El diagnóstico por imagen en la prevención de las lesiones del nervio dentario en la cirugía del tercer molar : Estudio descriptivo-comparativo entre la ortopantomografía y la tomografía transversal

El tratamiento quirúrgico de los terceros molares inferiores constituye una de las actividades mas frecuentes tanto para el cirujano bucal como para el maxilofacial. La posibilidad de lesionar durante la intervención el nervio dentario inferior conduce a una situación molesta y desagradable para el paciente y que en ocasiones puede conllevar una serie de implicaciones medico-legales. Es por ello que durante el desarrollo de este trabajo se ha planteado encontrar diferentes formas de diagnostico que posibiliten, al menos hipotéticamente, una solución fiable que evite la lesión de este tronco nervioso periférico. Para el desarrollo de nuestro trabajo se utilizaron, en una primera fase, 480, mandíbulas desecadas sobre las que se detectaron 50 casos que reunían los criterios de inclusión establecidos. En una segunda fase, se seleccionaron 112 casos sobre 532 pacientes que fueron remitidos para ser intervenidos por presentar retención de terceros molares inferiores. En ambas fases, se analizaron, entre otros, aspectos anatómicos del conducto dentario, así como una serie de signos radiológicos a nivel dentario y del conducto. El análisis de resultados permitió determinar que no existen diferencias significativas entre ambas muestras objeto de estudio. Anatómicamente, el conducto dentario resulto ser de mayores dimensiones en los varones, a la vez que en estos los terceros molares mas frecuentemente encontrados fueron los horizontales, siendo en el caso de las mujeres los verticales. En cuanto a la visualización radiológica del conducto, la radiografía panorámica ofreció una visión aceptable, que pudo complementarse en un alto porcentaje con la utilización de cortes tomográficos. Los signos radiológicos que presuponían un íntimo contacto entre el tercer molar y el conducto dentario fueron fundamentalmente el oscurecimiento de la raíz y la perdida de corticación del conducto. A raíz de estos resultados podemos establecer que uno de los métodos diagnósticos mas adecuados para la prevención de las lesiones del nervio dentario inferior durante las intervenciones de los terceros molares, será la utilización conjunta de la ortopantomografia junto a la tomografía transversal, lo que nos ofrecerá una imagen tridimensional

Study of available bone for interforaminal implant treatment using cone-beam computed tomography

Objectives: To analyze the availability of bone in the interforaminal region and to demonstrate the variation in diagnosis between panoramic x-ray and cone-beam computed tomography (CBCT). Material and methods: In 50 patients and in 5 areas of each, a series of parameters concerning available bone were measured on both the panoramic and the CT images. Results: Panoramic images underestimate the vertical and horizontal measurements when compared with CBCT. Regarding implant treatment, the interforaminal region presents the same remaining bone height throughout its full extent, the correlation between one side of the midline and the other was highly significant for all the parameters studied, and 20% of the sample showed some buccal and/or lingual concavity. Conclusion: Cone-beam CT is an advantageous system for interforaminal implant treatment planning, especially since the reported radiation dose is minimal and geometric accuracy is very high

Langerhans cell histiocytosis: literature review and descriptive analysis of oral manifestations

Langerhans cell histiocytosis (LCH) is a rare disease, of unknown pathogenesis, characterized by intense and abnormal proliferation of bone marrow-derived histiocytes (Langerhans cells). It can present both local and systemic manifestations involving bone, skin and mucosal tissue, and internal organs. Three basic clinical forms develop: Letterer-Siwe disease (subacute or acute disseminated form), Hand-Schüller-Christian disease (disseminated chronic form) and eosinophilic granuloma (localized chronic form).LCH may manifest orally with single or multiple lesions of the alveolar or basal bone, ulcerated mucosal lesions accompanied by adenopathies and/or periodontal lesions, presenting gingival inflammation, bleeding, recession, necrosis, odontalgia, dental hypermobility and premature loss of teeth. The principal differential diagnoses include advanced periodontal disease or a periapical process of dental or periodontal origin.The odontologist plays a vital role in the diagnosis and multidisciplinary treatment of such patients, by performing routine examinations for periodic follow-up of the disease and its possible oral manifestations, bearing in mind that these may be the first or only signs of LCH

Burnout syndrome assessment among Spanish oral surgery consultants:a two populations comparative pilot study

