Enzimas salivales y enfermedad periodontal

Objetivos: Las enfermedades que producen daño tisular producen la liberación de diferentes enzimas relacionadas con la muerte y destrucción celular, como son la aspartato y alanino aminotransferasa (AST, ALT), lactato dehidrogenasa (LDH), creatinin kinasa (CK), alcalina y ácida (ALP, ACP) y gamma glutamil transferasa (GGT). Al tratarse la enfermedad periodontal (EP) de un proceso inflamatorio con afectación de la encía y periodonto, parece lógico pensar que la actividad enzimática debe reflejar los cambios metabólicos secundarios a esta reacción inflamatoria. Diseño del estudio: En este artículo examinamos la actividad de CK, LDH, AST, ALT, GGT, ALP y ACP en la saliva de pacientes con EP, antes y después del tratamiento periodontal (grupo experimental'30 muestras) así como en la saliva de pacientes sin enfermedad periodontal (grupo control'20 muestras). La EP se diagnosticó en base a parámetros clínicos (índice gingival'GI, sangrado al sondaje-BOP y profundidad al sondaje-PD). Todos los pacientes con enfermedad periodontal recibieron tratamiento convencional de la misma. Se registró la actividad enzimática en todos los pacientes y se cuantificó por espectrofotometría Resultados: Se observó un aumento estadísticamente significativo en la actividad de CK, LDH, AST, ALT; GGT, ALP y ACP en la saliva de los pacientes con enfermedad periodontal en relación a los resultados obtenidos en el grupo control. Se detectó una correlación positiva entre la actividad de las enzimas salivales examinadas y el valor del GI. Después del tratamiento periodontal convencional la actividad de estas enzimas salivales disminuyó significativamente. Conclusiones: Basándonos en estos resultados. Podemos concluir que la actividad de estas enzimas puede ser útil en el diagnóstico y evaluación del tratamiento de la EP.Background: Host responses to periodontal disease include the production of different enzymes that are released by stromal, epithelial or inflammatory cells. There are important enzymes associated with cell injury and cell death like: aspartate and alanine aminotransferase (AST, ALT), lactate dehydrogenase (LDH), creatine cinase (CK), alkaline and acidic phosphatase (ALP, ACP), gama glutamil transferase (GGT). Changes in enzymatic activity reflect metabolic changes in the gingiva and periodontium in inflammation. Design of Study: In this paper we have examined the activity of CK, LDH, AST, ALT, GGT, ALP and ACP in saliva from patients with periodontal disease before and after periodontal treatment (experimental group ' 30 samples) and in saliva from healthy patients (control group ' 20 samples). Periodontal disease was determined based on clinical paIndexed desrameters (gingival index (GI), bleeding on probing (BOP), probing depth (PD)). Patients with periodontal disease were under conventional periodontal treatment. Results: Obtained results were shown statistically significant increases of activity of CK, LDH, AST, ALT, GGT, ALP, ACP in saliva from patients with periodontal disease in relation to control group. There is positive correlation between the activity of examined salivary enzymes and value of the gingival index. After conventional periodontal therapy the activity of all salivary enzymes was significantly decreased. Conclusions: Based on these results, it can be assume that activity of these enzymes in saliva, as biochemical markers for periodontal tissue damage, may be useful in diagnosis, prognosis and evaluation of therapy effects in periodontal disease

Queratoquiste odontogénico con cartílago en la pared: presentación de un caso

Existen siete casos publicados en la literatura médica referentes a la presencia de cartílago en la pared de un queratoquiste. Presentamos un nuevo caso con inclusiones de queratina y cartílago en la pared quística. Incluimos imágenes clínicas, radiográficas e histopatológicas, así como sus posibilidades etiopatogénicas.There are seven published cases in world literature on cartilage in the walls of odontogenic keratocysts. Herein is presented one further case with keratin inclusions in the cystic wall, which also bears a cartilaginous component. X-rays, clinical images and pathohistological images are included

