Periodontal and biochemical bone metabolism assessment on a chronic oral anticoagulation population treated with dicoumarins

The aim is to evaluate periodontal alteration and biochemical markers associated with bone turnover in chronic oral with dicoumarins anticoagulant treatment patients. 80 patients treated with oral anticoagulants were divided into 2 cohort: Group A (n=36) 6 month to 1 year with anticoagulant treatment and Group B (n=44) > 2 years with anticoagulant treatment. Clinical evaluation included: Clinical attachment level (CAL), plaque index (PI) and gingival index (GI). Analytically biochemical parameters of bone remodeling (calcium and phosphorus), formation (total acid phosphatase, alkaline phosphatase and osteocalcin) and resorption (tartrate-resistant acid phosphatase and beta-crosslaps) were evaluated. High values of PI (67-100%) especially in men and in Group B were observed. Men with anticoagulation treatment length showed an increased GI (49.167 vs 78.083) while Group B women showed a decreased GI in comparison with Group A (59.389 vs 42.120). Women presented a greater average CAL than men as well as Group B vs Group A but without statistical significance. All biochemical markers were decreased respect to values of general population. Osteocalcin in GroupB women showed a statistically significant outcome vs GroupA (p=0.004). Acid phosphatase (total and tartrate-resistant) has a slight increase in Group B women versus Group A, and Beta-crosslap showed lower values in Group A men than Group B and slightly lower in Group A women versus Group B, without statistical significance. Patients showed a slight to moderate degree of periodontal affectation, especially gingivitis related to bacterial plaque. Periodontal disorders tended to be more severe in Group B. While bone remodeling showed an overall decrease with greater affectation of bone neoformation phenomena, bone destruction tended to recover and normalize in time

Effectiveness of a recent topical sialogogue in the management of drug-induced xerostomia

Objectives: Use of certain drugs is the most common aetiology of xerostomia. Systemic sialogogues provide a longer effect than topic ones, but also induce relevant side effects. Topical sialogogues, as malic acid, allow a safe use as they induce no systemic side-effects or pharmacological interactions, being especially interesting in cases of mild hyposalivation and oral dryness, mainly the chronic use of xerostomizing drugs. The aim of this study was to evaluate the clinical effect of 1% malic acid in patients affected by xerostomia due to antihypertensives or antidepressants. Study Design: 10 patients with drug-induced xerostomia were prospectively evaluated before and after using malic acid spray during three weeks. Xerostomia Inventory (XI) was used to evaluate subjective improvement. Unstimulated and stimulated salivary flow rates were determinated. Results: Severity significantly decreased, from 38.22 to 31.00 points (p = 0.011) after using the product. 77.8% of subjects did not complain about xerostomia at the end and 66.6% achieved an improvement > 6 points. Unstimulated flow rate singnificantly increased, from 0.163 to 0.226 mL/min (p = 0.021) at the third week. Conclusions: 1% malic acid spray induces some improvement in the management of mild and reversible xerostomia. Carrying out of randomized controlled trials is justified according to this study

Pharmacological interactions of anti-microbial agents in odontology

In this third article we describe the pharmacological interactions resulting from the use of anti-microbial agents. Although the antimicrobials prescribed in odontology are generally safe they can produce interactions with other medicaments which can give rise to serious adverse reactions which are well documented in clinical studies. Antibiotics with grave and dangerous life threatening consequences are erythromycin, clarithromycin and metronidazol and the anti-fungal agents are ketoconazol and itraconazol. Regarding the capacity of the anti-microbials to reduce the efficacy of oral anti-contraceptives the clinical studies to date are inconclusive, however, it would be prudent for the oral cavity specialist to point out the risk of a possible interaction. Therefore the specialist should be aware of possible interactions as a consequence of administering an antibiotic together with other medicaments the patient may be taking

