperatively to prevent and/or treat postoperative complications dur…
Sensory disturbances of buccal and lingual nerve by muscle compression: a case report and review of the literature
Introduction Several studies on cadavers dissection have shown that collateral branches of the trigeminal nerve cross muscle bundles on their way, being a possible etiological factor of some nerve disturbances. Case Report A 45-year-old man attended to the Temporomandibular Joint and Orofacial Pain Unit of the Master of Oral Surgery and Implantology in Hospital Odontològic of Barcelona University, referring tingling in the left hemifacial región and ipsilateral lingual side for one year, with discomfort when shaving or skin compression. Discussion Several branches of the trigeminal nerve follow a path through the masticatory muscles, being the lingual nerve and buccal nerve the most involve…
Sharp mandibular bone irregularities after lower third molar extraction: incidence, clinical features and risk factors
Objectives: The purpose of this study was to determine the incidence and clinical symptoms associated with sharp mandibular bone irregularities (SMBI) after lower third molar extraction and to identify possible risk factors for this complication. Study Design: A mixed study design was used. A retrospective cohort study of 1432 lower third molar extractions was done to determine the incidence of SMBI and a retrospective case-control study was done to determine potential demographic and etiologic factors by comparing those patients with postoperative SMBI with controls. Results: Twelve SMBI were found (0.84%). Age was the most important risk factor for this complication. The operated side and…
Application of ultrasound in bone surgery: Two case reports
The present study describes some of the applications of ultrasound in bone surgery, based on the presentation of two clinical cases. The Piezosurgery® ultrasound device was used (Tecnología Mectron Medical, Carasco, Italy). In one case the instrument was used to harvest a chin bone graft for placement in a bone defect at level 1.2, while in the other case a bony window osteotomy was made in the external wall of the maxillary sinus, in the context of a sinus membrane lift procedure. The Piezosurgery® device produces specific ultrasound frequency modulation (25-29 kHz), and has been designed to secure increased precision in application to bone surgery. This instrument produces selective secti…
Dentigerous cyst with parietal and intracystic calcifications: a case report and literature review
Background Dentigerous cyst appears surrounding the crown of an included tooth. On the radiographic exam, a radiolucent rounded well-defined lesion can be observed. Material and methods This study reports a clinical case of a 34-years old man with a pericoronal radiolucent lesion associated to an impacted lower third molar with the presence of radiopaque material inside. The radiological differential diagnosis was calcifying odontogenic tumor, adenomatoid odontogenic tumor and dentigerous cyst. The impacted third molar was removed and the lesion was sent for the histopathological exam. Results The histopathological diagnosis was dentigerous cyst with capsular calcifications. Specifically, p…
Bone regeneration in diabetic patients. A systematic review
Background Oral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence. Material and Methods A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: “Diabetes Mellitus”, “guided bone regeneration”, “bone regeneration”, “alveolar ridge augmentation”, “ridge augmentation”, bone graft*, “sinus floor augmentation”, “sinus floor elevation”, “sinu…
In vitro evaluation of the temperature increment at the external root surface after Er,Cr:YSGG laser irradiation of the root canal
