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Periodontitis is currently defined as a multifactorial chronic inflammatory disease associated with deregulation of the biofilm with the susceptible host, which can lead to damage the periodontal tissue due to an inappropriate immune response, characterized by a neutrophilic inflammation with subsequent destruction of proteolytic connective tissue. Nowadays, there are arguments that associate the progression of this disease in elderly people, for this reason the objective of this article is to carry out a literature review that links the progression of periodontitis associated with age, in addition to determining if at an older age there is higher prevalence of periodontitis.

Background: Periodontitis is currently defined as a multifactorial chronic inflammatory disease associated with deregulation of the biofilm with the susceptible host, which can lead to damage the periodontal tissue due to an inappropriate immune response, characterized by a neutrophilic inflammation with subsequent destruction of proteolytic connective tissue. Objective: To carry out a literature review that links the progression of periodontitis associated with age, in addition to determining if at an older age there is higher prevalence of periodontitis. Methodology: A systematic bibliographic search was carried out in 5 scientific databases: PubMed, Cochrane, Scielo, Science Direct, EBSCO of 45 articles published in English and Spanish in the last 5 years (2018-2022). Results: Evidence suggests that elderly patients (60 years and older) are more likely to develop periodontitis due to a deficient immune response that keep them off from having a correct inflammatory response to various factors, there is also postulated a prolonged exposure to the etiological factor. Conclusions: Evidence reports that older patients have a higher prevalence of periodontitis because aging decreases immune response, which is responsible for protecting the body against different factors. Finally, as patient’s age, nutritional status is altered thereby the digestive process and nutrient absorption from food, which interact with other well-defined risk factors to increase susceptibility to periodontal disease.

The aim of this study was to determine the prevalence of gingivitis associated with dental biofilm in students with intellectual disabilities from “Unidad Educativa Especial del Azuay” and “Escuela de Educación Básica Fiscomisional San José de Calasanz” in the city of Cuenca - Ecuador during the period March 2018 - March 2019. It consists of a descriptive cross-sectional study, which analyzed 133 students with mental retardation, Down syndrome and autism between 3 and 20 years old. The quality of hygiene (O'Leary Index) and gingival status (Löe and Sillness Gingival Index and periodontogram data based on the classification of biofilm-induced gum diseases) were evaluated to identify the presence of gingival conditions associated with biofilm. The study included 65 women (48.87%) and 68 men (51.13%), of whom 51.88% were located within a mild cognitive disability. According to the O'Leary index, it was evidenced that 100% of the participants had poor hygiene, and when relating it to the Löe and Sillnes gingival index, a prevalence of moderate gingivitis was demonstrated at 58.65%. Only one person with healthy gums was found (0.75%). Regarding the Armitage classification of gingival diseases, a frequency of 68 participants (51.13%) presented localized gingivitis. In conclusion a high prevalence of gum disease is observed in the population evaluated, demonstrating an inadequate oral hygiene state where 99.25% of people with intellectual disabilities analyzed in the study presented indicators of gingivitis, with no differences in gingival health between the two groups of students. Keywords: Gingivitis; Biofilm; Intellectual disability; Descriptive cross-sectional study.

Gingival enlargement is an increase in the size of the gum mostly caused by inflammatory changes associated with the prolonged accumulation of biofilm and induced by drugs, among which calcium channel blockers such as amlodipine stands out. Amlodipine is a 3rd generation drug, commonly used to treat conditions such as hypertension, arrhythmias and angina pectoris. The prevalence recorded for amlodipine-induced gingival enlargement, in patients with heart disease, ranges between 3%. Gingival enlargement induced by amlodipine is due to an interaction between gingival fibroblasts, the biochemistry of inflammation mediators and drug metabolites. The following is a case report of a 57-year-old man, hypertensive, with amlodipine-induced gingival enlargement, and with a diagnosis of periodontitis stage 3 grade C, who underwent basic periodontal therapy treatment and amlodipine was replaced by another antihypertensive drug, additionally for the final resolution of the case, a gingivectomy and open flap scaling and root planning in recurrent pockets was performed. It is concluded that the replacement of the drug induced gingival enlargement and adequate periodontal therapy can improve the patient’s gingival health and quality of life.

