Preparación y caracterización de un material compuesto poli(uretano)/hidroxiapatita mediante separación de fases

Recientemente se han utilizado materiales porosos para la regeneración del tejido óseo, uno de los aspectos más importantes es contar con una morfología controlada la cual sirva como base y guía para el crecimiento del tejido. En este trabajo se han preparado poliuretanos y compositos poliuretano/hidroxiapatita por una separación de fase inducida térmicamente; por medio de la cual se pudieron producir materiales porosos con una morfología controlada y reproducible. La microestructura fue controlada por la variación en la concentración del polímero, temperatura de congelamiento, relación solvente/no solvente y co-solvente utilizado. Usando está técnica se pueden obtener materiales con un tamaño de poros desde unas cuantas micras hasta 200 mm. Debido a la porosidad interconectada y a la bioactividad que proporciona la hidroxiapatita pueden ser una alternativa para la regeneración del tejido óseo.Peer Reviewe

Ectopic third molar in the mandibular condyle: a review of the literature

Objectives: To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle. Study design: MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients. Results: We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined. Conclusions: The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery

Cavidad de Stafne de localización inusual en el sector anterior mandibular

La típica cavidad de Stafne, localizada en el sector posterior de la mandíbula, es una entidad relativamente poco frecuente, pero cuando el defecto se sitúa en la región anterior mandibular, es bastante raro, habiéndose descrito hasta ahora sólo 36 casos en la literatura científica. La mayoría de estos defectos aparecen entre la quinta y la sexta décadas de la vida, están localizados en el área de caninos y premolares, y muestran también una predilección por el sexo masculino. El canal dentario inferior, uno de los hitos anatomo-radiológicos principales que ayudan al diagnóstico de la cavidad de Stafne en la zona posterior, raramente está presente anteriormente al agujero mentoniano. Por ello, por su apariencia radiográfica más variable que en el defecto posterior, por soler encontrarse superpuesta a los ápices de los dientes, y por la rareza de presentación en el sector anterior mandibular, es mucho más difícil establecer un diagnóstico definitivo de cavidad de Stafne en esta localización, y por tanto es más fácil que pueda haber un error en el diagnóstico, sobre todo inicialmente. Presentamos un nuevo caso, en un varón de 68 años, en el que el diagnóstico fue fortuito, y revisamos especialmente sus aspectos etiopatogénicos, clínicos, y de diagnóstico diferencial.The typical Stafne's cavity, located on the posterior portion of the mandible, is a relatively uncommon entity. However, when the defect is located in the anterior region of the mandible, it is quite rare, having thus far been described in only 36 cases in the scientific literature. Most of these defects appear in the fifth and sixth decades of life, are localized to the area of the canines and premolars, and have a predilection for males. The inferior dental canal, one of the anatomical-radiographic landmarks that aid in the diagnosis of Stafne's cavity in the posterior region, is rarely present anterior the mental foramen. For this reason, because of its more variable radiographic appearance compared to the posterior defect, its tendency to be superimposed over the apices of the teeth, and the rarity of its localisation to the anterior mandible, it is much more difficult to establish a definitive diagnosis of a Stafne's cavity in this location. It is therefore more likely that a diagnostic error can occur, especially early on. We present a new case in a 68-year-old male in which the diagnosis was serendipitous, and we review in particular the aetiology and pathogenesis, clinical aspects, and differential diagnoses for this condition

Myxofibroma of the maxilla. Reconstruction with iliac crest graft and dental implants after tumor resection

Odontogenic fibromyxomas are benign odontogenic tumors of mesenchymal origin of rare presentation in the oral cavity, which exhibit locally aggressive behavior and are prone to local recurrence. The controversy has mainly been on therapeutic management with recommendations varying, depending on the clinical cases, from simple curettage of lesion to segmental bone resection. We present a case report describing the reconstruction of an osseous defect in the maxilla and the restoration with dental implants in a 32 year old female patient after radical surgical excision due to an odontogenic fibromyxoma with locally aggressive behavior. The primary reconstruction of maxillary discontinuity defect was carried out by an immediate non-vascularized cortico-cancellous iliac crest graft. Using a computer-guided system for the implant treatment-planning, three dental implants were secondary placed in the bone graft by means of flapless implant surgery. The patient was subsequently restored with an implant-supported fixed prosthesis that has remained in continuous function for a period of three years. The surgical, reconstructive and restorative treatment sequence and techniques are discussed. © Medicina Oral S. L