Objectives. A study was made to determine the temperature increment at the dental root surface following Er,Cr:YSGG laser irradiation of the root canal. Design. Human canines and incisors previously instrumented to K file number ISO 30 were used. Irradiation was carried out with glass fiber endodontic tips measuring 200 µm in diameter and especially designed for insertion in the root canal. The teeth were irradiated at 1 and 2 W for 30 seconds, without water spraying or air, and applying a continuous circular movement (approximately 2 mm/sec.) in the apico-coronal direction. Results. At the 1 W power setting, the mean temperature increment was 3.84ºC versus 5.01ºC at 2 W. In all cases the d…
Dexketoprofen/tramadol: randomised double-blind trial and confirmation of empirical theory of combination analgesics in acute pain
Background Combination analgesics are effective in acute pain, and a theoretical framework predicts efficacy for combinations. The combination of dexketoprofen and tramadol is untested, but predicted to be highly effective. Methods This was a randomised, double-blind, double-dummy, parallel-group, placebo-controlled, single-dose trial in patients with moderate or severe pain following third molar extraction. There were ten treatment arms, including dexketoprofen trometamol (12.5 mg and 25 mg) and tramadol hydrochloride (37.5 mg and 75 mg), given as four different fixed combinations and single components, with ibuprofen 400 mg as active control as well as a placebo control. The study objecti…
Efficacy of botulinum toxin in the treatment of bruxism : systematic review
Background Currently it has been shown that botulinum toxin is effective for a wide variety of medical conditions, and can be applied for therapeutic purposes as cosmetic. In recent years, there has been a growing trend in the use of this drug substance to control the muscular overactivity of bruxism. The objective of this study was the use of botulinum toxin type A (BTX-A) than traditional methods, by conducting a systematic review of randomized clinical trials (RCTs) published in the health sciences literature. Material and Methods An electronic search was made in the databases of the PubMed, Cochrane Library and Scopus data between March and October 2017, ECA, which will analyze the effe…
Prevalence of biopsied oral lesions in a Department of Oral Surgery (2007 - 2009)
Objectives: To determine the prevalence of the hard and soft tissue lesions biopsied in the Department of Oral Surgery of the Barcelona University Dental Clinic (Barcelona, Spain). Study design: A retrospective descriptive study was made of the biopsies performed between January 2007 and April 2009 in our Department of Oral Surgery. The following variables were recorded: age, the sex, location of the lesion, the biopsy technique, the reason for consultation, and the histological result obtained. Results: A total of 460 lesions amenable to histological analysis and corresponding to 450 patients were analyzed. The most frequently biopsied lesions were maxillary cysts, including particularly r…
Squamous odontogenic tumor-like proliferation in a radicular cyst: a case report
The squamous odontogenic tumour is a rare benign neoplasm whose aetiology remains unknown. It usually appears in the jaw and its origin could be related to the ephitelial remnants of Malassez. Histologically comprises numerous islets of squamous, non-keratinized, well-differentiated and rounded epithelial cells a fibrous stroma without signs of atypical cells. There is a non-neoplastic lesion with the same histological pattern than the squamous odontogenic tumour. This entity is characterized by squamous odontogenic tumour proliferations isolated into the cyst wall of an odontogenic cyst. It is rare and has a benign behavior. It has been suggested that these epithelial proliferations could …
Myofascial pain syndrome associated with trigger points: A literature review. (I): Epidemiology, clinical treatment and etiopathogeny
Over the last few decades, advances have been made in the understanding of myofascial pain syndrome epidemiology, clinical characteristics and aetiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic, and above all, therapeutic methods, as well as the establishment of prevention policies and protocols by the health profession. Nevertheless, randomized studies are needed to provide a better understanding and detection of the different factors involved in the origin of trigger points.