Gummy smile is a clinical condition in which a gingival exposure greater than 4mm occurs when smiling, aesthetically affecting many individuals. Gummy smile is due to multifactorial etiological conditions; that is why, for its correction, a correct diagnosis must be established, determining the etiological factor (s) to carry out an effective treatment plan. The following is a case report of a 24-year-old woman who presented extensive gingival exposure when smiling due to a hypermobile lip and an altered passive eruption, for which a gingivectomy was performed in combination with the lip repositioning technique, eliminating a band of mucosa of the maxillary vestibule creating a partial thickness flap between the junction of the mucogingival line and apical to the upper lip musculature to later suture and achieve a shorter vestibule, restricting the upper lip musculature giving resolution to the excessive gingival display. It is concluded that both procedures were successful, predictable, and minimally invasive, obtaining a satisfactory result without reporting relapses in 6 months.

The link that periodontitis has with systemic diseases such as type 2 diabetes mellitus (T2DM) has been studied for a long time. Current evidence suggests that the mechanisms underlying this link are related to the inflammatory mediators present in both diseases and indicates that both diseases represent a mutual risk factor for developing each disease, respectively. Likewise, the impact that periodontal treatment can have on T2DM has been extensively studied, which could develop new treatment guidelines for this metabolic disease. However, this situation is currently not clear despite the clinical studies that have been carried out. It is suggested that such treatment can improve glycemic control and complications related to diabetes. The objective of this present review is to inform about the possible pathophysiological mechanisms that link T2DM with periodontitis in a bidirectional way. In the same way, to approach in a general way the effect that periodontal treatment can have on control of T2DM. Keywords: Periodontitis; Type 2 Diabetes Mellitus; Glycosylated hemoglobin.

The link that periodontitis has with systemic diseases such as type 2 diabetes mellitus (T2DM) has been studied for a long time. Current evidence suggests that the mechanisms underlying this link are related to the inflammatory mediators present in both diseases and indicates that both diseases represent a mutual risk factor for developing each disease, respectively. Likewise, the impact that periodontal treatment can have on T2DM has been extensively studied, which could develop new treatment guidelines for this metabolic disease. However, this situation is currently not clear despite the clinical studies that have been carried out. It is suggested that such treatment can improve glycemic control and complications related to diabetes. The objective of this present review is to inform about the possible pathophysiological mechanisms that link T2DM with periodontitis in a bidirectional way. In the same way, to approach in a general way the effect that periodontal treatment can have on control of T2DM

Mental health is considered a state of well being that allows the individual to develop properly, however, all people can experience mental health problems and this could be associated with the activities they perform (1). Dental students are confronted to multiple stressors, such as, responding to high academic demands, financial problems, greater responsibility for their independence; all of this may increase the risk of developing conditions of stress, anxiety and depression (2, 3). General Objective: Determine the incidence of anxiety, depression and stress measured with the DASS 21 questionnaire in students of the school of Dentistry of the University of Cuenca enrolled in the period September 2020 - February 2021. Materials and methods: A descriptive cross-sectional study was conducted in which 199 students of the school of Dentistry of the University of Cuenca, who met the inclusion criteria were surveyed; using the DASS 21 questionnaire as a measurement tool for anxiety, depression and stress. Results: In the 199 participants in relation to stress, anxiety and depression an overall percentage of 62.3%, 73.9% and 55.8% respectively was observed, with anxiety being the most significant for the students of the school of Dentistry of the University of Cuenca. Conclusions: In the present research the DASS 21 questionnaire was a reliable and accurate psychological tool in measuring the incidence of anxiety, depression and stress in dental students of the University of Cuenca.