The relationship between quantity and level of competition, and cognitive expertise in Spanish tennis players

This work evaluates the relationship between quantity and level of competition, and cognitive expertise. To this end, cognitive expertise has been evaluated in Spanish tennis players (N=150) by means of declarative knowledge (DK) and procedural knowledge (PK) levels. DK and PK were assessed through a specific questionnaire (DK/PK-QT; García-González, Moreno, Moreno, Iglesias, & Del Villar, 2008). ANOVAs showed significant differences in both DK and PK with regard to the quantity of competitions played (F(2, 147)=23.28; p<.001; ηp 2=.24 for DK; F(2,147)=44.52; p<.001; ηp 2=.37 for PK) and with regard to the level of competition (F(2, 147)=20.91; p<.001; ηp 2=.22 for DK; F(2, 147)=37.59; p<.001; ηp 2=.34 for PK). Furthermore, the Spearman’s Rho test showed that DK and PK were strongly correlated to quantity and level of competition. These results suggest that quantity and level of competition could be of central importance for the development of expertise in tennis players. In sport training stages, we recommend coaches to plan participation in competitions (in the short and medium term), so that competitions would provide appropriate and significant experiences in real setting conditions (I.e. they should be ecologically valid). These competitions must be high level ones and sufficiently challenging so as to foster the development of cognitive expertise. Competitive structures (e.g. season competitions), which favor cognitive elements (e.g. DK and PK) and develop expertise in athletes, will also have to be put into practice

The relationship between quantity and level of competition, and cognitive expertise in Spanish tennis players

This work evaluates the relationship between quantity and level of competition, and cognitive expertise. To this end, cognitive expertise has been evaluated in Spanish tennis players (N=150) by means of declarative knowledge (DK) and procedural knowledge (PK) levels. DK and PK were assessed through a specific questionnaire (DK/PK-QT; García-González, Moreno, Moreno, Iglesias, & Del Villar, 2008). ANOVAs showed significant differences in both DK and PK with regard to the quantity of competitions played (F(2, 147)=23.28; p<.001; ηp 2=.24 for DK; F(2,147)=44.52; p<.001; ηp 2=.37 for PK) and with regard to the level of competition (F(2, 147)=20.91; p<.001; ηp 2=.22 for DK; F(2, 147)=37.59; p<.001; ηp 2=.34 for PK). Furthermore, the Spearman’s Rho test showed that DK and PK were strongly correlated to quantity and level of competition. These results suggest that quantity and level of competition could be of central importance for the development of expertise in tennis players. In sport training stages, we recommend coaches to plan participation in competitions (in the short and medium term), so that competitions would provide appropriate and significant experiences in real setting conditions (I.e. they should be ecologically valid). These competitions must be high level ones and sufficiently challenging so as to foster the development of cognitive expertise. Competitive structures (e.g. season competitions), which favor cognitive elements (e.g. DK and PK) and develop expertise in athletes, will also have to be put into practice

Effect of a mentoring through reflection program on the on the verbal behavior of beginner volleyball coaches: a case study

El propósito de este estudio fue modificar la conducta verbal del entrenador de voleibol durante la competición. Tres entrenadores de voleibol fueron sometidos a un programa formativo (feedback de supervisión con análisis sistemático de la conducta verbal del entrenador, y visionado de la actuación) durante una temporada de competición. La variable dependiente de la investigación fue la conducta verbal del entrenador durante los tiempos muertos, considerándose dos dimensiones en la misma: tipo de información, equipo al que hace referencia la información. Los resultados obtenidos muestran una modificación en la conducta verbal de los entrenadores, manifestada fundamentalmente en el incremento de información táctica y sobre el equipo contrario

Repair of complete bilateral cleft lip with severely protruding premaxilla performing a premaxillary setback and vomerine ostectomy in one stage surgery

Background: The authors present a technique for selected cases of CBCL. The primary repair of the CBCL with a severely protruding premaxilla in one stage surgery is very difficult, essentially because a good muscular apposition is difficult, forcing synchronously to do a premaxillary setback to facilitate subsequent bilateral lip repair and, thus, achieving satisfactory results. We achieve this by a reductive ostectomy on the vomero- premaxillary suture. Material and Methods: 4 patients with CBCL and severely protruding premaxilla underwent premaxillary setback by vomerine ostectomy at the same time of lip repair in the past 24 months. The extent of premaxillary setback varied between 9 and 16 mm. The required amount of bone was removed anterior to the vomero-premaxillary suture. The authors did an additional simultaneous gingivoperiosteoplasty in all patients, achieving an enough stability of the premaxilla in its new position, to be able to close the alveolar gap bilaterally. The authors have examined the position of premaxilla and dental arch between 6 and 24 months. We did not do the primary nose correction, because this increased the risk of impairment of the already compromised vascularity of the philtrum and premaxilla. Results : The follow-up period ranged between 6 and 24 months. None of the patients had any major complication. During follow-up, the premaxilla was minimally mobile. We achieved a good lip repair in all cases: adequate muscle repair, symmetry of the lip, prolabium and Cupid’s bow, as well as good scars. Conclusions : To our knowledge, there are few reports of one stage surgery with vomerine ostectomy to repair CBCL with severely protruding premaxilla. Doing this vomerine ostectomy, we don’t know how it will affect the subsequent growth of the premaxila and restrict the natural maxillary growth. Applying this alternative treatment for children with CBCL and protruded premaxilla without any preoperative orthopedic, we can successfully perform, in a single-stage surgery, a good primary lip repair at our center. Further confirmations of this surgery with follow up and anthropometric studies of these patients during childhood and adolescence are require

Rehabilitación implantoprotésica en el paciente oncológico: experiencia de 20 años

Resumen Los pacientes que han sido tratados por un proceso oncológico se encuentran con una alteración de funciones básicas, como la masticación, fonación y estética, que les impide desarrollar una vida normal en cuanto a la alimentación, habla y relaciones sociales, lo que disminuye de forma manifiesta su calidad de vida. En la medida de lo posible la restitución del tejido perdido se puede realizar con prótesis dental, si bien los implantes en estas situaciones han supuesto un elemento clave debido a que la alteración de la mucosa hace que el apoyo mucoso sea difícil. Tras 20 años de experiencia y dedicación en la Unidad de Rehabilitación Protésica de la Unidad de Gestión Clínica de Cirugía Oral y Maxilofacial en los Hospitales Universitarios Virgen del Rocío, nos planteamos estudiar los resultados obtenidos en dicha Unidad, analizando la supervivencia de los implantes endoóseos colocados en pacientes que han sido tratados de un cáncer en la cavidad oral y que, tras dos años supervivencia, precisan una rehabilitación protésic

Complications after superficial parotidectomy for pleomorphic adenoma

The significance of complications after superficial parotidectomy remains unclear, since prospective studies are lacking. The aim of this study was to evaluate facial nerve dysfunction and other postoperative complications after superficial parotidectomy for pleomorphic adenoma of the superficial lobe and to identify the associated risk factors. Prospective and descriptive clinical study on 79 patients undergoing formal superficial parotidectomy with the modified facelift incision, dissection of the facial nerve and reconstruction with the superficial musculoaponeurotic system flap. Function of the facial nerve using the House-Brackmann scale and the intra- and postoperative complications were recorded at 1 week and 1, 3, 6 and 12 months. A descriptive, inferential and binary logistic regression analysis were performed for the variables facial nerve dysfunction, tumor size and location, clinical presentation and duration of surgery. 77.2% of the patients presented facial paresis at 1 week, with the marginal-mandibular branch being the most commonly affected (64.5%). 94.9% recovered the facial function at 6 months and 100% at 12 months. A statistically significant relationship was found between the appearance of facial paresis and tumor location in the superior lateral area of the superficial lobe, size >2 cm and prolonged operative time. None of the remaining variables showed significant differences at any study timepoint. At 12 months, 57% of patients had recovered tactile sensitivity in the earlobe. The clinical occurrence of Frey?s syndrome was 11.4%. Despite the high incidence of postoperative facial paresis at 1 week, its magnitude was low and the recovery time was short. Tumor location in the parotid superficial lobe upper area, size and prolonged operative time are risk factors that can worsen facial paresis at different study timepoints. The knowledge of these complications is relevant for patient´s counseling and to achieve better long-term outcomes