Tratamiento de la boca seca: puesta al día

La boca seca es una situación muy común en la clínica odontológica y las causas que producen esta alteración de la secreción de saliva pueden ser múltiples. Es especialmente frecuente en personas de edad avanzada y en pacientes que están tomando gran cantidad de fármacos. El tratamiento de esta situación deberá estar relacionado con la eliminación de la causa que la produce y cuando esto no es posible se basará en el estimulo de la secreción salival con determinados fármacos o en la sustitución de la misma con las llamadas salivas artificiales. En este articulo queremos sistematizar de forma sucesiva las actuaciones terapéuticas a seguir en este tipo de pacientes.Dry mouth is a very common condition in dental practice, and the causes underlying this alteration in salivary secretion are diverse. The problem is particularly common in polymedicated elderly people. Treatment should aim to eliminate the background cause; however, when this is not possible, management should focus on the stimulation of salivation or the provision of a saliva substitute. The present study provides a systematic account of the management protocol for patients with dry mouth

Caries dental en diabéticos tipo 1: Influencia de factores sistémicos de la enfermedad en la instauración de la caries dental

Objetivos: La diabetes mellitus es una de las enfermedades crónicas más prevalentes en población general. Se presenta un estudio que pretende evaluar la presencia de caries en los pacientes diabéticos tipo 1. El objetivo específico era comprobar si había o no mayor incidencia de caries en diabéticos tipo 1 comparándolos con un grupo de individuos no diabéticos. También, se comprobó la relación con las tasas de flujo salival y con los factores propios de la enfermedad como el grado de control metabólico, el tiempo de evolución de la enfermedad y la existencia de complicaciones crónicas. Diseño del estudio: Se estudiaron 90 diabéticos tipo 1 de edades comprendidas entre los 18 y los 50 años de edad y un grupo de pacientes controles no diabéticos pareados por edad y sexo. Se realizó una exploración visual y táctil, en todos los dientes de los sujetos explorados. Se tuvo en cuenta el grado de la higiene oral mediante el índice de placa de O'Leary, y se estudiaron las tasas de saliva basal y estimulada en ambos grupos. En el grupo diabético se relaciono con el control de la enfermedad mediante la obtención de la media de la hemoglobina glicosilada (HbA1c) de los dos años previos a la exploración, así como la evolución de su enfermedad en años y la existencia de complicaciones como neuropatía diabética o retinopatía. Resultados: Bajo similares condiciones de higiene oral y de flujo salival, el grupo diabético resultó tener una incidencia de caries mayor que el grupo control (p<0.05). Asimismo, al estudiar específicamente al grupo diabético, ni el control metabólico de la enfermedad, ni la evolución de la enfermedad, ni la existencia de complicaciones de la diabetes tenían influencia en la instauración de caries dental. Conclusiones: Se sugiere que habría que estudiar factores cualitativos salivales que explicasen esta mayor incidencia de caries en los diabéticos.Objectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O'Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population

Type 1 diabetes mellitus and periodontal disease : relationship to different clinical variables

Objective: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications. Methods: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications. Results: Diabetics had greater bleeding index (p<0.01), deeper periodontal pockets (p<0.01) and more periodontal attachment loss (p<0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p?0.02). Conclusions: Patients with type 1 diabetes appear to show increased periodontal disease susceptibility, particularly those with poorer metabolic control or with diabetic complications

Dental caries in type 1 diabetics : influence of systemic factors of the disease upon the development of dental caries

Objectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O?Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population

Adjuvant Effect of Titanium Brushes in Peri-Implant Surgical Treatment: A Systematic Review

Background: the prognosis of peri-implant surgery can be affected by poor decontamination of the implant surface, which could be improved with the use of titanium brushes. The objectives of this systematic review were to evaluate the effectiveness of titanium brushes in the decontamination of the implant surface in terms of plaque index, probing depth, bleeding on probing and bone loss/gain; as well as its effectiveness according to the type of peri-implant bone defect. Methods: an electronic search was carried out in the PubMed, Scopus, Cochrane and Embase databases, as well as a manual search. The search strategy included four keywords: “Peri-implantitis”, “Periimplantitis”, “Implant Surface Decontamination” and “Titanium Brush”. Randomized controlled studies published in the last 10 years were included and systematic reviews, in vitro studies and animal studies were excluded. Results: 142 references were found, from which only four articles met the inclusion criteria. All of the studies included in the present review reported beneficial results in terms of probing depth, gingival index and radiographic bone loss and gain after implant surface decontamination adjuvated by titanium brushes. Conclusions: titanium rotary brushes show improvements in the evolution and prognosis of peri-implant surgery, although more long-term studies are needed to draw more solid conclusionsOdontologí

Cardiopulmonary resuscitation training for odontologists.