The association between periodontal disease and erectile dysfunction has not been sufficiently studied. However, recent studies have reported a possible link based on mutually shared risks factors between both pathologies, but the association is fundamentally attributed to endothelial dysfunction, phenomenon that is related to both diseases. It has been suggested that chronic periodontal disease can induce systemic inflammatory response that results in deterioration of the physiological and biochemical conditions of the endothelium causing endothelial dysfunction. On the other hand, erectile dysfunction is a multifactorial disease, but the vasculogenic factor is considered as the most frequent one, attributed to a vascular defect (endothelial dysfunction). So, the strongest link is the vascular function alteration, which undoubtedly demonstrates demonstrates a solid argument of association between both diseases. The objective of this literature review is to report the possible mechanisms of association between periodontal disease and erectile dysfunction, focusing mainly on endothelial dysfunction as the main existing link.

The association between periodontal disease and erectile dysfunction has not been sufficiently studied. However, recent studies have reported a possible link based on mutually shared risks factors between both pathologies, but the association is fundamentally attributed to endothelial dysfunction, phenomenon that is related to both diseases. It has been suggested that chronic periodontal disease can induce systemic inflammatory response that results in deterioration of the physiological and biochemical conditions of the endothelium causing endothelial dysfunction. On the other hand, erectile dysfunction is a multifactorial disease, but the vasculogenic factor is considered as the most frequent one, attributed to a vascular defect (endothelial dysfunction). So, the strongest link is the vascular function alteration, which undoubtedly demonstrates demonstrates a solid argument of association between both diseases. The objective of this literature review is to report the possible mechanisms of association between periodontal disease and erectile dysfunction, focusing mainly on endothelial dysfunction as the main existing link. KEYWORDS: PERIODONTAL DISEASES; PERIODONTITIS; ERECTILE DYSFUNCTION; VASCULAR ENDOTHELIUM.

The relationship between dental restorations and the periodontal tissues are importance because joint harmony offers predictable predictions and favorable long-term results. This requires certain features in the preparation of prosthetic restorations, where the gingival termination line has a direct impact on the dental support tissues. General objective: Clinically analyze of the gingival termination, as well as the periodontal health status in dental pieces with unitary fixed prostheses performed at the Faculty of Dentistry of the Universidad de Cuenca during the period 2012-2017. Materials and methods: A descriptive cross-sectional study was carried out in which 147 dental pieces with unitary fixed prostheses were examined, a clinical analysis was developed to evaluate both the gingival termination and the periodontal state. Results: The gingival termination was analyzed clinically by surfaces, the frequency of the supragingival termination level was 8.3%, paragingival in 50.1% and subgingival in 41.6%. In relation to the periodontal state were found 84.4% of gingivitis and 2.7% of stage I periodontitis. Conclusions: In relation to the location of gingival terminations, paragingival and subgingival terminations were mostly presented; with respect to the periodontal state was evident a high percentage of gingivitis.

Background. The greater accumulation of bacterial interdental biofilm can condition a greater predisposition to develop periodontal disease. Objective. To analyze the relationship between interdental cleaning and periodontal disease in undergraduate students of the University of Cuenca School of Dentistry in the period 2018. Methodology. A descriptive, transversal analytical study was carried out. A total of 305 undergraduate students were analyzed in relation to their demographic and clinical-odontological characteristics, including the periodontal status. The association between periodontal disease and clinical-demographic variables was evaluated using the chi square test, also calculating the ORs. Results. There was a statistically significant association between gingivitis and the percentage of interdental bacterial biofilm (p = <0.001, OR: 5.17, 95% CI 3.15-8.49). As well as the use of interdental cleaning with gingivitis (p = <0.009, OR: 2.35, 95% CI 1.40-3.94); dental floss is the most frequently used device (69.51%) and had a statistically significant association with gingivitis (p = 0.001, OR: 2.27, 95% CI 1.38-3.72). 59.67% of the students presented periodontal disease (41.96% gingivitis and 17.70% periodontitis). Conclusion. There is a moderate prevalence of periodontal disease in the study population associated with interdental hygiene deficiency.

Lipomas are benign tumors of adipose content, which rarely develop in the oral cavity. We present an unusual case of lip fibrolipoma in a pediatric patient and discuss the characteristics and etiopathogenesis of this entity. Keywords: Lipoma, fibrolipoma, lip