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Background: Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity.Material and Methods: we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago.Results: we used the following keywords: treatment, aphtous stomatitis, canker sores; combined with Bool-ean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7th day was of-6,29 +/- 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 +/- 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 +/- 1,6 points, and a reduction of the size of the lesions of 4,42 +/- 1,02mm on the 7th day.Conclusions: Besides the classic treatments for RAS, we have to take into account other treatment modalities, above all the different kinds of laser.

RESUMEN Introducción: Los queratinocitos presentes en las células epiteliales del cuerpo humano producen, de manera continuada, pequeñas cantidades de histamina que se mantienen en equilibrio en el epitelio oral. Cuando este equilibro se ve alterado, se produce un aumento de histamina en el tejido oral pudiendo provocar lesiones. Objetivo: En este trabajo de revisión se estudia la relación del exceso de histamina en el Liquen Plano Oral, la Leucoplasia oral y en el Carcinoma Oral de Células Escamosas. Material y método: Búsqueda bibliográfica en la literatura de estudios caso control y retrospectivos acerca del papel de la histamina en el Liquen Plano Oral, la Leucoplasia Oral y el Carcinoma Oral de Células Escamosas. Resultados: Se ha observado un aumento del número de mastocitos y de histamina en los tejidos orales con patología comparado con los tejidos sanos. Conclusión: Este aumento del número de mastocitos y de histamina en los tejidos orales con patología, provocan una desorganización en los precursores de la inflamaciónpudiendo así dañar el epitelio oral.

RESUMEN Introducción: El liquen plano se considera una enfermedad muco-cutánea crónica, en la que la etiopatogenia se considera una alteración autoinmune mediada por células, con una prevalencia entre 0.5 y 2%. La colocación de implantes dentales en pacientes con dicha enfermedad puede hacer cambiar el éxito del tratamiento. Material y Método: se realizó una búsqueda en la base de datos Pub Med y Med line, utilizándose como palabras clave: “lichen planus” y "dental implant". El criterio de inclusión fue de estudios en humanos con liquen plano oral a los que se les había tratado con implantes dentales osteointegrados publicados en lengua inglesa que sean observacionales, experimentales y series de casos publicados entre 1990 y 2020. Resultados: Se selecciona un total de 13 artículos, la N total de implantes fue de 362 implantes colocados en 148 pacientes. El seguimiento de los implantes es de 2 a 10 años. Hay un fracaso de 45 (12,43%) implantes, de los cuales 42 sucede en pacientes con liquen plano activo y 3 en cuadros de liquen erosivo sin especificar si está en fase activa o no. La tasa de fracaso fue mayor en las mujeres (61%) en comparación con los hombres (44%). En uno de los casos, se diagnostica carcinoma oral de células escamosas [COCE] 3 años después de la colocación del implante, lo que corresponde al 0,2% de los casos. Conclusión: el liquen plano oral es una enfermedad autoinmune que debemos tener en cuenta cuando colocamos implantes y controlar periódicamente.

Background: Oral antiplatelet and anticoagulant drugs are widely used in a large number of patients visiting the dentist, and there has been much controversy over the years towards their clinical management. The aim to carry out a literature review in order to develop an update on dental management in anticoagulated and / or anti aggregated patients, focusing on oral surgery. Material and methods: A bibliographic search was carried out in PubMed on studies published between January 1, 2018, until December 10, 2020, using the keywords ('antiplatelet' OR 'antiplatelets') AND ('dentistry'), and ('anticoagulant' OR 'anticoagulants') AND ('dentistry'). Results: The number of studies included in this review was 13, and the number of patients among all of them was 3.497 patients under treatment with some type of antithrombotic drug, who underwent different oral surgery treatments. Conclusions: There is a low risk of peri- and postoperative bleeding events during basic oral surgery treatments in antiplatelet or anticoagulated patients, which can be easily managed through the use of local haemostatic measures. Keywords: Oral surgery, antiplatelet drugs, anticoagulant drugs, dental treatment.

Background Metastases in the oral cavity are rare and account for only 1 to 3% of all malignant lesions in this area. The primary location from which most metastases have been described in the oral cavity in adult patients include lungs, breasts, kidneys and colon. Material and Methods A systematic search of the literature was carried out following the PRISMA statement in PubMed database. Clinical trials and case series published in the last 10 years [2010-2020] were eligible to be selected. The headings and keywords used in the searches were “cancer” AND “oral metastases”, “incidence” AND “oral metastases”, “oral metastases” AND “jaw bone”, “oral metastases” AND “soft tissue”. Results For the study of the incidence of metastases in the oral cavity, 9 reports of clinical trials and 7 retrospective studies of case series have been included in this article. The primary locations from which more metastases have been described in the oral cavity are lungs (30.6% or 183 cases), breasts (22.2% or 133 cases), liver (15.5% or 93 cases), prostate (9 % or 54 cases), thyroid glands (8.1% or 49 cases), kidneys (7.3% or 44 cases), skin (2.3% or 14 cases), soft tissues (2% or 12 cases), colon (2% or 12 cases) and gastrointestinal (0.6% or 4 cases). These metastases have a predilection for hard tissues. The clinical presentation of these lesions varies from painless granulomatous lesions to lytic areas in the jaws. Conclusions Although metastases in the oral cavity is an uncommon pathology, early diagnosis is needed so that in the event that it is the first manifestation, it allows the primary tumor to be diagnosed as soon as possible. Key words:Cancer, oral metastases, incidence, jaw bone, soft tissue.

