Spanish Rhythm Association member´s perspectives on cardiac implantable electronic device reuse in low- and middle-income countries

Background: Postmortem explanted cardiac implantable electronic devices (CIEDs) from developed countries could provide patients unable to afford new devices in low- and middle-income countries (LMIC) a treatment they lack. This study describes the preferences of electrophysiologists and device implanting cardiologists from Spain on the management of explanted CIEDs and opinions and concerns regarding reuse in LMIC. Methods: A nationwide self-administered questionnaire was sent to members of the Spanish Rhythm Association (n = 1110), between December 2020 and January 2021. Results: Forty-two physician responses were obtained (response rate 5%). There was a strong preference to donate explanted devices for reuse in humans (61.9%) or animals (31%). The vast majority of the participants thought device reutilization was safe, ethical, and a reasonable alternative if a new device is not accessible. Moreover, they indicated they would be comfortable asking patients to consider post-mortem donation, and willing to implant post-mortem explanted and resterilized devices if they were unable to obtain new ones. 57.1% of respondents considered it would be beneficial for patients to have a document so they could reflect their wishes regarding device handling after their death. The most mentioned concerns regarding device reuse were malfunction (57.1%) and infection (54.8%). Conclusions: The majority of respondents support reusable CIED donation to LMIC. It would be interesting to study the feasibility of a nationwide device reutilization program

Childhood dental caries experience in northern Spain: a cross-sectional study

Purpose This study aimed to describe the caries experience in primary and permanent dentition of schoolchildren from a sample taken in public schools in Bilbao, to identify the most vulnerable child population, and compare them with the findings obtained by the Children's Dental Care Programme in the region of the Basque Country (Spain). Methods A cross-sectional study was conducted using a representative sample (n = 1682) of children from 5-year-old early childhood education classes and the first- and second-year elementary classes in public schools in Bilbao. The dependent variable was the caries experience determined through oral examinations carried out by a single dentist. On the other hand, independent variables were measured through questionnaires completed by families, with help from teachers as appropriate. In the statistical analysis, Mann-Whitney and Kruskal-Wallis nonparametric tests, as well as two logistic regressions, were performed, and the significance level was set at alpha = 0.05 for decision making. Results The mean (SD) values of dft, DMFT, DMFS and DMFT of first permanent molars scores were 1.25 +/- 2.20, 0.16 +/- 0.61, 0.20 +/- 0.90 and 0.15 +/- 0.57, respectively. Compared to the findings in the most recent PADI report, the schoolchildren in our sample had slightly greater experience of dental caries in primary dentition and much greater experience in permanent dentition. Conclusion The dft index of the primary dentition for the current sample is 1.25, while the DMFT index for the permanent dentition is 0.16. Among pupils in early childhood and elementary education in public schools in Bilbao, children from families with low socioeconomic status and educational attainment are most vulnerable to developing caries.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. JF-B received a grant from Bilbao City Council to carry out this study (2015-061533)

Hortzetako txantxarra: etiopatogeniaren garapena eta osasun publikoaren erronka

Knowledge about the etiopathogenesis of dental caries has advanced a great deal in recent decades. Nevertheless, the disease remains a great challenge for public health. It is necessary to continue the research and implement new preventive strategies, especially in the most vulnerable communities, taking into account the sociodemographic factors that influence the onset of the disease. Currently, the individual preventive strategy is not effective to deal with caries inequalities. Dental caries experience has decreased in recent decades with the implementation of the PADI program and the fluoridation of waters in the region of the Basque Country, being among the best in Europe. However, lower social classes still have much higher caries experience than the rest. That is why it is very important that, if the Basque Government finally stops the fluoridation of water, methodologically rigorous studies are carried out to evaluate the impact of this measure, especially on vulnerable groups.; Hortzetako txantxarraren etiopatogeniari buruzko ezagutzak asko aurreratu dira azken hamarkadetan, baina gaixotasunak osasun publikoarentzat erronka handia izaten jarraitzen du. Beharrezkoa da ikerketarekin jarraitzea eta prebentzio-estrategia berriak ezartzea, batez ere komunitate ahulenetan, gaixotasuna sorrarazten duten faktore soziodemografikoak kontuan hartuta. Gaur egun jarraitzen den estrategia prebentibo indibiduala ez da eragikorra txantxarrak sortzen dituen desberdintasunei aurre egiteko. Azken hamarkadetan aho-hortzetako txantxarren indizeak jaitsi egin dira Euskal Autonomia Erkidegoan, PADI programari eta uren fluorizazioari esker; gaur egun Europako onenen artean daude. Hala ere, klase sozial baxuenek besteek baino indize askoz handiagoak dituzte. Hori dela eta, oso garrantzitsua da Eusko Jaurlaritzak, azkenean uraren fluorizazioa bertan behera uzten badu, azterketa metodologiko zorrotzak egitea erabaki horren eragina neurtzeko, bereziki talde ahuletan

