Tratamiento de la boca seca. Nuevas tendencias

La disminución de saliva afecta la calidad de vida de los pacientes, que pueden mejorar cambiando ciertos hábitos de salud general como hidratación, uso de humidificadores ambientales, evitar tóxicos y conductas saludables, incluyendo visitas frecuentes al dentista. La prevención en los pacientes que van a ser irradiados, la modificación de los fármacos xerostomizantes en los casos posibles contribuyen al bienestar de estos pacientes. Los diferentes métodos de estimulación salivar tanto farmacológicos (ácidos, pilocarpina) como no farmacológicos (mecánicos, eléctricos, láser, acupuntura u oxígeno hiperbárico) y el uso de sustitutos salivales ayudan a mantener mejor hidratación bucal. En el futuro, el desarrollo de componentes orgánicos a partir de células madre será probablemente una posibilidad de tratamiento efectiva

Influence of Matrix Type on Surface Roughness of Three Resins for Provisional Crowns and Fixed Partial Dentures

Purpose: This study evaluated the effect of matrix type on the surface roughness of resins for provisional crowns and fixed partial dentures. Materials and methods: Ninety specimens of two acrylic resins (Trim II, Tab2000) and one bis-acryl composite (Protemp II Garant) were fabricated using one of three matrices: irreversible hydrocolloid (Cavex CA37), poly(vinyl siloxane) (Aquasil) or vacuum-formed matrix (Bio-flow Hard). The sample size for each resin-matrix combination was 10. The vestibular face of one natural maxillary central incisor was used as a model to fabricate all the specimens, following the custom fabrication technique. The average roughness measurements, Ra (mum), were obtained using a profilometer, and the data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests. The results were contrasted against the surface roughness of the tooth using a one-sample t-test. Results: Aquasil and vacuum-formed matrix had a smoother surface than Cavex CA37 regardless of the resin tested (p < 0.05). Protemp II Garant had the smoothest surface regardless of the matrix used, with no significant differences when polymerized against the three different matrices. Trim II polymerized against Cavex CA37 had a rougher (p < 0.05) surface than Aquasil or vacuum-formed matrix. Tab2000 had the smoothest surface (p < 0.05) when polymerized against a vacuum-formed matrix. Conclusions: There is no universal matrix that produces the smoothest surface: this depends on the compatibility between the resin and the matrix. Protemp II Garant polymerized against Cavex CA37 matrix yields a surface that is smooth enough not to require polishing unless this surface is adjusted

Probiotics and oral health : a systematic review

Probiotics are microorganisms, mainly bacteria, which benefit the host?s health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. An electronic search in PubMed database with the keywords ?oral health AND probiotics AND dentistry? was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles

Probiotics and oral health: A systematic review

Background: Probiotics are microorganisms, mainly bacteria, which benefit the host's health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. Objectives: To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. Material and Methods: An electronic search in PubMed database with the keywords 'oral health AND probiotics AND dentistry' was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. Results: Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. Conclusions: The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/ incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles

Relationship between unilateral posterior crossbite and human static body posture

Background: We compared photogrammetry-assessed body posture between young adults with and without unilateral posterior crossbite (UPCB). Assessments were controlled by vision, mandibular position and sitting/standing position. In addition, we aimed to determine the relationship between UPCB laterality and the direction of body posture using photogrammetry and a static postural platform. Methods: Adults with natural dentition, with and without UPCB, were enrolled. Static body posture was assessed by photogrammetry based on horizontal acromial alignment and horizontal anterior-superior iliac spine (ASIS) alignment. Frontal photographs were taken with participants asked to open or close their eyes and hold their jaws at rest, at an intercuspal position, and at left or right lateral positions. Distribution of foot pressure was recorded using a static postural platform at different visual input and mandibular positions. General linear models with repeated measures were used to assess the effect of the various within- and between-subject factors. Results: In total, 36 adults (left UPCB = 12; Right UPCB = 6; controls = 18) participated. There were significant differences between the control and UPCB groups in horizontal alignment at the acromion (p = 0.035) and ASIS (p = 0.026) levels when controlled by visual input and mandibular position. No significant differences in horizontal alignment or foot pressure distribution were observed by laterality in the UPCB group. Conclusion: The presence of UPCB affects static body posture, but the side of crossbite is not related to the direction of effect on static body posture

Use of local anesthetics with a vasoconstrictor agent during dental treatment in hypertensive an coronary disease patients. A systematic review

