Periodontal disease affecting tooth furcations. A review of the treatments available

The molars are the teeth that suffer the greatest periodontal destruction in untreated patients. When periodontal disease affects the furcation of a tooth, the chance that it will be lost increases considerably. An increase in the exposed root surface, anatomical peculiarities and irregularities of the furcation surface all favor the growth of bacteria. These problems make it harder for the patient to maintain hygiene, and impede adequate treatment. The treatment of furcations affected by periodontal disease is one of the most difficult problems for the general dentist and periodontist. The motivation of both the attending professional and of the patient are therefore of great importance. No ideal procedure for treating such lesions exists. The present paper reviews those options that are currently available. Long-term research will be needed, along with the development of new techniques, to solve the problem of furcations affected by periodontal disease, possibly including substitution of the affected tooth by an implant

Etiology, risk factors and management of implant fractures

Implant fracture is an infrequent and late biomechanical complication with a serious clinical outcome. In effect, such fractures pose important problems for both the patient and the dental surgeon. According to most literature sources, the prevalence of dental implant fractures is very low (approximately 2 fractures per 1000 implants in the mouth). Considering that implant placement is becoming increasingly popular, an increase in the number of failures due to late fractures is to be expected. Clearly, careful treatment can contribute to reduce the incidence of fracture. An early diagnosis of the signs alerting to implant fatigue, such as loosening, torsion or fracture of the post screws and prosthetic ceramic fracture, can help prevent an undesirable outcome. The present literature review describes the management options and discusses the possible causal mechanisms underlying such failures, as well as the factors believed to contribute to implant fracture

Periodontal disease and nonsurgical periodontal therapy on the ohrqol of the patient: a pilot study of case series

© 2023. The authors. This document is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/ This document is the published version of a published work that appeared in final form in Dentistry JournalThe objective of this prospective study was to assess oral health-related quality of life (OHR-QoL) in patients with periodontitis and nonsurgical periodontal treatment. A prospective, longitudinal case series study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia. Eighty periodontal patients with periodontitis, aged 22 to 72 years, were included in this study. The Spanish version of the Oral Health Impact Profile 14 (OHIP-14sp) questionnaire was used on two occasions: at the first visit and one month after completing the nonsurgical periodontal treatment. Clinical measurements of probing depth, plaque index and bleeding on probing were performed at baseline and after periodontal therapy. Data were analyzed using Student’s t-test and analysis of variance. We found statistically significant differences (p < 0.05) between the pre- and posttreatment in all the dimensions studied except disability. Similarly, statistically significant differences were also found according to the degree or stage of the disease. However, these differences were not observed with respect to the extent of periodontal disease. Periodontal disease has a negative impact on the OHRQoL of periodontal patients, especially in severe stages (III–IV). Basic periodontal treatment can improve the OHRQoL of periodontal patients one month after treatment

Root Structure and Growth in Diverse Soils

Unlike most biofuel species, Jatropha curcas has promise for use in marginal lands, but it may serve an additional role by stabilizing soils. We evaluated the growth and structural responsiveness of young J. curcas plants to diverse soil conditions. Soils included a sand, a sandy-loam, and a clay-loam from eastern Mexico. Growth and structural parameters were analyzed for shoots and roots, although the focus was the plasticity of the primary root system architecture (the taproot and four lateral roots). The sandy soil reduced the growth of both shoot and root systems significantly more than sandy-loam or clay-loam soils; there was particularly high plasticity in root and shoot thickness, as well as shoot length. However, the architecture of the primary root system did not vary with soil type; the departure of the primary root system from an index of perfect symmetry was 14 ± 5% (mean ± standard deviation). Although J. curcas developed more extensively in the sandy-loam and clay-loam soils than in sandy soil, it maintained a consistent root to shoot ratio and root system architecture across all types of soil. This strong genetic determination would make the species useful for soil stabilization purposes, even while being cultivated primarily for seed oil

A GIS-supported Multidisciplinary Database for the Management of UNESCO Global Geoparks: the Courel Mountains Geopark (Spain)

[Abstract] The management of a UNESCO Global Geopark (UGGp) requires a vast wealth of miscellaneous scientific knowledge that can be successfully organised using a Geographical Information System (GIS). This paper presents a pragmatic GIS database to assist in the suitable governance of the Courel Mountains UGGp (2017) in Northwest Spain. The database is structured in 66 coverages compiled from public sources and previous works or produced through traditional mapping (combining fieldwork and photointerpretation) and GIS tools. The acquired data was later homogenised and validated by a multidisciplinary team and archived in independent coverages. Forty thematic maps illustrate the broad range of cartographic information included in the GIS database. Among them, 25 basic maps provide an overview of the UGGp and 15 new maps focus on crosscutting and technical issues. All maps illustrate the huge potential of GIS to create new resources combining coverages and adapting the legend according to their purpose and audience. The database facilitates the suitable publishing of consistent outputs (e.g., brochures, books, panels, webpages, web serves), as well as the elaboration of technical data to assist the park management. The database furnishes information on the design of education actions, touristic routes, activities and Geopark facilities. The GIS database is also a supportive tool for scientific research and provides the necessary knowledge to conduct geoconservation actions based on land use, geological hazards and the occurrence of natural and cultural heritages. Altogether, the GIS database constitutes a powerful instrument for policy-making, facilitating the identification and evaluation of alternative strategy plans.This work was developed in the framework of the Scientific Program of the Courel Mountains UGGp with the cooperation of tourism agents (A.M. Arza and A. López), roofing slate quarries (Pizarras de Villarbacú, Pizarras de Quiroga) and local people (M. Reinosa, G. Díaz, O. Álvarez). We are deeply grateful to J.R. Martínez Catalán (Universidad de Salamanca), A. Pérez-Alberti and J. Guitián (both from Universidade de Santiago de Compostela), J.R. Gutiérrez-Marco (ICOG, Universidad Complutense de Madrid/CSIC), J. Vegas (IGME-CSIC), L. González-Menéndez (IGME-CSIC), J.M. García Queijeiro (Universidade de Vigo), L. Santos and A. Grandal-D’Anglade (both from Universidade da Coruña) for their assistance supplying information involved in the database. We thank also E. de Boer for proofreading the article. DB is grant holder of Plan Andaluz de Investigación, Desarrollo e Innovación 2021, funded by Junta de Andalucí

Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol

Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy

Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects

Foro de debate: seguridad de las alternativas a la transfusión alogénica en el paciente quirúrgico y/o crítico

Estos últimos años han aparecido alertas de seguridad, no siempre bien sustentadas, que cuestionan el uso de algunas alternativas farmacológicas a la transfusión de sangre alogénica y/o lo restringen en indicaciones establecidas. Asistimos también a la preconización de otras alternativas, incluyendo productos hemáticos y fármacos antifibrinolíticos, sin que haya una base científica sólida que lo justifique. Por iniciativa del Grupo de Estudios Multidisciplinares sobre Autotransfusión y del Anemia Working Group Espana¿ se reunió a un panel multidisciplinar de 23 expertos del área de cuidados de la salud en un foro de debate para: 1) analizar las diferentes alertas de seguridad en torno a ciertas alternativas a la transfusión; 2) estudiar los antecedentes que las han propiciado, la evidencia que las sustentan y las consecuencias que conllevan para la práctica clínica, y 3) emitir una valoración argumentada de la seguridad de cada alternativa a la transfusión cuestionada, según el uso clínico de la misma. Los integrantes del foro mantuvieron contactos por vía telemática y una reunión presencial en la que presentaron y discutieron las conclusiones sobre cada uno de los elementos examinados. Se elaboró un primer documento que fue sometido a 4 rondas de revisión y actualización hasta alcanzar un consenso, unánime en la mayoría de los casos. Presentamos la versión final del documento, aprobada por todos los miembros del panel, esperando sea de utilidad para nuestros colegas

Design of a GIS-database for the management of the Courel Mountains UNESCO Global Geopark (Spain)

X Congreso Geológico de España, 5-7 Julio 2021, Vitoria - GasteizSe ha desarrollado una base de datos en un sistema de información geográfica (SIG) para la gestión del Geoparque Mundial de la UNESCO Montañas do Courel (NO de España). El SIG incluye 66 capas de información topográfica, geológica, minera, biológica, arqueológica y etnográfica, que pueden ser combinadas entre sí para elaborar mapas temáticos adaptados a la finalidad y al usuario. Los mapas generados son empleados en actividades de divulgación, en el diseño de cartografías técnicas de apoyo a los gestores del Geoparque, en el desarrollo de estudios científicos y en acciones de geoconservació