Osteonecrosis de los maxilares: actualización a propósito de un caso clínico

La Osteoquimionecrosis maxilar (ONM /OQNM) es una complicación asociada al tratamiento farmacológico con bifosfonatos (orales o intravenosos) y anticuerpos monoclonales (Denosumab y Bevacizumab). Este artículo tiene como objetivo principal revisar la literatura más reciente sobre el tema, actualizando los conocimientos referentes a la prevención y el manejo de la ONM. Para ello, realizamos una búsqueda de los artículos de revisión publicados en los últimos 5 años en las principales bases de datos (PubMed, Scielo y Cochrane) utilizando el término MeSH: "Bisphosphonate- Associated Osteonecrosis of the Jaw"

Short dental implants in atrophic jaws rehabilitation: update

Los implantes dentales cortos, aunque históricamente se han asociado a un mal pronóstico en las rehabilitaciones orales implantosoportadas, con el paso de los años y los avances en implantología, se han convertido en un tratamiento habitual en la práctica diaria de muchos clínicos, obteniendo tasas de éxito que se han incrementado recientemente hasta prácticamente igualarse a los implantes convencionales para muchos autores. La necesidad de reducir tiempos de trabajo, costes económicos y morbilidad intraoperatoria unida a la creciente demanda derehabilitaciones implanto soportadas en pacientes de un rango de edad cada vez mayor hace necesario añadirlos entre nuestras opciones rehabilitadoras implantológicas. Para ello es necesario conocer sus pros y contras y establecer unos protocolos quirúrgicos y de selección del paciente receptor

Analytical parameters and vital signs in patients subjected to dental extraction

Dental consultation may provoke stress to the patient, especially when a dental surgery is going to be performed, stressful situations can cause a reaction in the sympathetic nervous system that could lead to cardiovascular alterations. Blood pressure and cardiac frequency are used often as an indirect measurement and this parameters combined can serve as good indicators of stress. Objective: Analyze the changes in vital signs and analytical parameters induced by a dental extraction. 24 healthy patients who required a simple dental extraction underwent to a blood test and motorization of their pre- and post-extraction vital signs before, at 2 and 48 hours after the procedure. Data analysis was performed by means of repeated measures one way ANOVA followed by multiple comparisons Bonferroni’s Post-hoc test. The evaluated patients were 13 women and 11 men with an average age of 35.1. Thirteen patients (54.17% of the sample) were smokers and five were regular drinkers (20.8%). No significant differences were observed in the vital signs with the exception of diastolic blood pressure and cardiac rate that were slightly lower after extraction. Only two analytical parameters showed statistical significant changes. Total bilirubin was significantly higher at 48 hours after extraction and leukocyte count was significantly lower at this time. In any case, the magnitude of the changes observed was very low. The analytical parameters and the vital signs did not show any relevant change. Eventual alterations found after simple tooth extraction should not be attributed to the procedure

Analytical parameters and vital signs in patients subjected to dental extraction

BACKGROUND: Dental consultation may provoke stress to the patient, especially when a dental surgery is going to be performed, stressful situations can cause a reaction in the sympathetic nervous system that could lead to cardiovascular alterations. Blood pressure and cardiac frequency are used often as an indirect measurement and this parameters combined can serve as good indicators of stress. Objective: Analyze the changes in vital signs and analytical parameters induced by a dental extraction. MATERIAL AND METHODS: 24 healthy patients who required a simple dental extraction underwent to a blood test and motorization of their pre- and post-extraction vital signs before, at 2 and 48 hours after the procedure. Data analysis was performed by means of repeated measures one way ANOVA followed by multiple comparisons Bonferroni's Post-hoc test. RESULTS: The evaluated patients were 13 women and 11 men with an average age of 35.1. Thirteen patients (54.17% of the sample) were smokers and five were regular drinkers (20.8%). No significant differences were observed in the vital signs with the exception of diastolic blood pressure and cardiac rate that were slightly lower after extraction. Only two analytical parameters showed statistical significant changes. Total bilirubin was significantly higher at 48 hours after extraction and leukocyte count was significantly lower at this time. In any case, the magnitude of the changes observed was very low. The analytical parameters and the vital signs did not show any relevant change. CONCLUSIONS: Eventual alterations found after simple tooth extraction should not be attributed to the procedure. Key words:Blood pressure, heart rate, monitoring physiologic, oxygen saturation, tooth extraction

Lemierre Syndrome associated with dental infections : report of one case and review of the literature