Pharmacological interactions of anti-inflammatory-analgesics in odontology

In this second article we describe the more interesting pharmacological interactions in dental practice based on the prescription of analgesic narcotics, paracetamol and non-selective non-steroid anti-inflammatory drugs (NSAI) (which inhibit cyclooxigenase 1 ?COX 1- and cyclooxigenase 2 ?COX 2-) and selective NSAIs (COX 2 inhibitors). The importance of preventing the appearance of these pharmacological interactions is because these are medicaments prescribed daily in odontology for moderate pain treatment and inflammation in the oral cavity. Paracetamol can interact with warfarin and therefore care should be taken with chronic alcoholic patients. All NSAIs reduce renal blood flow and consequently are capable of reducing the efficacy of medicaments used for treating arterial hypertension, which act via a renal mechanism. Especial attention should be taken considering the risk of interaction between the antagonists of AT1 receptors of angiostensin II (ARAII) and the NSAIs

Pharmacological interactions of vasoconstrictors

This article is the first of a series on pharmacological interactions involving medicaments commonly prescribed and/or used in odontology: vasoconstrictors in local anaesthetics and anti-inflammatory and anti-microbial analgesics. The necessity for the odontologist to be aware of adverse reactions as a result of the pharmacological interactions is due to the increase in medicament consumption by the general population. There is a demographic change with greater life expectancy and patients have increased chronic health problems and therefore have increased medicament intake. The presence of adrenaline (epinephrine) and other vasoconstrictors in local odontological anaesthetics is beneficial in relation to the duration and depth of anaesthesia and reduces bleeding and systemic toxicity of the local anaesthetic. However, it might produce pharmacological interactions between the injected vasoconstrictors and the local anaesthetic and adrenergic medicament administered exogenically which the odontologist should be aware of, especially because of the risk of consequent adverse reactions. Therefore the importance of conducting a detailed clinical history of the general state of health and include all medicaments, legal as well as illegal, taken by the patient

Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping

To the researchers of the research group Análisis de la Realidad Educativa (AREA) (HUM-672). Research group by belonging to the Ministry of Education and Science of the Junta de Andalucía and based in the Department of Didactics and School Organization of the Faculty of Education Sciences of the University of Granada.Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed.Ministry of Education and Vocational Training of the Government of Spain (project reference: FPU18/01595)

Educational Innovation in Higher Education: Use of Role Playing and Educational Video in Future Teachers’ Training

Information and communication technologies (ICTs) have led to the emergence of a variety of active and innovative teaching methods. This is the case in role-playing, which consists of simulating a real-life situation, in this case the school context, in which the student takes on a certain role and interacts with other students in a fictitious situation. Framed in this way, the present study aims to show if the application of the role-playing method promotes the improvement of attitude variables and practical skills. To this end, we advocated the use of a quasi-experimental methodology, with a control and experimental group and the application of a post-test. The sample is composed of 138 students from the Master of Teachers of Compulsory Secondary Education in Ceuta (Spain). The results showed that the students positively valued the application of the method, obtaining better scores in the set of variables studied, especially in motivation, creativity and collaboration. Therefore, it continues to be observed that the application of innovative methodologies through technology promotes the increase of multiple skills in the student body. This study aimed to prove that the use of active methods provides an increase in students’ skills, and that, therefore, we must bet on the use of sustainable pedagogies in order to promote a real innovation in the classrooms.This study is financed by the Teaching Training and Information Plan of the University of Granada. FIDOugr Plan 2018-2020, in the program of Innovation and Good Teaching Practices. Code: 19-43

Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid

Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectom

Meta-analytic study of implant survival following sinus augmentation

Objectives: To evaluate graft types used for maxillary sinus augmentation and review success rates of dental implants inserted in these areas, analyzing the graft materials used, implant surface types and the moment of implant placement. Study Design: A meta-analytic study reviewing articles on sinus augmentation published during the last ten years. Results: 3,975 implants placed in sinus augmentations (with bony windows) were registered, of which 3,749 implants survived, a survival rate of 94.3%. Conclusions: When performing sinus augmentation, bone substitute materials are just as effective as autologous bone, whether used alone or in combination with autologous bone. Implant surface treatments can have an important effect on implant survival and it would appear that roughened surfaces are the best option. When implants are inserted simultaneously to grafting, a higher failure rate can be expected. © Medicina Oral S. L