espanolObjetivo: Demostrar la existencia de agregacion bacteriana a los materiales de sutura que suelen emplearse en la practica odontologica, comprobar si dicha agregacion esta relacionada con la inflamacion que sucede al acto quirurgico y por ultimo dar recomendaciones sobre que tipo de sutura se adapta mejor para la prevencion de la adherencia bacteriana. Material y metodo: Busqueda bibliografica a traves de las bases de datos PubMed, Cochrane y Scielo empleando las palabras clave: surgical sutures, bacterial adherence. Como criterios de inclusion se aceptaron los estudios publicados en los ultimos 15 anos, in vivo o in vitro en relacion con la cirugia oral y con un nivel de evidencia cientifico superior a 3 segun los criterios de evidencia cientifica. Fueron excluidas todas aquellas publicaciones que no tenian como objeto de estudio las sutura seda, Nylon™, Supramid™, Monocryl™, Vicryl™ o Vicryl Plus™. Tambien se excluyeron todas aquellas publicaciones que no relacionaban los materiales de sutura a la agregacion bacteriana. Resultados: Un total de 9 publicaciones se organizaron en funcion del tipo de sutura empleada, si eran estudios in vivo o in vitro, el numero de pacientes/muestras, tiempo transcurrido hasta la remocion de las suturas, si se realizaron controles, si existio algun tipo de reaccion inflamatoria, que tipo de bacterias se agregaron y que material obtuvo mayor agregacion. Discusion: Los materiales de sutura que mayor acumulo de placa bacteriana presentan bajo las mismas condiciones de tiempo de exposicion a bacterias, son los de tipo multifilamento reabsorbible no tratados con antimicrobianos. EnglishObjective: To demonstrate the existence of bacterial aggregation to the suture materials that are usually used in dental practice, to verify if aggregation is related to the inflammation that occurs after the surgical act and finally give recommendations on what type of suture is best suited for the prevention of bacterial adhesion. Material and method: Bibliographic search through PubMed, Cochrane and Scielo databases using the keywords: surgical sutures, bacterial adherence. Inclusion criteria were accepted studies published in the last 15 years, in vivo or in vitro in relation to oral surgery and with a level of scientific evidence of more than 3 according to the criteria of scientific evidence. All those publications that did not have the suture subject Silk, Nylon™, Supramid™, Monocryl™, Vicryl™ or Vicryl Plus™ were excluded. All publications that did not relate suture materials to bacterial aggregation were also excluded. Results: A total of 9 publications were organized according to the type of suture used, whether they were in vivo or in vitro studies, the number of patients/samples, time elapsed until removal of the sutures, controls if they were performed, any type of inflammatory reaction, which type of bacteria were added and which material obtained greater aggregation. Discussion: The suture materials with the greatest accumulation of bacterial plaque present under the same conditions of exposure to bacteria, are the reabsorbable multifilament type not treated with antimicrobials.

Multiple systems and associated factors have been described in the literature to assess the prognosis of teeth with periodontal disease. Nowadays there is a tendency among clinicians to consider implants as the best solution after tooth extraction, in cases of teeth with a questionable prognosis. However, the value of the natural tooth must be considered, as the proprioception of the periodontal ligament is preserved, and it adapts to stress during functional loads. We first review the literature focusing on analyzing the factors that should guide decision-making to maintain or extract a tooth with a compromised periodontium. Then, we propose a schematic diagram of prognostic indicators to reflect the main factors to consider and the survival rate that each one represents when preserving or extracting a tooth.

The association between general health and oral health has been studied over recent years. In order to evaluate the lifestyle and the presence of healthy habits, a descriptive observational study was conducted from December 2018 to April 2019 with 230 patients, aged from 18 to 65 years old, that attended the Dental Hospital of the University of Barcelona for the first time. A total of 230 participants were considered, 98 (43%) were men and 132 (57%) were women, with a mean age of 37 years old. Our hypothesis was that patients with healthy habits had a better oral status in comparison with patients with bad lifestyle habits. No statistically significant results were found regarding oral hygiene between gender, smokers and patients with systemic pathology. Regarding a healthy lifestyle (High adherence to dietary intake), no statistically significant results were found. No significant differences were found regarding physical activity between male and female patients. Our hypothesis wasn’t confirmed, therefore, we cannot conclude that patients with healthy habits have better oral status in comparison with patients with bad lifestyle habits. Consequently, more prospective longitudinal studies should be carried out.