The first publication on Lemierre Syndrome appears in 1936 by Lemierre. It is defined as an ?oropharynx bacterial infection characterized by the thrombophlebitis in the internal jugular vein, derived in a systemic septic embolism?. In 81% of the cases, the Fusobacterium necrophorum is the most frequent etiologic agent. Fever is the most common symptom, but it can depending on the primary infection, tonsillitis, mastoiditis or odontogenic infection. According to the literature the mortality is very low, but with a significant morbidity, that is why the diagnosis and early treatment is very important. The diagnosis it´s clinical, even though the CT scan and other diagnosis methods (echography, MRI) help to determine the extent of the infection. It?s necessary to administrate the antibiotics endovenous at high dose, (keeping in mind that the most frequent micro organism is anaerobic), and vital support measures if neccessary. We present a case report of Lemierre Syndrome associated to an odonthogenic infection caused by the 4.8 molar

Fractura mandibular tardía post exodoncia de molares inferiores. Caso clínico

La extracción del tercer molar es un procedimiento común en cirugía oral. Una de las complicaciones es la fractura mandibular. Con una incidencia postoperatoria menor a un 0.005%. Los factores que contribuyen al riesgo de fractura del ángulo mandibular después de una extracción del tercer molar incluyen el nivel de impactación, la anatomía del diente, infecciones locales previas, edad, sexo, presencia de formaciones quísticas y bruxismo entre otras. Presentamos un caso clínico de fractura mandibular postoperatoria a las cinco semanas tras la exodoncia del 47 y 48 incluidos en posición horizontal. El objetivo final del trata-miento de una fractura mandibular es la consolidación ósea manteniendo la oclusión dental. En nuestro caso, al no tratarse de una fractura que sobrepasaba las corticales y sin desplazamiento mandibular, no fue subsidiaria de un tratamiento quirúrgico y se resolvió con reposo funcional

Granulomatosis with Poliangeitis (Wegener's Granulomatosis): Orofacial Manifestations. Systematic Review and Case Report

Purpose: To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity. Materials and methods: A bibliographic search was performed on Pubmed with the keywords 'Wegener's granulomatosis', 'etiology', 'oral manifestations', 'oral cavity', 'gingiva'. The inclusion criteria were papers published in English in the last 10 years that made reference to clinical cases with in which the oral cavity was affected. The quality of the results was assessed with 'The 2013 Care Checklist'. Results: Nineteen clinical cases were analysed. The average quality was 7.68/13 (range 5-10/13). 73.7% of patients were women, the most frequent area for the lesions was the gingiva and the most prevalent lesion was gingival hyperplasia. 68.4% of the patients had this lesion as a first sign, 21.1% as a progression and 10.5% as a recurrence. 68.4% of the lesions resolved once medical treatment was established. Conclusion: GPA is a multisystem disorder associated with considerable morbidity and mortality if not treated. Early diagnosis improves the prognosis. The first manifestation of the disease can be seen in the oral cavity. It is important that dentists recognise the oral manifestation in order to improve the prognosis. Key words: granulomatosis, polyangiiitis, Wegener's granulomatosis

Comparative study on the prevalence of oral lesions biopsied in the elderly and non-elderly population in the Master of oral Medicine, Surgery and Implantology

Objective: To determine the prevalence of biopsied oral lesions in elderly patients and to compare it with the non-elderly population. Materials and methods: Observational, retrospective and cross-sectional study where a total of 151 biopsies of oral lesions from last year were analyzed. The sample was divided into two age groups: Elderly group (EG) (≥65 years of age) and non-elderly group (NEG) (<65 years), and several clinical parameters were collected. Results: Of the 151 records, 51 were elderly and 100 were non-elderly. The most prevalent lesion in both groups was the fibroma (n=41). Within the GA the most frequent pathologies were: the lichen planus/lichenoid reaction (LPO/RL) (n=9), epithelial hyperplasia (EH) (n=3) and leukoplakia (n=3). In the GNA the lesions with increased incidence were: radicular cyst (n = 20), the periapical granuloma (PG) (n=6) mucocele (n=5) and squamous papilloma (SP) (n=5). Regarding gender distribution in the elderly population, women (n=27) present a higher prevalence of fibroma and PG, and men (n=24) have a higher incidence of LP and fibroma. Conclusions: There are few epidemiological studies of oral lesions in Spain, even less related to the elderly population. These studies are essential to detect patterns and implement preventive measures, especially in the elderly population, often considered as a risk group. Among the literature, we obtain similar results; however, we obtain a higher prevalence of certain rare lesions, such as lipoma and neuroma, and a low prevalence of OSCC