Salivary enzymes and periodontal disease

Background: Host responses to periodontal disease include the production of different enzymes that are released by stromal, epithelial or inflammatory cells. There are important enzymes associated with cell injury and cell death like: aspartate and alanine aminotransferase (AST, ALT), lactate dehydrogenase (LDH), creatine cinase (CK), alkaline and acidic phosphatase (ALP, ACP), gama glutamil transferase (GGT). Changes in enzymatic activity reflect metabolic changes in the gingiva and periodontium in inflammation. Design of Study: In this paper we have examined the activity of CK, LDH, AST, ALT, GGT, ALP and ACP in saliva from patients with periodontal disease before and after periodontal treatment (experimental group ? 30 samples) and in saliva from healthy patients (control group ? 20 samples). Periodontal disease was determined based on clinical parameters (gingival index (GI), bleeding on probing (BOP), probing depth (PD)). Patients with periodontal disease were under conventional periodontal treatment. Results: Obtained results were shown statistically significant increases of activity of CK, LDH, AST, ALT, GGT, ALP, ACP in saliva from patients with periodontal disease in relation to control group. There is positive correlation between the activity of examined salivary enzymes and value of the gingival index. After conventional periodontal therapy the activity of all salivary enzymes was significantly decreased. Conclusions: Based on these results, it can be assume that activity of these enzymes in saliva, as biochemical markers for periodontal tissue damage, may be useful in diagnosis, prognosis and evaluation of therapy effects in periodontal disease

Estimation of the age of majority through radiographic evaluation of the third molar maturation degree

Although the third molar is the tooth with the greatest anatomical and developmental variability, some authors consider it important to estimate whether a subject is of legal age or not. The Demirjian?s technique is the most widely used tool to estimate dental age and was therefore used in our study to assess possible correlation between the age of majority and the maturational degree of the lower third molars, evaluated through radiographic images. This observational transversal study was conducted on 180 panoramic radiographs from consecutive patients. The degree of maturation of the lower third molar was independently classified by two observers, according to the Demirjian´s maturational stage method. A total of 180 patients ? 65 men (36.12%) and 115 women (63.88%) ? were included (mean age 21.6 years; standard deviation 5.2). The age range of our subjects corresponded to maturational stages D to H in the Demirjian?s classification. A logistic regression analysis showed that subjects classified into the highest maturational stage H had a significantly higher probability of being considered of legal age by both observers, as compared with subjects in the lowest stage D. Inter-observer agreement was very high. Gender predictive capacity was not observed. Our results showed that subjects with the lower third molars in the highest maturational stage could be estimated to be older than 18 years and therefore considered of legal age, a finding also reported by other authorsThe Demirjian´s tooth maturational stage method, applied to the lower third molars, can be reliably used to estimate whether an individual is of legal age (18 years or older). High concordance between different observers using this method can be expected

Bisphosphonate-associated osteonecrosis of the jaw : a proposal for conservative treatment

The use of bisphosphonates (BPs) has proven effective in the treatment of bone-related diseases, despite the potential risk of developing osteonecrosis of the jaw (ONJ). So far, results for the treatment of ONJ have not been satisfactory. In our study, we have treated two patients diagnosed with ONJ. In addition to local treatments a hydrogel was applied, with promising results. The fistulae disappeared 2-3 weeks into the treatment. After a six-month follow-up period there has been no sign of recurrence. The extent of maxillary bone exposure has diminished notably, although not entirely disappeared. In all cases, the patients exhibit no other symptoms (they suffer from no pain or swelling or functional impotence). For this reason we believe this protocol might be useful in the case of patients who suffer from pain and fistulation secondary to BP-associated ONJ to improve the state of their lesions until definitive treatment can be undertaken. Although these findings are not conclusive, given that we are reporting data on two patients only, we believe that this might be an alternative treatment in refractory cases where other therapies are counter-indicated. A controlled randomized and prospective study would be required to confirm our findings