Techniques for early diagnosis of oral squamous cell carcinoma: systematic review
Background and objectives The diagnosis of early oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) is of paramount clinical importance given the mortality rate of late stage disease. The aim of this study is to review the literature to assess the current situation and progress in this area. Material and Methods A search in Cochrane and PubMed (January 2006 to December 2013) has been used with the key words “squamous cell carcinoma”, “early diagnosis” “oral cavity”, “Potentially Malignant Disorders” y “premalignant lesions”. The inclusion criteria were the use of techniques for early diagnosis of OSCC and OPMD, 7 years aged articles and publications written …
Prevalence of intraoperative and postoperative iatrogenic mandibular fractures after lower third molar extraction: A systematic review
Background The surgical extraction of the lower third molars is one of the most common procedures in oral surgery, and this surgical operation can cause intra- and postoperative complications such as pain, trismus, bleeding, infection, oedema, inferior alveolar nerve injuries, displacement of teeth to neighbouring spaces and mandibular fractures. The aim of this systematic review is to report the prevalence of mandibular fractures that occur intra- and postoperatively in patients who have undergone surgical removal of the lower third molar. Material and Methods An electronic database search for articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted using the key words “Mo…
Materials and prognostic factors of bone regeneration in periapical surgery: a systematic review
Objectives: Analyse the effectiveness of different materials and techniques used in guided tissue regeneration (GTR) applied in periapical surgery, comparing the success rate obtained in 4-wall defects and in through-and-through bone lesions as well as to establish prognostic factors. Material and Methods: A Cochrane, PubMed-MEDLINE and Scopus database search (October 2012 to March 2013) was conducted with the search terms “periapical surgery”, “surgical endodontic treatment”, “guided tissue regeneration”, “bone regeneration”, “bone grafts”, “barrier membranes” and “periapical lesions” individually and next, using the Boolean operator “AND”. The inclusion criteria were the use of GTR (bone …
Evaluation of effectiveness of photobiostimulation in alleviating side effects after dental implant surgery. A randomized clinical trial
Background To assess if photobiostimulation (PBS) alleviates pain intensity/duration and swelling after implant surgery. Material and Methods Sixty subjects (27 male and 33 female, with a mean age of 47,13 8.05 years) were included and randomly assigned to experimental group (implant surgery and photobiostimulation), placebo group (implant surgery and simulated photobiostimulation) and control group (implant surgery only). Inclusion criteria: subjects older than 20 years, with a healthy oral mucosa and requiring implant surgery. Exclusion criteria: pregnancy, history of implant failure, light sensitivity, metabolic deseases, consumption of antibiotics or corticosteroids in the last two week…
Papillary cystoadenoma lymphomatosum (Warthin-like) of minor salivary glands
Papillary cystadenoma lymphomatosum is a benign salivary gland tumor most frequently located in the parotid gland (Warthin?s tumor). Its presentation in other major, or in minor, salivary glands is rare. Clinically, it manifests as a slow growing tumor, fluctuant on palpation due to its cystic morphology. The treatment of choice is complete excision with wide tumor-free margins. We present a 73-year-old female patient with an asymptomatic tumor of 8 years evolution in the right posterior area of the hard palate. We performed surgical excision and a biopsy, which was reported as papillary cystadenoma lymphomatosum. During the post-operative examination carried out after 3 weeks, it was obser…
Bifid mandibular condyles: A systematic review.
Background Bifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle. Its prevalence ranges from 0.31% to 1.82% in the published literature. Objectives The primary objective was to describe the main etiological, clinical and radiological characteristics of patients with BMCs and the existent treatment options. The secondary objective was to simultaneously include the characteristics of two new cases of BMC. Material and Methods An electronic search in Pubmed (MEDLINE), Scopus and The Cochrane Library was carried out by two independent reviewers until April 2018. Prospective or retrospective cohort studies, case…
Treatment of oral mucocele - scalpel versus C02 laser
Objective: To compare the results obtained after oral mucocele resection with the scalpel versus the CO2 laser, based on the complications and recurrences after surgery Patients and Methods: Of the 68 patients we studied who have mucocele, 38 were resected with a scalpel and the remaining 30 with the CO2 laser (5-7 W). Patient sex and age were documented, along with location of the lesion as well as size, symptoms, duration, etiological factors, type of treatment, complications and recurrences after surgical removal.Results: The sample comprised 40 males and 28 females, aged between 6-65 years. The histological diagnosis was extravasation mucocele in 95% of the cases. The most frequent loca…
Salivary gland choristoma in the buccinator muscle: A case report and literature review
Salivary gland choristoma (SGCh) is defined as the presence of normal salivary tissue in an abnormal location. It is a rare entity in oral and maxillofacial region and its ethiology is unknown. The typical presentation of salivary gland heterotopia is an asymptomatic mass that may or may not produce saliva. Some examples of ectopic salivary tissue in the pituitary gland, in the lymph nodes, in the middle ear, in the neck, in the jaw, in the thyroid gland, in the mediastinum and in the rectum have been documented in literature. We report the case of a 61-year-old male presented with a bilateral tumorlike mass in the cheek. The mass was painless, of fibrous consistency and had size change wit…
Anesthetic efficacy of Oraqix versus Hurricaine and placebo for pain control during non-surgical periodontal treatment
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 diff…
Quality of life following third molar removal under conscious sedation
Aim: The aim of this study was to assess quality of life (QoL) and degree of satisfaction among outpatients subjected to surgical extraction of all four third molars under conscious sedation. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after extraction. Study design: Fifty patients received a questionnaire assessing social isolation, working isolation, eating and speaking ability, diet modifications, sleep impairment, changes in physical appearance, discomfort at suture removal and overall satisfaction at days 4 and 7 after surgery. Pain was recorded by patients on a 100-mm pain visual analogue scale (VAS) ev…
Myofascial pain associated to trigger points: a literature review. Part 2: differential diagnosis and treatment.