La formación en procedimientos de resucitación cardiopulmonar es cada vez más necesaria en ámbitos extrahospitalarios como son los gabinetes de odonto-estomatología. El presente artículo muestra un estudio observacional sobre la evaluación teórica, práctica y el control de calidad en un curso de reanimación cardiopulmonar instrumental impartido en el conjunto de la programación del Máster universitario y oficial para odontólogos, de la Universidad Católica de Valencia San Vicente Mártir. Se concluye que la adquisición del conocimiento y de las habilidades psicomotoras necesarias para abordar con eficacia situaciones de paro cardiorrespiratorio, se pueden conseguir con escaso coste económico y de consumo de tiempo por los profesionales de odontología en activo; se evidencia, de forma objetiva, la adquisición de un elevado nivel de conocimientos teóricos y prácticos en todos los participantes, así como el haber conseguido un elevado nivel de seguridad y confianza para abordar situaciones futuras de paro cardiorrespiratorio.Training in cardiopulmonary resuscitation procedures is increasingly necessary in extra-hospital settings, such as cabinets of stomatology. This article presents an observational study on the theoretical, practical assessment and quality control, in a course of cardio pulmonary resuscitation instrumental given in the whole programming University Master for dentists, Catholic University of Valencia. Concluding that the acquisition of knowledge and psychomotor skills necessary to effectively address situations of cardio respiratory arrest can be achieved with little cost and time consumption by dental professionals active; objectively demonstrating the acquisition of a high level of knowledge and skills of all participants; as well as having achieved a high level of security and confidence among all participants to address future situations of cardio respiratory arrest.Medicin

Formación en reanimación cardiopulmonar instrumental para odontólogos

Training in cardiopulmonary resuscitation procedures is increasingly necessary in extra-hospital settings, such as cabinets of stomatology. This article presents an observational study on the theoretical, practical assessment and quality control, in a course of cardio pulmonary resuscitation instrumental given in the whole programming University Master for dentists, Catholic University of Valencia. Concluding that the acquisition of knowledge and psychomotor skills necessary to effectively address situations of cardio respiratory arrest can be achieved with little cost and time consumption by dental professionals active; objectively demonstrating the acquisition of a high level of knowledge and skills of all participants; as well as having achieved a high level of security and confidence among all participants to address future situations of cardio respiratory arrest.La formación en procedimientos de resucitación cardiopulmonar es cada vez más necesaria en ámbitos extrahospitalarios como son los gabinetes de odonto-estomatología. El presente artículo muestra un estudio observacional sobre la evaluación teórica, práctica y el control de calidad en un curso de reanimación cardiopulmonar instrumental impartido en el conjunto de la programación del Máster universitario y oficial para odontólogos, de la Universidad Católica de Valencia San Vicente Mártir. Se concluye que la adquisición del conocimiento y de las habilidades psicomotoras necesarias para abordar con eficacia situaciones de paro cardiorrespiratorio, se pueden conseguir con escaso coste económico y de consumo de tiempo por los profesionales de odontología en activo; se evidencia, de forma objetiva, la adquisición de un elevado nivel de conocimientos teóricos y prácticos en todos los participantes, así como el haber conseguido un elevado nivel de seguridad y confianza para abordar situaciones futuras de paro cardiorrespiratorio

In Vitro Study on the Influence of Silver Diamine Fluoride on the Adhesion Strength of Dental Restorative Materials

Silver diamine fluoride (SDF) has demonstrated its clinical success for years in the arrest of caries lesions; however, the influence it could have on the success of restorations after its application still remains unknown. The purpose of this research was to study the relationship between the use of SDF and the adhesive strength of the materials used in restorations made with glass ionomers and composite resin, as well as with different adhesive systems. A sample consisting of 240 teeth divided into eight groups with 30 teeth in each of them (n = 30) was used. In these groups, the use of restoration with composite resin and glass ionomer was compared using different adhesive systems, with and without prior application of SDF. Notable differences in adherence were observed among the different groups depending on the filling material. There is also a significant effect of tooth type on adhesion. We can conclude that there is a relationship between the use of SDF and the adhesion between the tooth and the restorative materials analyzed.The authors thank the Catholic University of Valencia San Vicente Mártir for their contribution and help in the payment of the Open Access publication fee under grant number 2021-196-001