Efectos del láser Er : respuesta microbiológica y clínica

La cirugía periapical es una técnica que se realiza en los tejidos periapicales como apicales del propio diente con el fin de lograr el sellado del conducto radicular y limpieza del tejido afectado. Los OBJETIVOS de nuestra investigación fueron: l°Comprobar elefecto esterilizante del láser Er:YAG en dientes in vitro con distintas potencias de aplicación. 2 Corroborar dicho efecto esterilizante enlesiones granuloinatosas periapicales, mediante controles microbiológicos. 3 Controlar la evolución de lesiones periapicales, a través de controles radiográficos y clínicos. MATERIAL Y METODOLOGÍA: En la primera fase utilizamos 47 dientes unirradiculares que fueron divididos en tres grupos de irradiación con láser y un grupo control. Los dientes irradiados se introdujeron en el medio de enriquecimiento en condiciones de anaerobiosis durante 72 horas, realizándose controles visuales para comprobar la presencia bacteriana, seguidos de controles microbiológicos para corroborar dichos resultados. En la segunda fase participaron 45 pacientes susceptibles de cirugía periapical, tomándose muestras microbiológicas antes y después de la irradiación con láser de Er:YAG. Posteriormente se realizaron controles clínicos y radiográficos a los 3, 6, 12, 24 meses. Los RESULTADOS del estudio in vitro muestran una disminución del crecimiento bacteriano de los dientes irradiados con láser de Er:YAG, a medida que aumentamos la potencia de aplicación. En el estudio clínico se observa una disminución de los microorganismos después del tratamiento fundamentalmente: "P.gingivalis, T.forsythensis, F.nucleatum y P.intermedia. En cuanto ala evolución clínica los resultados muestran un éxito del 95'5% a los 24 meses, y el 77'7% han terminado su osificación, presentando una relación estadisticamente significativa entre el grado de osificación y la presencia de microorganismos después del tratamiento

Social demand in ambulatory oral surgery. Experience in the Master of Oral Surgery of Madrid Complutense University (Spain)

Objectives. An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery. Study design. A descriptive statistical analysis (frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years. Results. A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62% versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was tooth extraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%. Conclusions. Our results show third molar extraction to be the most commonly demanded intervention in ambulatory oral surgery

Metaanalysis of the epidemiology and clinical manifestations of odontomas

Objective: To evaluate the epidemiological and clinical aspects of the different types of odontomas. Study design: A metaanalysis was made of 3065 odontomas obtained from a literature review of 30 articles published in recent years. Results: Odontomas show no gender predilection, and are most often diagnosed in the second decade of life. They are preferentially located in the upper maxilla, particularly in the anterior sector. Compound odontomas are more prevalent than complex odontoma, and show no predilection in terms of patient gender, age or location. Most such lesions are asymptomatic and constitute casual findings in X-ray studies indicated for other reasons. The most common clinical manifestations are the retention of permanent teeth and the presence of a tumor. Treatment consists of surgical removal of the lesion. The prognosis is very good, with a scant tendency towards relapse. Conclusions: Odontomas are the most common odontogenic tumors. Their most significant characteristics comprise alterations in tooth eruption, and the diagnosis is casually established in the course of routine X-ray studies

Clinical and radiological course in apicoectomies with the Erbium : YAG LASER

Objective. A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls. Material and methods. The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively. Results. The clinical course proved asymptomatic in 95.5% of the cases. As regards remodeling of the bone cavity, 77.7% had completed ossification after 24 months, 13.3% were in an advanced stage of ossification and 4.5% in an intermediate stage, while 4.5% showed treatment failure. Conclusions. The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7% bone cavity remodeling rate after 24 months

Knowledge about COVID-19 and pandemic impact on Madrid dental students (Spain)

COVID-19 has had a major impact on dental activity, with implications on dental education. The aim of this study was to assess the knowledge about it and the pandemic impact on Spanish dental students. An observational and cross-sectional study with a 1

Systematic review of the oral manifestations produced by the SARS-CoV-2 vaccine

To combat the coronavirus pandemic different vaccines have been developed. However, diverse adverse effects have been reported due to their use, including oral manifestations. Our objective is to review the existing bibliography to analyze what complications these vaccines have caused in the oral cavity.A bibliographic search was conducted by two independent reviewers (TS and CL), in parallel in 6 electronic databases (PubMed, Scopus, Cochrane, Google Scholar, LILACS, BioMed Central). A total of 22 articles were analyzed.The most frequent adverse effect was oral lichen planus, with a higher prevalence in women and after the Pfizer mRNA BNT162b2 vaccine.These complications are minor and resolve with treatment, so the benefit of the use of vaccines outweigh the potential risks associated with these