Coronary disease and Hypertension are highly prevalent health problems worldwide, with the latter being one of the most common diseases in patients visiting dental clinics. Local anesthetics (LAs) with vasoconstrictor agents (VC) are known to be commonly used in dental practice. For the above-mentioned rea- sons, dentists should know how to adapt and treat patients with these hazardous conditions. Objective The aim of this study was to find out if the use of local anesthetics (LAs) in combination with vasoconstrictor (VC) agents in dental treatment presents a risk in patient with a known history of Hypertension and/or Coronary disease. Materials and methods This systematic review was conducted in accordance with The PRISMA guidelines and registered on the PROSPERO database (CRD42020187369). The search strategy was based on Mesh terms, Boolean operator AND, and the PICO model. It was designed to identify all the randomized clinical trials (RCTs) published in the last 30 years, which assessed whether the use of LA with VC agents in dental treatment produces a significant increase/decrease in hemodynamics in patients with known history of Hypertension and/or Coronary disease. The Cochrane Collaboration's tool was used to assess risk of bias of the included RCTs. Results An initial electronic search resulted in 87 papers; however only 9 RCTs met the inclusion criteria. There was a total of 482 subjects ( N = 482), of which 412 had a known history of Hypertension or Coronary disease

Marginal Bone Loss in Implants with External Connection versus Internal Conical Connection Prior to Prosthetic Loading. A Randomized Clinical Study

Introduction: The prosthetic connection of implants has been related to the loss of marginal bone. The aim of this study was to evaluate bone loss around external connection (EC) and internal conical connection (ICC) implants prior to prosthetic loading. Material and methods: A randomized clinical trial (RCT) was carried out, with a sample size of 93 implants (31 EC and 62 ICC) placed in 27 patients. Radiological controls were performed and stability was measured by resonance frequency analysis (RFA) on the day of placement, at 1 month and at 4 months after the placement. Results: Bone loss in EC implants was not statistically different than in ICC implants between the time of placement (T0) and the subsequent month (T1): (EC = 0.18 mm and ICC = 0.17 mm). Between one month (T1) and four months (T2): (EC = 0.39 mm and ICC = 0.19 mm) this difference was highly significant (p = 0.00). Bone loss between T0 and T2 was significantly lower in the ICC (EC = 0.57 mm and ICC = 0.36 mm), (p = 0.01). The overall success rate of the implants was 97.8%. The stability of the implants increased from 70.69 (T0) to 73.91 (T1) and 75.32 (T2). Conclusions: ICC showed less bone loss up to the time of prosthesis placement. Such bone loss did not have a significant impact on bone stability. Long term RCTs are needed to demonstrate whether this bone loss, which is more pronounced at the beginning in EC, tends to stabilize and equate to ICC

Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans

The goal of the current study is to assess the difference in connective tissue adherence to laser microtextured versus machined titanium abutments. Six patients were selected and each of them received 2 implants, one combined with a laser treated abutment and one with a machined abutment. After three months, the abutments were retrieved together with their surrounding gingival tissue for histological analysis. Qualitative and quantitative evaluation of microscopical images was performed to assess the presence or absence of adherence between the soft tissues and the abutment, and the percentage of soft tissue adhered to the two different surfaces. Intimate adherence between connective tissue and the laser treated abutments, while on machined abutments no adherence was detected. A significant difference was found in the percentage of surface in contact with soft tissue between both implant abutments p=0.03. Within the limitation of the current study, it can be concluded that connective tissues show enhanced adherence to microtextured abutments compared to machined abutments

Inflammatory papillary hyperplasia : a systematic review

Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual

Opciones terapéuticas en quistes odontogénicos. Revisión

Los huesos maxilares constituyen asiento de una gran variedad de quistes y neoplasias que pueden ser de difícil diagnóstico. De entre todos los procesos tumorales que se dan en el territorio maxilofacial, los quistes son de gran importancia debido a la frecuencia de su presentación. Los quistes maxilares tienen distinto origen y comportamiento clínico. A partir de la clasificación de la OMS de 1992, esta revisión estudia las características clínicas, radiográficas y epidemiológicas de los quistes del desarrollo odontógenos. Una adecuada exploración clínica y radiográfica por parte del odontólogo es suficiente para alcanzar un diagnóstico de presunción. Las consideraciones clínicas y terapéuticas de cada uno de estos quistes son variables, por lo que es necesario conocer el comportamiento epidemiológico de ellos. El diagnóstico de presunción, el tamaño de la lesión y la relación de esta con estructuras anatómicas vecinas condicionará el tipo de tratamiento. El diagnóstico definitivo lo dictaminará el análisis anatomopatológico