Non-Hodgkin lymphomas of oral cavity

Non-Hodgkin lymphomas (NHL) often show up in an extranodal pattern, especially in the head and neck. Intraoral locations are much less frequent, particularly when they are single. This, in turn, can lead to a prolonged diagnosis and even to inadequate treatment. Different patients with initial extranodal location of NHL which were not previously diagnosed and in which it was manifested only intraoraly are presented in this paper. These cases are presented together with the additional examinations used for the early diagnosis and with the corresponding clinical pictures, as well as with the overview of other cases from the available literature

Bone metabolism and clinical study of 44 patients with bisphosphonate-related osteonecrosis of the jaws

Osteonecrosis of the jaws is a clinical entity described and linked to treatment with bisphosphonates in 2003. Its real incidence is unknown and it could increase due to the large number of patients treated with these drugs, and its cumulative effect on the bone. State of the art knowledge regarding its etiopathogeny, clinical course and suitable treatments is limited. Objectives: To study the clinical characteristics of 44 patients with bisphosphonate-related osteonecrosis of the jaws and the state of their bone mineral metabolism: bone remodeling state, prevalence of fractures, bone mineral density study, and assessment of the different treatment strategies. Design of the Study: Observational. Information was gathered prospectively through interviews, clinical examinations, additional tests and review of medical records. Results: We studied 16 men and 28 women with a mean age of 64.7 years. Breast cancer was the most frequent underlying disease. Zoledronate was used in 82% of the cases and in the non-oncology group of patients; alendronate was the most frequently used bisphosphonate. The mean duration of the zoledronate and alendronate treatments was 25 months and 88 months respectively. The lower jaw was the most frequent location, and previous exodontias- among the triggering factors known-were the most closely linked to its onset. We found considerable osteoblastic activity in patients suffering from neoplasia, with artifacts present in their bone densitometry and a high percentage of vertebral fractures. Conclusions: According to our results, osteonecrosis of the jaws affects elderly patients. We found a direct relationship between the duration of exposure and the accumulated dose. Other relevant factors are: Poor oral and dental health, corticoids, diabetes and teeth extractions. In essence, it is a clinical diagnosis. Prevention is the best strategy to handle this clinical entity

The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome

Objectives: The goal of the present study was to evaluate the results of applying acupuncture or occlusal decompression splints in the treatment of patients diagnosed with the temporomandibular joint pain-dysfunction syndrome. Design of the study: We conducted a randomized clinical trial including 20 patients to whom the mentioned treatments were applied. Results were evaluated through an analogue pain scale, measurements of mouth opening and jaw lateral deviation in millimetres, and assessment of sensitivity to pressure on different points: preauricular, masseter muscle, temporal muscle and trapezius. Parameters were evaluated before and 30 days after the treatment. For standardized pressure, we used a pressure algometer. Results: Patients treated with decompression splints showed reductions in subjective pain and pain upon pressure on temporal, masseter and trapezius muscles, as well as increased mouth opening after the treatment. Patients treated with acupuncture showed pain reduction in the short term and improvements in all of the evaluated para- meters (stronger pressure was required to produce pain; mouth opening was improved). Conclusion: Acupuncture was an effective complement and/or an acceptable alternative to decompression splints in the treatment of myofascial pain and temporomandibular joint pain-dysfunction syndrome

Formas de Hispanidad

Este texto presenta estudios sobre las múltiples formas de hispanidad, desarrollados en los últimos años por destacados investigadores del mundo hispánico que, poco a poco, han estado construyendo un nuevo espacio de investigación para una creciente y activa comunidad científica. En este libro el lector encontrará estudios con enfoques desde la ciencia política, la teoría política, la historia, la filosofía, la sociología, la economía, los estudios literarios y culturales, entre otras perspectivas académicas. Los aportes de cada aproximación teórica y disciplinar están orientados al logro de una meta común: la de reconstruir y reinterpretar la tradición histórica hispánica, desmantelando prejuicios ideológicamente provocados, con el fin de comprender los fenómenos políticos que la caracterizan. Por las mismas razones este libro se sitúa en el debate sobre las formas de escritura de la historia, que no es sólo un debate de teoría de la historia sino también de filosofía de lo histórico