Complete excavation or removal of carious tissues to hard dentin: Overtreatment

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Relationship between periodontal and endodontic diseases and systemic health: correlation does not imply causation.

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Editorial: Molecular and Cellular Crosstalk on Neuronal Functionality and Regulation, From Development to Pathology

EDITORIAL articleWe are grateful to all authors and reviewers that contributed to this Research Topic. IS acknowledges to the Max Planck Society for support. JE acknowledges IRBLLEIDA and the University of Lleida for support and the Ministerio de Economia y Competitividad of Spain for funding (PGC2018-101910-B-I00)

Reacción liquenoide oral en relación con una restauración de amalgama de plata

La amalgama de plata es uno de los materiales de uso odontológico, frente al que se pueden producir reacciones de hipersensibilidad. La forma más frecuente es la aparición de una reacción liquenoide, que afecta a la mucosa oral en contacto directo con la restauración de amalgama y que está producida por una reacción de hipersensibilidad retardada tipo IV, como respuesta inmune mediada por células frente al mercurio o a algún otro componente de la amalgama dental. En este trabajo presentamos un caso de reacción liquenoide oral (RLO) asociada a una restauración de amalgama de plata. Una mujer de 38 años de edad solicitó asistencia odontológica para el tratamiento de la caries del diente #37, realizándose una preparación cavitaria clase I de Black, que se rellenó con amalgama de plata. Pasados 19 meses, la paciente volvió al consultorio dental, apreciándose una zona atrófica, ligeramente eritematosa, en la mucosa yugal izquierda, justamente en la región de mucosa contactante con el molar restaurado con amalgama de plata. La mucosa yugal derecha tenía un aspecto normal. La paciente había sentido cierta sensación rara en esa zona al comer comidas picantes. No había recibido ningún tipo de tratamiento desde la anterior visita, ni presentaba antecedentes alérgicos. Tras la toma de biopsia, el estudio anatomopatológico demostró cambios histológicos compatibles con liquen plano oral. La paciente decidió no recambiar la restauración, por valorar que no tenía molestias importantes y no deseaba someterse de nuevo al tratamiento. Las restauraciones de otros dientes se le realizaron con resina compuesta, sin que se produjese reacción alguna en la mucosa.Hypersensitivity to mercury associated with amalgam restorations may occur and present in one of two different ways. Most commonly it presents as an oral lichenoid reaction affecting oral mucosa in direct contact with an amalgam restoration and represents a delayed, type IV, cell mediated immune response to mercury or one of the other constituents of the dental amalgam. We report a case of oral lichenoid reaction associated to amalgam restoration. A 38 year-old woman presented a caries lesion of tooth #37. A Black's class I preparation was performed and filled with amalgam. After 19 months, intra-oral examination revealed atrophic lesion, lightly erythematous, affecting the left buccal mucous. The lesion contacted directly with the amalgam restoration in the lower first molar. The right buccal mucosa was normal. His medical history was unremarkable, he was taking no medication and had no known allergies. However, the patient had felt certain rare sensation in that zone when eating sharp meals. Biopsy showed histological changes compatible with oral lichen planus. The patient decided not to change again the restoration, because she did not have important annoyances and she did not wish to be treated again. Other restorations were performed with composite resins, and no reaction was evidenced in the mucosa

Serum, Saliva, and Gingival Crevicular Fluid Osteocalcin: Their Relation to Periodontal Status and Bone Mineral Density in Postmenopausal Women

Background: Periodontitis and osteoporosis are characterized by the loss of bone mass. Osteocalcin levels have been postulated as a marker of inhibition of bone formation. The aim of the present study was to assess plasma, saliva, and gingival crevicular fluid (GCF) levels of osteocalcin and correlate them with periodontitis and osteoporosis. Methods: Seventy-three postmenopausal women, over 35 years old, were recruited for the study. Serum, saliva, and GCF osteocalcin were measured. Vertebral bone mineral density was measured by dual-energy x-ray absorptiometry. Differences between groups were assessed by analysis of variance (ANOVA), chi-square test, and non-parametric Kruskal-Wallis test. Results: Thirty-four (46.6%) were classified in the normal healthy bone group, 11 women (15.1%) in the osteopenic group, and 28 women (38.4%) in the osteoporotic group. No statistically significant differences between these densitometric groups were observed in probing depth (P = 0.24); clinical attachment level (P = 0.11); or mean osteocalcin concentrations in serum, saliva, and GCF. Twenty-seven (37.0%) of the women were classified without periodontitis (NPG) and 63.0% (N = 46) with periodontal disease (PG). There were no statistical differences in serum and saliva osteocalcin concentrations between these two groups. GCF osteocalcin concentrations were significantly higher in the PG women than in the NPG group (P = 0.008). Mean probing depth correlated significantly with GCF osteocalcin concentrations (r = 0.35; P = 0.002). Conclusion: The results further support the concept that osteocalcin levels in GCF correlates with periodontal but not with osteoporosis status