Efectos esterilizantes del láser Erbium:Yag sobre las estructuras dentarias: estudio in vitro

Objetivo: Comprobar el efecto esterilizante del láser de Erbium:YAG, a diferentes potencias, en dientes in vitro Diseño del estudio: Estudio in vitro sobre 47 dientes unirradiculares extraídos por motivos periodontales en la Unidad Docente de Cirugía Bucal y Maxilofacial (Departamento de Medicina y Cirugía Bucofacial) de la Facultad de Odontología de la Universidad Complutense de Madrid. Las muestras fueron divididas en tres grupos de irradiación con láser (250mJ, 350mJ y 450mJ) y un grupo control -no irradiados-. A continuación se introdujeron en un medio de enriquecimiento durante 72 horas en anaerobiosis, realizando controles visuales a las 24, 48 y 72 horas. Y posteriormente se realizaron cultivos microbiológicos en agar sangre, para confirmar los resultados de los controles visuales. Resultados: Se observa como a medida que aumenta la potencia de irradiación con el láser hay un mayor porcentaje de esterilización de las muestras, existiendo diferencias estadísticamente significativas entre el grupo control y cualquiera de los grupos láser. Conclusiones: El láser de Erbium:YAG presenta efecto esterilizante sobre las estructuras dentarias in vitro, que se va incrementando a medida que aumenta la potencia de aplicación del mismo.Aim: An evaluation was made of the sterilizing effects of the Erbium:YAG laser at different power ratings upon dental structures in vitro. Design: An in vitro study was made of 47 single-root teeth removed for periodontal reasons in the Oral and Maxillofacial Surgery Teaching Unit (Department of Medicine and Orofacial Surgery, Madrid Complutense University Dental School, Spain). The teeth were divided into three laser irradiation groups (250, 350 and 450 mJ) and a non-irradiated control group. The teeth were then immersed in an enrichment medium for 72 hours under conditions of anaerobiosis, with visual controls after 24, 48 and 72 hours. Posteriorly, microbiological cultures were made in blood agar to confirm the results of the visual inspections. Results: Increased percentage sterilization of the samples was recorded with increasing irradiation power - statistically significant differences being observed between all irradiated groups versus the controls. Conclusions: The Erbium:YAG laser exerts a sterilizing effect upon dental structures in vitro. This effect increases with increasing laser power ratings

Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects

Background: In recent years the use of orthopantomography has been proposed as a low-cost, reliable and noninvasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Patient and Methods: The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. Results: For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). Conclusions: The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque

Immediate post-extraction implants subject to immediate

Since Brånemark first started developing its implant system, there has been a continuous and significant evolution in oral implantology through experimental and clinical research, and many of the concepts that were once considered valid have now become the subject of debate. The insertion of the implant immediately after extraction of the tooth to be substituted has now become the implant treatment of choice and is associated with preserving the bone structure and the gingival architecture, as well as with reducing the treatment time, which ultimately benefits the patient. Objective: To evaluate the success rate of the immediate post-extraction implants (IPI) subject to immediate loading. Study Design: A meta-analytic study was carried out on 659 immediate post-extraction implants obtained from a bibliographic review of 25 articles published within the last 9 years. Results: We obtained a sample of 322 patients who had been treated with a total of 659 implants placed immediately following extraction. The mean age of the patients was 51 years old. A total of 441 implants were inserted in the maxilla, 152 in the mandible and 64 were placed in an unspecified location. The survival rate ranged between 85% and 100%. Conclusions: Immediate post-extraction implant treatment is an implant alternative with a survival rate similar to that of the conventional technique for implant placement and enables preserving both the bone structure and gingival architecture, as well as providing immediate functional loading, thus improving the quality of the treatment as far as the patient is concerned. © Medicina Oral S. L

Transmigrated canines: review and update

Transmigrated canines are impacted canines that have crossed the midline. Objective: To evaluate the epidemiological and clinical aspects that have to do with transmigrated canines. Study design: Bibliographic review of 209 transmigrated canines obtained from a review of articles from 1971 to the present. Results: Transmigrated canines are most frequent among females and are usually diagnosed within the first two decades of life. They are usually located in the mandible, with transmigration being most frequent in the left mandibular canine. In a large number of cases, the deciduous canine remains in the arcade. Transmigrated canines are most often found impacted, the primary position being mesially inclined, having crossed the midline. There is no pathology that is clearly associated with these canines, although radiolucence compatible with a cyst was found in a great percentage. Conclusions: Given that it is not possible to predict when dental transmigration is going to occur, we must monitor those mandibular canines which present a delay in their eruption, in order to try to carry out an interceptive treatment and avoid possible pathologies