Systemic antibiotics are routinely prescribed in implant procedures, but the lack of consensus causes large differences between clinicians regarding antibiotic prophylaxis regimens. The objectives of this systematic review are to assess the need to prescribe antibiotics to prevent early implant failure and find the most appropriate antibiotic prophylaxis regimen. The electronic search was conducted in PubMed/MEDLINE, Scielo and Cochrane Central Trials Database for randomized clinical trials of at least 3 months of follow-up. Eleven studies were included in the qualitative analysis. Antibiotics were found to statistically significantly reduce early implant failures (RR = 0.30, 95% CI: 0.19–0.47, p < 0.00001; heterogeneity I2 = 0%, p = 0.54). No differences were seen between preoperative or both pre- and postoperative antibiotic regimens (RR = 0.57, 95% CI: 0.21–1.55, p = 0.27; heterogeneity I2 = 0%, p = 0.37). A single preoperative antibiotic prophylaxis dose was found to be enough to significantly reduce early implant failures compared to no antibiotic (RR = 0.34, 95% CI: 0.21–0.53, p < 0.00001; heterogeneity I2 = 0%, p = 0.61). In conclusion, in healthy patients a single antibiotic prophylaxis dose is indicated to prevent early implant failure.

Simple Summary Stage of the disease at diagnosis has been recognized as one of the most important prognostic markers for oral cancer. Unfortunately, still two thirds of patients are diagnosed at an advanced stage of disease with a 5-year survival rate of 50% or less. Although the detection of oral cancer at an early stage is the most effective means to improve survival and reduce morbidity, in the past years, there has been little change in the diagnosis of oral cancer at early stages, which is believed to be a result of delays in diagnosis and treatment of oral cancer, among other independent factors. Following the Aarhus statement, developed in effort to standardize the design, methods and reporting of studies concerning time-intervals in early diagnosis research, the review assessed the causes that influence the patient, diagnosis and pre-treatment intervals in the pathway of time-to-treatment in oral cancer and its impact on survival. Abstract The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.

Background The COVID-19 disease first appeared in December 2019 in Wuhan, China. The World Health Organization (WHO) declared the pandemic in March 2020, with 40 million cases and a million deaths in October 2020. COVID-19 also includes manifestations on the skin and mucous mucosal membrane. Objective: To evaluate the prevalence of the oral lesions associated to COVID-19 disease; and evaluate their clinical presentation and the hypothesized etiology. Material and methods An electronic literature search was performed in PubMed, Scopus and Indice Medico Espanol databases. The following combination of keywords and Boolean operators were used: "COVID-19 AND oral manifestations"; "COVID-19 AND oral lesions"; "COVID-19 AND mucosal lesions" ; "COVID-19 AND mucosal manifestations"; "SARS-COV-2 AND oral manifestations"; "SARS-COV-2 AND oral lesions"; "SARS-COV-2 AND mucosal lesions"; "SARS-COV-2 AND mucosal manifestations". Furthermore, the bibliography was reviewed to manually include additional articles. The risk of bias in individual studies was assessed by two blinded reviewers using the Joanna Briggs Institute (JBI) and the evidence levels of the articles found will be cataloged according to the level of evidence and grade of recommendation of Oxford Centre for Evidence-Based Medicine (CEBM). Results 249 articles were found in the Medline / Pubmed database. There are no additional articles in the Scopus and Indice Medico Espanol databases. We selected 14 articles plus 5 more articles due to manual searching. Patients presented a wide variety of oral manifestations. The most prevalent were lesions with a solution of continuity (n = 48, 73.85%) and the most frequent area was the tongue (n = 41, 52.56%). The preferred treatment for the lesions is a localized one by using rinses. Conclusions To conclude, after the bibliographic review was performed, we can expect that the COVID-19 disease can cause cutaneous and mucosal lesions as secondary manifestations. Despite more studies being needed to confirm this. Key words:COVID-19, SARS-COV-2, oral lesions, oral manifestations.