Complications of harvesting a connective tissue graft from the palate. A retrospective study and description of a new technique

Connective tissue graft (CTG) is considered as the gold standard for the treatment of gingival recessions (GR). There are few studies assessing the complications that can arise in the donor site when harvesting a connective tissue graft (CTG) and how the harvesting technique can influence those complications. A retrospective clinical study was carried out in order to compare the complications observed in 40 patients with Miller class I, II and III GR ? 3 mm, after using the trap-door technique (TD) in the control group and a newly described technique, the ?UPV/EHU technique?, in the test group. Patients were consecutively allocated to each treatment group. Patients were monitored 14 days after surgery in order to evaluate post-operative complications in the donor site: presence of pain (P), bleeding (B), infection (I) and necrosis > 30%. Although morbidity was observed in both groups, it was less important in the test group (no pain and minimal pain in 30% and 35% of the cases, respectively, and absence of bleeding or infection and necrosis >30% in only 5% of the cases). Within the limits of this study, this newly described ?UPV/EHU technique? should be considered as a treatment option when harvesting a CTG, with minimal morbidity for patients

Description of the Modified Vestibular Incision Subperiosteal Tunnel Access (m-VISTA) Technique in the Treatment of Multiple Miller Class III Gingival Recessions: a Case Series

BackgroundGingival recession is a common finding in the adult population. It is considered a challenge for clinicians to obtain a complete root coverage of Miller class III recession. The aim of this case series was to assess the outcomes achieved with the use of modified VISTA technique (m-VISTA) in patients having multiple Miller class III recessions after 6 months.MethodsTen patients (six women and four men; mean age: 53 years), who showed multiple Miller class III recessions (depth >= 2 mm) and who met the established inclusion and exclusion criteria, were treated by postgraduate students with the use of m-VISTA technique.ResultsA total of 38 recessions were performed. The recessions were mainly located in the mandible (80%), which included six molars. The mean baseline recession was 3.12 mm. Post the intervention, a mean root coverage of 58.72% was achieved, with complete root coverage observed in 29% of the recessions.Conclusionsm-VISTA may offer several advantages in the treatment of Miller class III gingival recession. Nevertheless, more clinical trials with a longer follow-up period are needed to arrive at a concrete conclusion about its advantages.Trial registration: NCT03258996.Data registration: 08/18/2017

Epidermal growth factor receptor expression in different subtypes of oral lichenoid disease

The oral lichenoid disease (OLD) includes different chronic inflammatory processes such as oral lichen planus (OLP) and oral lichenoid lesions (OLL), both entities with controversial diagnosis and malignant potential. Epidermal growth factor receptor (EFGR) is an important oral carcinogenesis biomarker and overexpressed in several oral potentially malignant disorders. Objectives: To analyze the EGFR expression in the OLD to find differences between OLP and OLL, and to correlate it with the main clinical and pathological features. Material and Methods: Forty-four OLD cases were studied and classified according to their clinical (Group C1: only papular lesions / Group C2: papular and other lesions) and histopathological features (Group HT: OLP-typical / Group HC: OLP-compatible) based in previous published criteria. Standard immunohistochemical identification of EGFR protein was performed. Comparative and descriptive statistical analyses were performed. Results: Thirty-five cases (79.5%) showed EGFR overexpression without significant differences between clinical and histopathological groups (p<0.05). Histological groups showed significant differences in the EGFR expression pattern (p=0.016). Conlusions: All OLD samples showed high EGFR expression. The type of clinical lesion was not related with EGFR expression; however, there are diff erences in the EGFR expression pattern between histological groups that may be related with a different biological profile and malignant risk

Single Tooth Restoration in the Maxillary Esthetic Zone Using a One-Piece Ceramic Implant with 1 Year of Follow-Up: Case Series