The professional Burnout Syndrome (BOS) or Burnout is considered a professional disease made up of three interrelated dimensions (emotional exhaustion, depersonalization and lack of personal fulfillment). BOS has been documented to most severely affect the healthcare professions, especially dentists. On the other hand, its appearance has been documented at an early age, during dental training. However, there are no studies that analyze its incidence in professionals dedicated to Oral Surgery and Implantology, determining the age of onset and related factors. The modified Maslach questionnaire was carried out anonymously among the professors and students of the Master of Oral Surgery and Implantology at the Complutense University of Madrid. A total of 36 participants were enrolled in this study and the results of the modified Maslach Questionnaire were established into four groups [1st year (n=6), 2nd year (n=6), 3rd year (n=6) postgraduate students and clinical teachers (n=18)]. The following variables were recorded: Age, sex, years of experience, weekly hours of work, dedication on weekends and scope of work. The statistical analysis performed included Pearson's correlation, analysis of variance, Student's t-test, F-Anova, Chi-Square and Gamma correlation. Statistical Significance of the tests was established of p?0.05. 36 questionnaires were analyzed, of which 22.2% (n = 8) presented BOS, and 77.8% (n = 28) a medium risk of suffering it. The mean values and standard deviation ??of emotional exhaustion (7.50 ± 2.43; 9.83 ± 4.12; 15.83 ± 6.21; 30.22 ± 7.86), depersonalization (5.50 ± 1.23; 50 ± 3.27; 11.33 ± 1.75; 17.56 ± 4.13), low personal fulfillment (39.67 ± 3.72; 39.33 ± 2.34; 43.17 ± 3, 55; 37.33 ± 5.51) and professional burnout (54.33 ± 2.66; 61.67 ± 2.88; 70.33 ± 5.43; 85.11 ± 9.05) in the four groups respectively. A significant association was found in the appearance of emotional exhaustion and depersonalization, years of experience, weekly work hours and the work environment. BOS is a disease that can appear from 30 years of age, after 5 years of professional experience and when there is a clinical consultation of 40 hours a week. Oral Surgery and Implantology seems to be a risk activity for the manifestation of depersonalization

Brain complications from odontogenic infections: A systematic review

Purpose: Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3−1.3 / 100,000 population and only 2−5% are of dental origin. The main objective is to research brain complications derived from odontogenic infections. Secondary objectives were to identify the most common symptoms in brain abscess, to describe the microbiology involved in these infectious processes, report which parts of the brain complex are most commonly affected and report the sequelae of this patients. Methods: A systematic review following the PRISMA Guide and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was carried out in PubMed, Scopus and Web of Science. The search terms were: Brain infection, brain abscess, oral health oral origin, odont* infect*. Results: The database search identified a total of 1000 articles. A total of 18 publications were identified after applying inclusion and exclusion criteria. A total of 38 patients were analyzed. Mean age was 49.64§ 18.80 years. Conclusion: The most common symptoms of patients with brain abscess are neurological affectations first and then fever and headache second, without necessarily presenting as a symptomatological triad. Microbiological diagnosis is key to determining the origin of the infection. Anaerobic pathogens such as Streptococcus (F. Milleri), Fusobacterium Nucleatum and Porfiromonas Gingivalis families are common bacterial agents. The frontal lobe is the most frequently affected, followed by the parietal and temporal lobe. The most frequent brain complications are neurological disorders. However, most patients with brain abscesses recover without sequelae

Evaluación del aprendizaje según dos métodos de enseñanza diferentes: clase tradicional frente a aprendizaje basado en problemas cortos

Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaFALSEsubmitte

Aplicación de la herramienta Socrative® para la evaluación en la asignatura "Repercusiones Bucales de las Enfermedades Sistémicas" en los alumnos de Odontología a través de dispositivos móviles. Fase I. Examen tipo test de preguntas dicotómicas

Incorporación de la herramienta interactiva Socrative® para la gestión de la participación de los alumnos y la evaluación rápida en tiempo real por parte del profesor en la asignatura "Repercusiones Bucales de las Enfermedades Sistémicas" en 3er Curso de Grado de Odontología.Se realizan preguntas y los alumnos contestan a través de sus dispositivos móviles, obteniendo un feedback inmediato de sus contestaciones

Adaptación a la docencia online de las prácticas preclínicas de Cirugía Bucal I

Los cambios en la docencia debido a la pandemia por la COVID-19 ha llevado a la reducción de la presencialidad y a un aumento de la docencia online. Por ello se diseñó este proyecto, cuya finalidad fue la adaptación a la docencia online de las prácticas preclínicas de Cirugía Bucal I. Para el desarrollo de este trabajo se realizaron las rúbricas de evaluación de cada módulo de la asignatura, se elaboraron videos y documentación para subir al campus virtual antes de la realización de la práctica. Finalmente, se elaboraron cuestionarios de evaluación de la satisfacción de los estudiantes y profesorado con esta metodología. Los resultados mostraron una elevada satisfacción de ambos grupos, considerándola una herramienta de utilidad en el aprendizaje y de implementación en cursos posteriores

Use of Phentolamine Mesylate in Implant Surgery: Analysis of Adverse Effects and Haemodynamic Changes

The clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p < 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p < 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients’ quality of life without increasing the risks

Use of Phentolamine Mesylate in implant surgery: analysis of adverse effects and haemodynamic changes

FI: 4,964 ; 55/172; Q2; Medicine, General & Internal, 2021; AP: SIThe clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p < 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p < 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients’ quality of life without increasing the risks.Depto. de Odontología Conservadora y PrótesisFac. de OdontologíaTRUEpu