El diagnóstico por imagen en la prevención de las lesiones del nervio dentario en la cirugía del tercer molar : Estudio descriptivo-comparativo entre la ortopantomografía y la tomografía transversal

El tratamiento quirúrgico de los terceros molares inferiores constituye una de las actividades mas frecuentes tanto para el cirujano bucal como para el maxilofacial. La posibilidad de lesionar durante la intervención el nervio dentario inferior conduce a una situación molesta y desagradable para el paciente y que en ocasiones puede conllevar una serie de implicaciones medico-legales. Es por ello que durante el desarrollo de este trabajo se ha planteado encontrar diferentes formas de diagnostico que posibiliten, al menos hipotéticamente, una solución fiable que evite la lesión de este tronco nervioso periférico. Para el desarrollo de nuestro trabajo se utilizaron, en una primera fase, 480, mandíbulas desecadas sobre las que se detectaron 50 casos que reunían los criterios de inclusión establecidos. En una segunda fase, se seleccionaron 112 casos sobre 532 pacientes que fueron remitidos para ser intervenidos por presentar retención de terceros molares inferiores. En ambas fases, se analizaron, entre otros, aspectos anatómicos del conducto dentario, así como una serie de signos radiológicos a nivel dentario y del conducto. El análisis de resultados permitió determinar que no existen diferencias significativas entre ambas muestras objeto de estudio. Anatómicamente, el conducto dentario resulto ser de mayores dimensiones en los varones, a la vez que en estos los terceros molares mas frecuentemente encontrados fueron los horizontales, siendo en el caso de las mujeres los verticales. En cuanto a la visualización radiológica del conducto, la radiografía panorámica ofreció una visión aceptable, que pudo complementarse en un alto porcentaje con la utilización de cortes tomográficos. Los signos radiológicos que presuponían un íntimo contacto entre el tercer molar y el conducto dentario fueron fundamentalmente el oscurecimiento de la raíz y la perdida de corticación del conducto. A raíz de estos resultados podemos establecer que uno de los métodos diagnósticos mas adecuados para la prevención de las lesiones del nervio dentario inferior durante las intervenciones de los terceros molares, será la utilización conjunta de la ortopantomografia junto a la tomografía transversal, lo que nos ofrecerá una imagen tridimensional

Brain complications from odontogenic infections: A systematic review

Purpose: Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3−1.3 / 100,000 population and only 2−5% are of dental origin. The main objective is to research brain complications derived from odontogenic infections. Secondary objectives were to identify the most common symptoms in brain abscess, to describe the microbiology involved in these infectious processes, report which parts of the brain complex are most commonly affected and report the sequelae of this patients. Methods: A systematic review following the PRISMA Guide and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was carried out in PubMed, Scopus and Web of Science. The search terms were: Brain infection, brain abscess, oral health oral origin, odont* infect*. Results: The database search identified a total of 1000 articles. A total of 18 publications were identified after applying inclusion and exclusion criteria. A total of 38 patients were analyzed. Mean age was 49.64§ 18.80 years. Conclusion: The most common symptoms of patients with brain abscess are neurological affectations first and then fever and headache second, without necessarily presenting as a symptomatological triad. Microbiological diagnosis is key to determining the origin of the infection. Anaerobic pathogens such as Streptococcus (F. Milleri), Fusobacterium Nucleatum and Porfiromonas Gingivalis families are common bacterial agents. The frontal lobe is the most frequently affected, followed by the parietal and temporal lobe. The most frequent brain complications are neurological disorders. However, most patients with brain abscesses recover without sequelae

Evaluación del aprendizaje según dos métodos de enseñanza diferentes: clase tradicional frente a aprendizaje basado en problemas cortos

Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaFALSEsubmitte

Aplicación de la herramienta Socrative® para la evaluación en la asignatura "Repercusiones Bucales de las Enfermedades Sistémicas" en los alumnos de Odontología a través de dispositivos móviles. Fase I. Examen tipo test de preguntas dicotómicas

Incorporación de la herramienta interactiva Socrative® para la gestión de la participación de los alumnos y la evaluación rápida en tiempo real por parte del profesor en la asignatura "Repercusiones Bucales de las Enfermedades Sistémicas" en 3er Curso de Grado de Odontología.Se realizan preguntas y los alumnos contestan a través de sus dispositivos móviles, obteniendo un feedback inmediato de sus contestaciones

Adaptación a la docencia online de las prácticas preclínicas de Cirugía Bucal I

Los cambios en la docencia debido a la pandemia por la COVID-19 ha llevado a la reducción de la presencialidad y a un aumento de la docencia online. Por ello se diseñó este proyecto, cuya finalidad fue la adaptación a la docencia online de las prácticas preclínicas de Cirugía Bucal I. Para el desarrollo de este trabajo se realizaron las rúbricas de evaluación de cada módulo de la asignatura, se elaboraron videos y documentación para subir al campus virtual antes de la realización de la práctica. Finalmente, se elaboraron cuestionarios de evaluación de la satisfacción de los estudiantes y profesorado con esta metodología. Los resultados mostraron una elevada satisfacción de ambos grupos, considerándola una herramienta de utilidad en el aprendizaje y de implementación en cursos posteriores

Influence of the Sanitary, Economic, and Social Crisis of COVID-19 on the Emotional State of Dentistry in Galicia (Spain)

