A critical assessment of oral care protocols for patients under radiation therapy in the regional University Hospital Network of Madrid (Spain)

Background: This research was aimed to critically evaluate, under the light of the available scientific evidence, the oral care protocols recommended by different hospitals in head and neck cancer (HNC) patients under radiation therapy. Material and Methods: A questionnaire requesting all the relevant information for the oral care of these patients was sent to the 9 University Hospitals in Madrid. The answers were categorized and analyzed. In addition, an electronic search was conducted to identify the most relevant papers (systematic reviews [SR] and randomized clinical trials [RCTs]) assessing oral care protocols for patients treated for HNC with radiation therapy. Results: Eight out of nine centers answered the questionnaire and the retrieved information was tabulated and compared. These recommendations were analyzed by a computerized search on MEDLINE and the Cochrane Oral Health Collaboration Database. The results of the analysis clearly shown a great heterogeneity, in terms of oral health care protocols, regarding the management of irradiated patients (for HNC) within the Hospitals of Madrid region. In addition, some of the recommendations lack solid scientific support. Conclusions: The present survey revealed that the recommendations provided by the different hospitals were clearly different. The available evidence, supported by SR and RCTs, suggested the need of an oral assessment before cancer treatment, in order to prevent and treat dental pathologies and avoiding potential complications; during cancer treatment, it is relevant monitoring the patient in order to decrease the severity of the side effects, and to avoid any tooth extraction or surgery and special attention should be paid to mucositis, xerostomia and candidiasis; after cancer treatment, the following are relevant aspects: the risk of osteoradionecrosis, trismus, caries and the risks associated to dental implants

La nueva planta y las instituciones borbónicas

Decreto de Nueva Planta e instituciones borbónicas

Plets, senyories i propietat a la València del segle XVIII

Estructura senyorial de la València set-centista

In vitro effect of different implant decontamination methods in three intraosseous defect configurations

Objectives This in vitro investigation was aimed to evaluate the cleaning ability of four mechanical devices designed for decontaminating implant surfaces. Material and methods Ninety-six implants were coated with permanent ink and inserted into 3D-printed resin blocks simulating three different intraosseous defect configurations (types Ib, Ic, and Ie). The four tested mechanical decontamination devices (air-polishing with glycine powder, rotating titanium brush, polyetheretherketone [PEEK]-coated ultrasonic tip, and stainless steel ultrasonic tip) were randomly applied onto the 5 mm exposed implant surface. Standardized photographs were taken from a frontal perspective and with a 30° angle coronally and apically to the implant axis. The area with remnant ink on the implant surface was calculated. Results Although none of the groups achieved complete ink removal, air-polishing with glycine and titanium brushes demonstrated a higher cleaning ability when compared with ultrasonic devices either with standard or PEEK tips for all three defect configurations. For the three tested models, the best cleaning ability in all groups was shown on implant surfaces without facing an intraosseous wall. Titanium brush was the most effective when the intraosseous walls existed. Cleaning effectiveness diminished in the threads located in the apical third, especially when using air-polishing and ultrasonic devices. Conclusions Titanium brushes and air-polishing devices were more effective in removing artificial biofilm using this in vitro model, although their effectiveness was influenced by the presence of the intrabony component

Mucositis in irradiated cancer patients : effects of an antiseptic mouthrinse

Objective: To assess the effects of an antiseptic, non-alcohol based mouth-rinse containing chlorhexidine and cetylpyridinium chloride, in preventing the oral complications associated to radiation therapy in head-and-neck cancer patients. Study design: This was a parallel, double blind, prospective, randomized clinical trial. Cancer patients were randomly assigned to one of the two treatments (test mouth-rinse or a placebo). Three visits were scheduled (baseline, 14 and 28 days). Different outcome variables were evaluated: mucositis, plaque and gingival indices, stimulated saliva and salivary pH. Results: 70 patients were screened and 36 were included. The presence and the degree of mucositis significantly increased in both groups and no significant differences were detected between groups, although the median increase in the placebo group (1.81) at 2 weeks was higher than in the test group (1.20). Conclusions: Within the limitations of the small sample size, this study suggests that the use of the tested mouthrinse may lead to some improvements in clinical parameters in patients irradiated for head-and-neck cancer

Microbiological effects of an antiseptic mouthrinse in irradiated cancer patients

Objective: To assess the microbiological effects of an antiseptic, non-alcohol based mouth-rinse containing chlorhexidine and cetylpyridinium chloride, in patients undergoing radiation therapy for head-and-neck cancer. Study Design: This was a parallel, double-blind, prospective, randomized clinical trial, including patients irradiated as part of the therapy of head-and-neck cancer, aged 18-75, with at least 10 teeth, and willing to sign an informed consent. Cancer patients were randomly assigned to one of the two treatments (test mouth-rinse or a placebo). Three visits were scheduled (baseline, 14 and 28 days). Microbiological findings were evaluated in tongue, mucosa and subgingival samples, by means of culture. Microbiological variables were assessed by means of the Mann-Whitney, Wilcoxon and chi-square tests. Results: 70 patients were screened and 36 were included. The detection of Candida species in mucosa and tongue samples showed significant reductions in the test group. Total bacterial counts decreased in both groups from baseline to the 2-week visit, while minor changes occurred between 2 and 4 weeks (effects on P. gingivalis, P. intermedia, C. rectus, E. corrodens). Conclusions: Within the limitations of the small sample size, this study suggests that the use of the tested mouth-rinse may lead to improvements in microbiological parameters in patients irradiated for head-and-neck cancer. © Medicina Oral S. L

The impact of term fake news on the scientific community. Scientific performance and mapping in web of science

Nowadays, multiple phenomena have promoted an impact on society, constituting in some cases, not only a contribution of benefits but also of risks. Among them, the fake news phenomenon is considered one of the most burning phenomena today due to the risk it poses to society. In view of this situation, the research community has carried out numerous studies that seek to address this issue from a multidisciplinary perspective. Based on this, the objective of this work was to analyze the productivity and, therefore, the impact of this topic in the research community. To this end, this work advocated a scientometric-type methodology, through scientometric laws, impact indicators, and scientific evolution of 640 publications of the web of science (WOS). The results showed the impact of the fake news discipline today, which is considered an emerging issue that is of interest to many knowledge disciplines around the world. Likewise, the results showed that the publications not only have a focus on analyzing the veracity or not of the news, but that it begins to vertebrate a new line of an investigation directed to the informational education and towards the prevention of the consumption of this type of news through the internet.Ministry of Education, Culture and Sport of the Government of Spain (Project reference: FPU17/05952

Patología endodóntica periodontal. Revisión bibliográfica

Los procesos patológicos que afectan a las estructuras del periodonto pueden tener diversos orígenes y cursar con una sintomatología parecida. No hay signos ni síntomas patognomónicos que nos indiquen una etiología concreta. Por tanto, es preciso utilizar todas las pruebas diagnósticas disponibles para descubrir el origen de la afectación, e instaurar el tratamiento apropiado, Sólo así se evitarán fracasos diagnósticos y terapéuticos. En este trabajo se revisan las comunicaciones existentes entre la pulpa y el periodonto, la patogenia de las lesiones endoperiodontales, su pronóstico, su tratamiento y se hace especial hincapié en el diagnóstico y diagnóstico diferencial de dichas lesiones

De novo bone formation around implants with a surface based on a monolayer of multi‐phosphonate molecules. An experimental in vivo investigation

Objectives: The purpose of this experimental in vivo investigation was to evaluate the influence of modifying the implant surface by adding a monolayer of multiphosphonate molecules on the de novo bone formation and osseointegration. Material and Methods: The study was designed as an animal preclinical trial with intra-animal control and two healing periods, 2 and 8 weeks, to compare implants with an identical macro-design but with two different surfaces. Eight female Beagle dogs participated in the study. Control implants had a moderately rough surface combining sandblasting and acid etching; test implants had an additional monophosphonate layer covalently bonded to titanium. Histologic and radiographic (micro-CT) outcome variables were evaluated. Results: The first bone-to-implant contact (fBIC) was located more coronally for the test implants at the first (0.065 mm (95% CI = −0.82, 0.60)) and second healing milestones (0.17 mm (95% CI = −0.9, 0.55)). Most coronal BIC of the test implants displayed a higher percentage of osseointegration, +6.33% and +13.38% after 2 and 8 weeks, respectively; however, the differences were not statistically significant. The micro-CT examination did not show any BIC difference. Conclusions: The monophosphonate layer coating demonstrated clinical, histological, and radiographic results similar to the control surface