During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most ef…
Analysis of the unpredictable migration of impacted mandibular third molars: A pilot study
Background Eruption of an impacted mandibular third molar (3MM) is often unpredictable. The objective of this study was to establish the radiographic parameters of migration in patients whose 3MMs evolved unpredictably. Material and Methods This was a retrospective observational study. Patients with unusual 3MM migration (away from their physiological eruption position with changes in the longitudinal and horizontal axes) and with at least two panoramic radiographs were included. To evaluate the radiographic parameters, images were superimposed, using mandibular angle and ipsilateral condyle as references. Results Of a total of 2851 patients, four were included in our study. The average age…
Antiepileptic drugs for the treatment of neuropathic pain : a systematic review
Many therapies have been proposed for the management of neuropathic pain, and they include the use of different antiepileptic drugs. However, the lack of high quality studies indicates that results on the different neuropathic disorders under study do not recommend a particular drug treatment. This study makes a systematic review of the published literature on the use of several antiepileptic drugs to treat neuropathic pain, and has the objective of considering both its clinical characteristics and pharmacological use, which will depend on their level of scientific evidence and will follow the principles of evidence-based dentistry. The articles were stratified according to their scientific…
Influence of operator’s professional experience in the postoperative course after surgical extrac-tion of the impacted lower third molar: A pilot study
Background Third molars are present in 96.6% of humans, although they do not always erupt completely. Between 9.5% and 73% of them remain impacted. Surgical removal of impacted third molars is the most common practice in oral and maxillofacial surgery. This procedure results in traumatism and, consequently, the postoperative phase will involve symptomatology. It is uncommon to find studies that directly relate postoperative symptomatology and the operator's experience. The aim of this study was to determine the differences regarding postoperative symp-tomatology in patients undergoing the bilateral extraction of lower impacted third molars and according to the operator's experience. Materia…
Survival of immediately versus delayed loaded short implants: a prospective case series study
Background: To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. Material and Methods: 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delayed loading. Failures, bone loss, probing depth and bleeding on probing were evaluated. Results: 54 Mk III Shorty TiU and 15 Brånemark System®MK III TiU implants with a length longer than 7mm were inclu…
A survey of oral surgeons tobacco-use-related knowledge and intervention behaviors
Objectives: To evaluate whether oral surgeons are aware of tobacco’s role in oral health. Moreover, we wanted to know professionals’ attitudes towards smoker patients and physicians’ involvement in detecting and eradicating this habit in patients. Study Design: We conducted a survey to determine the awareness of the members of the Spanish Society of Oral Surgery about tobacco’s damage on oral health and the role of dentists in the prevention and elimination of the smoking habit. Results: 450 surveys were distributed during the Seventh National Congress of the Spanish Society of Oral Surgery, of which 224 (49.8%) were answered. Seventy-six point eight percent of oral surgeons said that they …
Previous dry socket as a risk factor for alveolar osteitis: A nested case-control study in primary healthcare services
Dry socket is one of the most common complications following tooth extraction, though no studies have been made on its main risk factors in the primary healthcare services of Barcelona (Spain). Objectives: To analyze the influence of different factors upon the appearance of dry socket in patients attended in the primary care setting, and to determine the possible presence of risk factors in patients who have suffered a previous episode of dry socket.During 24 months, questionnaires were filled with data on the patients seen in different public primary healthcare services in the area of Barcelona (Spain). A case-control study was conducted to identify the main risk factors for developing com…
Efficacy of different methods used for dry socket prevention and risk factor analysis: A systematic review
Background Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. Objectives Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. Material and Methods A Cochrane and PubMed-MEDLINE database search was conducted with the search terms “dry socket”, “prevention”, “risk factors”, “alveolar osteitis” and “fibrynolitic alveolitis”, both individually and using the Boolean operator “AND”. The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written …
Short time guided bone regeneration using beta-tricalcium phosphate with and without fibronectin. An experimental study in rats
Background The aim of this histomorphometric study was to assess the bone regeneration potential of beta-tricalcium phosphate with fibronectin (β-TCP-Fn) in critical-sized defects (CSDs) in rats calvarial, to know whether Fn improves the new bone formation in a short time scope. Material and Methods CSDs were created in 30 Sprague Dawley rats, and divided into four groups (2 or 6 weeks of healing) and type of filling (β-TCP-Fn, β-TCP, empty control). Variables studied were augmented area (AA), gained tissue (GT), mineralized/non mineralized bone matrix (MBM/NMT) and bone substitute (BS). Results 60 samples at 2 and six weeks were evaluated. AA was higher for treatment groups comparing to …
Alveolar distraction osteogenesis for dental implant treatments of the vertical bone atrophy : a systematic review
Background To determine if alveolar vertical distraction osteogenesis obtains better results compared to other bone regeneration treatments (guided bone regeneration with membranes and / or filling material, or autogenous bone graft) in terms of bone gain, complications, and implant survival and success rates. Material and Methods An electronic search was performed in Pubmed (MEDLINE), Cochrane Library and Scopus databases in March 2017. Besides, a manual search was carried out. Inclusion criteria were randomized controlled trials published within the last 10 years with at least 1 year of follow-up after implant placement. No language restriction was applied. Exclusion criteria were studies…
Lowering of the mouth floor and vestibuloplasty to support a mandibular overdenture retained by two implants. A case report
In Oral Implantology most of the procedures are predictable and have high success rates. The use of osseointegrated implants as a therapeutic option for the rehabilitation of patients with severe mandibular atrophy has decreased the need for pre-prosthetic surgery Nevertheless, complications may occur during implant surgery and also once the prosthesis has been placed. This paper describes the case of a totally edentulous patient with an upper complete removable denture and an implant-retained overdenture with two implants in the intermentonian region. During clinical examination, the implant abutments were totally covered by soft tissue since the floor of the mouth was elevated. The panora…
Analysis of the antibiotic prophylaxis prescribed by Spanish oral surgeons
Aim: To identify prophylactic antibiotic prescription practices among Spanish dentists with preferential dedication to Oral Surgery in different types of tooth extraction surgeries. Method: Members of the Spanish Oral Surgery Society were surveyed on antibiotic prophylaxis use in 4 different tooth extraction modalities scaled according to their surgical invasiveness. Results: Sixty-nine of the 105 distributed questionnaires were returned completed. Thirteen percent of the surveyed surgeons would prescribe antibiotics to prevent postoperative wound infection when confronted with conventional tooth extraction lasting less than 5 minutes. In the case of surgery lasting more than 5 minutes, the…
Effect of undersized drilling on the stability of immediate tapered implants in the anterior maxillary sector. A randomized clinical trial.