The main objective of this research was to analyze the economic, social, and emotional repercussions among Galician dentists (Spain) as a consequence of the COVID-19 pandemic. A survey was filled out by 347 professionals. After verifying the survey’s reliability using Cronbach’s alpha = 0.84, the professional activity and emotional state of the participants were assessed based on aspects related to their personal and family data. The economic impact of the pandemic was considerable, and all participants experienced a decrease in income. In total, 72% of the participants considered that working with personal protective equipment (PPE) made their clinical activities difficult, and 60% expressed concern about being infected during their professional practice. Among the professionals, women (p = 0.005), and separated, divorced, or single professionals (p = 0.003) were the most strongly affected. Separated or divorced professionals were the group that most frequently raised the need to make a radical change in their lives. Finally, it was observed that the emotional consequences varied substantially in the lives of these professionals, mainly among female dentists (p = 0.010), separated and divorced men (p = 0.000), and those with fewer years of professional practice (p = 0.021). The COVID-19 pandemic had an economic impact, due to the decrease in the number of patients and hours of attention, as well as an emotional impact, mostly expressed in the form of sleep disorders and stress. The most vulnerable professionals were women and professionals with fewer years of experience

Calcium Phosphate Modified with Silicon vs. Bovine Hydroxyapatite for Alveolar Ridge Preservation: Densitometric Evaluation, Morphological Changes and Histomorphometric Study

After tooth extraction, the alveolar bone undergoes a physiological resorption that may compromise the future placement of the implant in its ideal position. This study evaluated bone density, morphological changes, and histomorphometric results undergone by alveolar bone after applying a new biomaterial composed of calcium phosphate modified with silicon (CAPO-Si) compared with hydroxyapatite of bovine origin (BHA). Alveolar ridge preservation (ARP) was performed in 24 alveoli, divided into a test group filled with CAPO-Si and a control group filled with BHA. Three months later, the mineral bone density obtained by the biomaterials, horizontal and vertical bone loss, the degree of alveolar corticalization, and histomorphometric results were evaluated. Both biomaterials presented similar behavior in terms of densitometric results, vertical bone loss, and degree of alveolar corticalization. Alveoli treated with CAPO-Si showed less horizontal bone loss in comparison with alveoli treated with BHA (0.99 ± 0.2 mm vs. 1.3 ± 0.3 mm), with statistically significant difference (p = 0.017). Histomorphometric results showed greater bone neoformation in the test group than the control group (23 ± 15% vs. 11 ± 7%) (p = 0.039) and less residual biomaterial (5 ± 10% vs. 17 ± 13%) (p = 0.043) with statistically significant differences. In conclusion, the ARP technique obtains better results with CAPO-Si than with BHA

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology

Periosteal Pocket Flap technique for lateral ridge augmentation. A comparative pilot study versus guide bone regeneration

Background: Implant rehabilitation of posterior mandibular defects is frequently associated to a horizontal bone loss. There exist several regenerative techniques to supply this bone deficiency, one of which is the Periosteal Pocket Flap Technique (PPF) proposed by Steigmann et al. to treat small horizontal bone defects. The present study proposes a modification of this technique based on the concurrent use of PPF with the use of xenogeneic and autologous bone and Plasma Rich in Growth Factors (PRGF). The aim of this study is to evaluate clinical and radiographic outcomes of the PPF with the use of xenogeneic and autologous bone and PRGF in comparison with conventional Guided Bone Regeneration (GBR) procedures. Methods: Nine patients were enroled in the study (7 women and 2 men, mean age: 53 ± 2.74 years) and allocated to PPF or GBR. In both groups implant placement was performed simultaneously to bone regeneration. Preoperative CBCT scans were performed for each patient. Surgical time and postoperative pain were recorded, as well as tissue healing. Moreover, horizontal bone gain (mm), graft surface area (mm2) and graft volume (mm3) were evaluated. Results: Nine surgeries were performed: 6 PPF and 3 GBR. Regarding clinical outcomes, operative time was significative greater in GBR group than in PPF group (51.67 ± 3.51 min vs. 37 ± 5.69 min; p = 0.008). Postoperative pain was higher in GBR compared to PPF (p = 0.011). Regarding radiographical results, there were not significant differences in horizontal bone gain (PPF: 9.43 ± 1.8 mm; GBR: 9.28 ± 0.42 mm), surface area (PPF: 693.33 ± 118.73 mm2; GBR: 655.61 ± 102.43 mm2), and volume (PPF: 394.97 ± 178.72 mm3; GBR: 261.66 ± 118 mm3) between groups. Conclusions: This prospective study demonstrates that the combination of autograft/xenograft and PRGF in PPF technique is a simpler, cheaper, and faster technique than GBR technique for achieving moderate lateral bone augmentation in implant treatment. Future randomised clinical studies are needed to confirm the results.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaTRUEpu

Clinical performance of tooth root blocks for alveolar ridge reconstruction

This systematic literature review set out to investigate the clinical outcomes of autogenous tooth root blocks used for ridge augmentation: survival rates, block resorption, implant survival, post-surgical complications, and histology findings. This review followed PRISMA guidelines. An automated search was made in four databases, supplemented by a manual search for relevant articles published before December 2020. The quality of evidence provided was assessed with the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Seven articles fulfilled the inclusion criteria and underwent analysis. The articles included a total of 136 patients, who received 118 autogenous tooth root blocks and 26 autogenous bone blocks showing block survival rates of 99.15% and 100%, respectively. Tooth root blocks presented a mean bone gain that was similar to autologous bone blocks but showed less resorption. The implant survival rate was 98.32% for autogenous tooth root blocks. Reconstruction of alveolar crests by means of autogenous tooth root blocks appears to be a satisfactory option for single-tooth gaps and low grades of bone atrophy in terms of the survival of the bone block and the implants placed subsequently. More research providing long-term data is needed to confirm these findings.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaTRUEpu