Uso del láser en urgencias por periodontitis apical post tratamiento endodóntico

Introduction: Laser therapy and stimulation of the acupuncture points are anti-inflammatory and analgesic alternative treatments in dentistry.Objective: to describe the use of low power laser therapy in the emergency treatment of apical periodontitis after endodontic treatment during 2018.Methods: observational, descriptive, longitudinal, and prospective study of patients who attended emergency department at Guama Dentistry Clinic during 2018, Pinar del Río, presenting apical periodontitis after endodontic treatment; 86 patients participated in the study. Descriptive statistics was applied, respecting the bioethical principles.Results: female gender predominated (53,49 %), apical periodontitis after endodontic treatment was more prevalent in the age group 20-24 (30,23 %); 65,5 % of the patients presented remission and relief after the third treatment session. Only 2,33 % needed more than six treatment sessions.Conclusions: apical periodontitis after endodontic treatment is more common in women during the first half of the second decade of life. The treatment showed effectiveness from the first treatment sessions.Introducción: la terapia y estimulación con láser en puntos acupunturales constituyen alternativas de tratamiento antiinflamatorio y analgésico en estomatología.Objetivo: describir el uso de la terapia láser de baja potencia en el tratamiento de urgencias por periodontitis apical post tratamiento endodóntico durante el 2018.Método: estudio observacional, descriptivo, longitudinal y prospectivo en pacientes que acudieron a la consulta de urgencias de la Clínica Estomatológica “Guamá’’, municipio Pinar del Río, en el período durante el año 2018, por presentar periodontitis apical post tratamiento endodóntico. El universo estuvo constituido por 86 pacientes trabajándose con la totalidad. Se empleó estadística descriptiva y se siguieron los principios bioéticos.Resultados: predominó el sexo femenino (53,49 %), donde la periodontitis apical post tratamiento endodóntico se presentó en mayor cuantía en el grupo etario de 20 a 24 años de edad (30,23 %). El 65,5 % de los pacientes presentaron remisión y alivio tras la tercera sesión de tratamiento. Solo el 2,33 % necesitó más de seis sesiones de tratamiento.Conclusiones: la periodontitis apical post tratamiento endodóntico se presentan en mayor cuantía en las féminas, durante la primera mitad de la segunda década de vida. El tratamiento con terapia laser de baja frecuencia mostró efectividad desde las primeras sesiones de tratamiento

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Oral health status in relation to socioeconomic factors among the municipal employees of Mysore city

Aim: To assess the prevalence of dental caries, periodontal diseases, oral pre-malignant and malignant lesions in relation to socioeconomic factors among the municipal employees of Mysore city. Settings and Design: The study was cross sectional in nature. Materials and Methods: All the available employees (1187) during the study period were considered. World Health Organization (WHO) Oral Health Assessment form (1997) and a preformed questionnaire were used to collect the required data. Modified Kuppuswamy scale with readjustment of the per capita income to suit the present levels was used for classifying the individuals into different socioeconomic status (SES) categories. Data were collected by a single, trained and calibrated examiner (dentist) using mouth mirror and community periodontal index (CPI) probe under natural daylight. Data analysis was done using SPSS windows version 10. Quantitative data were analyzed using one-way analysis of variance (ANOVA) with Tukey′s post hoc test and qualitative data were analyzed using chi-square or contingency coefficient. Results: The age range of the study population was 19-57 years (mean 40.74 years, standard deviation 9.17). The prevalence of dental caries in the upper SES category was lesser (43.3%) compared to that in lower SES category (78.6%). 16.4% of the subjects in the upper category had a CPI score of 0 (healthy periodontium) and none of the subjects in the lower middle, upper lower and lower SES category had this score. The prevalence of oral pre-malignant and malignant lesions was higher in lower SES category (17.9%) than in upper class (0%). Conclusion: There was an inverse relationship between oral health status and SES. The overall treatment need was more in the lower class people than in the upper class

The effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface

Background: Bonding brackets to fluorosed enamel remains a clinical challenge and bracket failure at the compromised enamel interface is common. Objective: To check the effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface. Materials and Methods: Sixty freshly extracted human premolar teeth having moderate to severe dental fluorosis as per Dean′s criteria were collected and divided into three groups of 20 each. The groups were treated as follows: In group I, acid etching was followed by bonding with Transbond XT® ; in group II, sandblasting and acid etching was followed by bonding with Transbond XT® ; and in group III, sandblasting and acid etching was followed by bonding with Enlight LC® . An Instron™ universal testing machine was used for determining the debonding force, and from this the shear bond strength was computed. The sample with highest shear bond strength from each group was selected for the scanning electron microscopy (SEM) study. The prepared specimens were examined under a JSM-840A scanning electron microscope (JEOL Ltd, Tokyo, Japan) operated at 20 kV. Photographs were taken at progressively higher magnifications of ×50, ×100, ×500, and ×1000 to view the enamel surface and the adhesive remaining on the enamel surface after debonding. The shear bond strengths of the groups were compared using the one-way ANOVA (analysis of variance) and Tukey post hoc test. The distribution of adhesive remnant index (ARI) score was compared using the Chi-square test. Results: The mean shear bond strength in group I was 10.36 MPa, with a standard deviation of 0.225. The corresponding values in group II and group III were 11.41±0.237 MPa and 11.39±0.201 Mpa, respectively. There was a statistically significant difference between the three groups in the mean shear bond strength values. Conclusion: Sandblasting followed by acid etching provides significantly higher bond strength values compared to acid etching alone, irrespective of the bonding material employed