Background To evaluate the effect of undersized drilling on the primary and secondary stability of immediate implants placed in the anterior maxilla. Material and Methods A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty tapered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately after anterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis (RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation. The results were compared using parametric statistical tests. Results All implants showed adequate stabilit…
Retrograde filling material in periapical surgery: a systematic review
Background Periapical surgery focuses on the treatment of teeth with persistent periapical lesions when orthograde root canal treatment fails. Although MTA® is the gold standard material for retrograde filling, Biodentine® - a tricalcium silicate-based cement - has been proposed in order to resolve several of its limitations. A systematic review has been carried out to compare the physicochemical properties of Biodentine® versus MTA® as root-end filling material in periapical surgery. Material and Methods An electronic search was conducted by two independent examiners during March 2020 in the Cochrane, PubMed-MEDLINE and Scopus databases. In addition, a manual search was made in specialized…
Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management
Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following…
Antibiotic prescription in the treatment of odontogenic infection by health professionals: a factor to consensus
Objective: To observe the attitude of dentists and family doctors in prescribing antibiotics for the treatment of dental infections. Study Design: A poll was performed to determine the differences in the prescription of antibiotics for the treatment of odontogenic infection by dentists and family doctors of the primary care department of the Catalan Health Care Service. Results: A hundred polls were distributed among family doctors, and another 100 ones among primary care dentists assigned to the Catalan Health Care Service of the Generalitat de Catalunya. Of the total of questionnaires distributed, 63 were retuned and answered from dentists and 71 from family doctors. Eighty-one percent of…
Prognostic factors on periapical surgery: A systematic review
Background Analyze the most important prognostic factors when performing periapical surgery and compare the success rates of distinct authors. Introduction Periapical surgery is an approach to treat non-healing periapical lesions and it should be viewed as an extension of endodontic treatment and not as a separate entity. Material and Methods A search of articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted with the key words “prognostic factors”, “prognosis”, “periapical surgery”, “endodontic surgery” and “surgical endodontic treatment”. The inclusion criteria were articles including at least 10 patients, published in English, for the last 10 years. The exclusion criter…
Clinician-related factors behind the decision to extract an asymptomatic lower third molar. A cross-sectional study based on Spanish and Portuguese dentists
Background: Scientific literature estimates that around 18 to 40 % of asymptomatic third molars are extracted. The aims of the present study were to determine the indications for extraction of asymptomatic lower third molars in a sample of Spanish and Portuguese dentists, and to relate these indications to the clinicians’ training and professional experience. Material and Methods: A survey consisting of 15 cases of asymptomatic lower third molars was emailed to Portuguese and Spanish dentists. The clinicians were asked to assess the level of difficulty of the extractions and to make a reasoned recommendation based on the panoramic radiographs, gender and age of the patients. Results: 381 cl…
Validation of a computer-assisted system on classifying lower third molars
Objectives: The present study evaluates the reliability of the Radio Memory® software (Radio Memory; Belo Horizonte, Brasil.) on classifying lower third molars, analyzing intra- and interexaminer agreement of the results. Study Design: An observational, descriptive study of 280 lower third molars was made. The corresponding orthopantomographs were analyzed by two examiners using the Radio Memory® software. The exam was repeated 30 days after the first observation by each examiner. Both intra- and interexaminer agreement were determined using the SPSS v 12.0 software package for Windows (SPSS; Chicago, USA). Results: Intra- and interexaminer agreement was shown for both the Pell and Gregory …
A prospective clinical study of polycarboxylate cement in periapical surgery
Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also measured, and the prognosis following surgery was recorded. Results: A total of 23 patients with 31 apicoectomized teeth were studied (2 patients being lost to follow-up). The mean area of the periapic…
Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial
Objectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study Design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three f…
Prevalence of complications after the oral rehabilitation with implant-supported hybrid prostheses
Objectives: Assess the main problems referred by the patients and observed by the professionals after the bucodental rehabilitation with an implant-supported hybrid prothesis. Patient and Methods: A retrospective study was carried out in which there were 43 patients included who were visited in the Department of Oral Surgery and Orofacial Implantology of University of Barcelona Dental School for one year. An oral rehabilitation with an implant-supported hybrid prosthesis was made to those patients. The following variables were registered: age, gender, number of inserted implants, type of implant and principal problems produced by the hybrid prosthesis. Results: The rehabilitation with an im…
Regeneration of periodontal bone defects with dental pulp stem cells grafting: systematic rewiew
Background The main objective is to evaluate the way to graft the dental pulp stem cells (DPSC) in periodontal defects that best regenerate periodontal tissues. Numerous procedures have been done to promote periodontal regeneration. Bone grafts show good gains clinically and radiographically but histologically seem to have minimal osteoinductive capacity. Another option that exceeds conventional surgery in reducing probing depth and increasing insertion is guided tissue regeneration and tissue engineering that could be an alternative approach to help in the regeneration of living functional bone and peri-dental structures. Material and Methods A search was carried out in Cochrane, PubMed-ME…
Continuous neurophatic orofacial pain: a retrospective study of 23 cases
Background To determine the clinical characteristics of Continuous Neuropathic Orofacial Pain in patients that suffer Persistent Idiopathic Facial Pain (PIFP), Painful Post-Traumatic Trigeminal Neuropathy (PPTTN) or Burning Mouth Syndrome (BMS) and to describe their treatment. Material and Methods A retrospective observational study was made, reviewing the clinical history of the patients diagnosed with Continuous Neuropathic Orofacial Pain between 2004 and 2011 at the Orofacial Pain Unit of the Master of Oral Surgery and Implantology of the University of Barcelona and at the Orofacial Pain Unit of the Teknon Medical Center of Barcelona. Results The average age of the patients with Continuo…
Effect of the suture technique on postoperative pain, swelling and trismus after removal of lower third molars: a randomized clinical trial
Background: To evaluate the intensity of pain, swelling and trismus after the removal of impacted lower third molars comparing two different suture techniques of the triangular flap: the complete suture of the distal incision and relieving incision and the partial suture with only one suture knot for closure of the corner of the flap and the closure of the distal incision, without suturing the relieving incision. Material and Methods: A prospective, randomized, cross-over clinical trial was conducted in 40 patients aged from 18 to 45 years who underwent surgical extraction of impacted lower third molars at the Department of Oral Surgery in the Odontological Hospital of the University of Bar…
Knowledge, aptitudes, and preferences in implant dentistry teaching/training among undergraduate dental students at the University of Barcelona
Background Oral implant rehabilitation should be considered a treatment option for any edentulous patient and Implant Dentistry is currently a discipline taught in the undergraduate formation. The level of knowledge acquired and how the students perceive the quality of training in Implant Dentistry could assess to know if it is necessary to improve the syllabus. Material and Methods A questionnaire was developed with 11 questions: Basic knowledge (7); Perception of training received (2); Ways in which students would receive training (2). To be responded anonymously and voluntarily for undergraduates students in the Faculty of Dentistry (University of Barcelona, Spain). Results One hundred a…
Florid cemento-osseous dysplasia : report of 2 cases
Introduction Florid cemento-osseous dysplasia is a non-neoplastic fibro-osseous lesion which often has an asymptomatic slow growth. Unfortunately, these lesions are usually diagnosed through routine radiographic examination. The aim of this study was to describe the main clinical, radiological and histological characteristics of two case reports diagnosed with florid cemento-osseous dysplasia. Case reports Two cases of florid cemento-osseous dysplasia with different clinical and radiological features were presented. Panoramic radiographs showed multiple radiopacities compatible with fibro-osseous lesions in distinct areas of the maxillary bones. The histological study revealed a sclerotic m…
Effect of the local administration of betamethasone on pain, swelling and trismus after impacted lower third molar extraction. A randomized, triple blinded, controlled trial