BACKGROUND: Oral implants have helped clinicians to improve the quality of life for many patients. The material of choice for dental implants currently remains titanium type IV, whose mechanical and biological properties have been proven throughout the history of implantology. Yet, this material is not exempt from complications. For these reasons, ceramic alternatives to titanium have emerged. Thus, the purpose of this study is to evaluate peri-implant hard and soft tissue stability with the use of a one-piece ceramic implant (Straumann PURE Ceramic Implant) during 1 year of follow-up. STUDY DESIGN: One-piece all-ceramic zirconia (ZrO2) implants were placed to replace single missing teeth in the esthetic zone. Six to 8 weeks after the procedure, the definitive prosthesis was fabricated. At the time of prosthesis, placement (T0) photographs and periapical radiographs were taken, and the following clinical parameters were recorded: probing depth (PD), plaque index (PI), bleeding on probing (BOP), suppuration on probing (SOP), distance from gingival margin to incisal edge (GM-IE), and Jemt papilla index (JPI). Follow-up appointments were scheduled at 4 (T4), 8 (T8), and 12 (T12) months, when the same parameters were recorded. In addition, plaque control was reinforced and prophylaxis was carried out. In this last appointment, a final periapical radiograph was taken to assess marginal bone loss. RESULTS: A total of 32 zirconia implants were placed in 28 patients (16 women and 12 men, aged between 34 and 67 years). The survival and success rate were 96.9%. The increase in probing depth from baseline to 12 months was 0.78 mm. Assessments of plaque index and bleeding on probing showed a slight increase throughout the study. CONCLUSIONS: The results obtained with the Straumann PURE Ceramic implants show them to exhibit very good clinical behavior. The survival rate of the implants of our pilot study was 96.9%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zon

The role of microRNAs in oral lichenoid disorders. Systematic review

Background: Certain changes in the microRNA expression are considered to be associated with chronic inflammatory processes and with the malignant transformation of oral potentially malignant disorders. The purpose of this systematic review is to update the existing data on the aberrant microRNA expression profiles identified in oral lichenoid disease (OLD).Material and Methods: A search in PubMed-Medline and Scopus was performed on the English literature published between 2010 and August 2016 using the following keywords: oral lichenoid disease, oral lichen planus and microRNA. Results: Originally, 25 articles were considered, of which 12 case-control articles were selected according to the inclusion/exclusion criteria.Conclusions: OLD seems to have altered microRNA expression profile. Certain altered microRNAs (146a, 155) may be useful as biomarkers for this disorder. More studies including larger number of cases are needed in order to study further on the biological processes and on the regulation pathways of these altered microRNAs.peer-reviewe

Prevalence of acute oral mucosal damage secondary to the use of systemic antineoplastics: A systematic review and meta-analysis

OBJECTIVE: The aim of this study was to determine the prevalence of acute oral mucosal toxicities in non-irradiated patients treated with systemic antineoplastics agents. The secondary objective was to find out differences in its prevalence among the different types of systemic antineoplastics. STUDY DESIGN: A systematic review and meta-analysis was performed. Articles from 2010 to July 2022 were retrieved and included if patients were adults undergoing oral assessment after administration of commercially available systemic antineoplastics. Data was extracted and pooled proportions were estimated using random-effect model method (Der Simonian and Lair). RESULTS: Eighty-two articles were included in the study. The overall prevalence of acute oral mucosal damage across studies was 38.2% (95% CI: 33.1%-43.3%). The prevalence was 42.9% (95% CI: 32.8%-53%) in patients treated with chemotherapy alone, 38% (95% CI: 29.1%-47%) in patients treated with a combination of chemotherapy and targeted therapies, and 32.1% (95% CI: 26.8%-37.5%) in targeted therapies alone-treated patients. No statistically significant differences were found in the prevalence of oral mucosal toxicities between the different types of systemic antineoplastic treatments. CONCLUSIONS: Oral mucosal toxicity is a major side effect in non-irradiated cancer patients undergoing systemic antineoplastics

20 years of alveolar distraction : a systematic review of the literature

The Vertical Alveolar Distraction Osteogenesis (VADO) technique is an excellent solution for bone and soft tissue neoformation in areas in which there has been significant bone atrophy that hinders normal rehabilitation using dental implants. The goal of this systematic review is to analyze the most relevant articles published on VADO in the literature over the past 20 years. The review was performed by using the keywords: ?alveolar ridge?, ?distraction ostegenesis? and ?dental implant?. This search produced a total result of 240 articles. The clinical studies and cases reported in humans amounted to 113 articles, 18 articles referred to studies developed on animals and 33 review articles. The presentation of this systematic analysis follows the criteria described in the PRISMA declaration. 22 articles complied with the inclusion criteria and 7 articles more were added manually, reaching a total sample of 29 studies. Following the analysis of the studies, they were classified into 18 high-quality, 10 mediumquality and 1 low-quality study. Only 4 studies achieved a maximum score of 9 (according to NewCastle Ottawa Scale, NOS). VADO is a technique with greater potential in vertical gain. The performance of dental implants has a success and survival rate similar to dental implants placed on bones that are not subject to increase techniques