Objectives: The aim of this study is to compare the analgesic and anti-inflammatory effects of the local postoperative administration of a single 12-mg dose of betamethasone after the surgical removal of impacted lower third molars. Study Design: A split-mouth, triple-blind, randomized, placebo-controlled clinical trial of 25 patients requiring the surgical removal of symmetrical lower third molars was performed. In the experimental side, a 12-mg dose of betamethasone was administered submucosally after the surgical procedure, while in the control side a placebo (sterile saline solution) was injected in the same area. To assess postoperative pain, visual analogue scales and the consumption …
Fracture resistance after implantoplasty in three implant-abutment connection designs
Background To assess the effect of implantoplasty and implant-abutment design on the fracture resistance and macroscopic morphology of narrow-diameter (3.5 mm) dental implants. Material and Methods Screw-shaped titanium dental implants (n = 48) were studied in vitro. Three groups (n = 16) were established, based on implant-abutment connection type: external hexagon, internal hexagon and conical. Eight implants from each group were subjected to an implantoplasty procedure; the remaining 8 implants served as controls. Implant wall thickness was recorded. All samples were subjected to a static strength test. Results The mean wall thickness reductions varied between 106.46 and 153.75 µm. The me…
Dental implications in oral cancer patients
Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Maxxillofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had…
Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review
Background Oral and pharynx cancer represent a serious global problem, reaching an incidence of half a million cases annually. The role of tobacco and alcohol have been studied and proven to be one of its risk factors. We also know that mouthwashes contain a variable percentage of alcohol, so there is a reasonable concern about their role in carcinogenesis. Material and Methods To answer the PICOS (Population; Intervention; Comparison; Outcomes; Study) question: "Do patients (Population) who use alcohol-based mouthwashes (Intervention) compared to those who do not use them (Comparison) have higher acetaldehyde levels in saliva or higher risk of oral cancer development? (Outcomes)" Meta-anal…
Tuberous sclerosis complex with oral manifestations: A case report and literature review
Introduction: Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome produced by a number of genetic mutations. The disease is characterized by the development of benign tumors affecting different body systems. The most common oral manifestations of TSC are fibromas, gingival hyperplasia and enamel hypoplasia. Clinical Case: A 35-year-old woman diagnosed with TSC presented with a reactive fibroma of considerable size and rapid growth in the region of the right lower third molar. Discussion: In the present case the association of TSC with dental malpositioning gave rise to a rapidly evolving reactive fibroma of considerable diameter. Few similar cases can be found in the literature. P…
Indications of the extraction of symptomatic impacted third molars. A systematic review
Background A literature review was made to determine when third molar (3M) extraction is recommended in symptomatic patients and when it is not recommended. Material and methods A Medline (PubMed) and EMBASE search was made for articles related to indications for the extraction of 3Ms, published in the last 10 years and up until September 2018. Results The electronic search yielded 175 articles. After eliminating duplicates, a total of 173 articles were subjected to review of the title and abstract. Only 19 studies were finally included in the systematic review. There was a well documented increase in morbidity associated to impacted 3Ms (non-restorable caries, fracture, infection, periodon…
Buccal fat pad excision for cheek refinement: A systematic review
Background Buccal Fat Pad (BFP) excision has become an aesthetic surgical procedure. Although this procedure is quite common, it is important to bear in mind that the scientific evidence supporting the efficacy of this treatment is scarce and of low quality. The purpose of this systematic review was to analyse all relevant data to assess the efficacy and safety of BFP excision for improving midface aesthetics. Material and Methods A thorough search of MEDLINE (PubMed), Scopus and Cochrane Library databases was conducted. The PICO approach was used where healthy patients seeking cheek slimming and facial silhouette refining undergo BFP excision and were compared before and after surgery in t…
Oral metamizol (1 g and 2 g) versus ibuprofen and placebo in the treatment of lower third molar surgery pain: randomised double-blind multi-centre study
Objective: To assess the efficacy of metamizol 1 g and 2 g in the relief of pain after surgical extraction of the lower third molar, and to compare the therapeutic effect with that of ibuprofen 600 mg or placebo.