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.

espanolUno de los retos mas importantes, hoy en dia, en implantologia oral es evitar la perdida osea alrededor de los implantes oseointegrados y funcionales con el paso del tiempo. Una de las superficies que se ha desarrollado en los ultimos anos es la resultante de la microtexturacion mediante laser. Diversos estudios han demostrado la adhesion del tejido conectivo a las superficies tratadas con laser en la zona cervical de los implantes oseointegrados, consiguiendo de este modo un sellado biologico a este nivel. Revisamos lo publicado sobre este tema y presentamos un caso clinico de insercion de un implante unitario con tratamiento laser en su zona cervical desde su colocacion hasta la restauracion final, donde se observa la buena integracion de los tejidos y el exito del caso a largo plazo. EnglishThere are certainly situations where the standard implants can not be placed or suppose a risk for the crestal bone maintenance. The narrow implants have been used for a wide variety of indications, stablishing scientifically-based treatment protocols with excellent long-term results.In the present study we present a narrative review of narrow implants highlighting their indications and limitations, and a case report where narrow implants have been sh it is evident that narrow implants are an alternative when rehabilitate edentulous spaces with low available bone in the horizontal direction or reduced mesio-distal spaces in aesthetic areas.

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.

Background The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It’s important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants. Methods An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic” AND "Dental implants" OR "Oral implants”. Results After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67). Conclusions The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.

Guided bone regeneration techniques are increasingly used to enable the subsequent placement of dental implants. This systematic review aims to analyze the success rate of these techniques in terms of bone gain and complications rate using titanium membranes as a barrier element. Electronic and hand searches were conducted in PubMed/Medline, Scielo, Scopus and Cochrane Library databases for case reports, case series, cohort studies and clinical trials in humans published up to and including 19 September 2020. Thirteen articles were included in the qualitative analysis. Bone gain both horizontally and vertically was comparable to that obtained with other types of membranes more commonly used. The postoperative complication rate was higher that of native collagen membranes and non-resorbable titanium-reinforced membranes, and similar that of crosslinked collagen membranes and titanium meshes. The survival rate of the implants was similar to that of implants placed in native bone. Due to the limited scientific literature published on this issue, more randomized clinical trials comparing occlusive titanium barriers and other types of membranes are necessary to reach more valid conclusions.

RESUMEN Introducción: la sífilis es una infección bacteriana, que se puede transmitir por contacto sexual o de forma congénita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. Material y método: se realizó una búsqueda en la base de datos PubMed, utilizándose como palabras clave: “sexually transmitted diseases”, “venereal diseases”, “syphilis”, “primary syphilis”, “secondary syphilis”, “tertiary syphilis”, “oral manifestations”, “oral lesions”. Como criterios de inclusión se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sífilis y trabajos en inglés y español. No hubo restricción por fecha. Resultados: se seleccionaron un total de 18 artículos, la N total de pacientes fue de 201. El 10,05% padecía sífilis primaria, el 52,76% sífilis secundaria y el 36, 68% sífilis terciaria. Las lesiones orales predominantes de la sífilis primaria fueron úlceras, inflamación, chancro sifilítico; en la sífilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamación, lesiones papulares, lesiones maculares, lesiones erosivas; en la sífilis terciaria aparecen gomas sifilíticos, lesiones leucoplásicas y atrofia lingual. Discusión: la sífilis es una infección bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnóstico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomática. ABSTRACT Introduction: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. Material and method: a search was made in the PubMed database, using as keywords: “sexually transmitted diseases”, “venereal diseases”, “syphilis”, “primary syphilis”, “secondary syphilis”, “tertiary syphilis”, “Oral manifestations”, “oral lesions”. The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. Results: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. Discussion: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form.

Background TORS has become one of the latest surgical alternatives in the treatment of oropharynx squamous cell carcinomas (OPSCC) and has become increasingly accepted by surgeons as a treatment option. Surgical robots were designed for various purposes, such as allowing remote telesurgery, and eliminating human factors like trembling. The study aimed to compare systematic review of the available literature in order to evaluate the safety and efficacy of Transoral Robotic Surgery (TORS) compared with open surgery. Material and Methods We performed a systematic review of the available literature in order to evaluate the safety and effectiveness of TORS compared with open surgery. We compared TORS and open surgery based on 16 outcomes divided in to 3 groups: intra-operative complications, post-operative complications, and functional and oncologic outcomes. An electronic search of observational studies was carried out using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Oral Health Group Trials Register, and Scielo. Data analysis was carried out in accordance to Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) and the quality of the studies were evaluated using the Newcastle-Ottawa Scale. No language restrictions were imposed. Results From the 4 studies identified (Newcastle-Ottawa Scale mean score 6.5), 371 patients were revised (186 patients were treated with TORS and 185 with conventional surgery). Overall, TORS, when compared with open surgery, appears to have better functional results (less hospital time, decannulation) and fewer intraoperative and post-operative complications. There is no significant difference when assessing the oncological outcomes (positive margins, survival rate) when comparing both techniques. Conclusions TORS has an overall better functional outcome, and less intraoperative and postoperative complications with no difference in positive margins and survival rate when compared with conventional therapy. Key words:Transoral Robotic Surgery, TORS, open surgery, conventional surgery, head and neck cancer, oral cancer.

RESUMEN Objetivo: Demostrar la existencia de agregación bacteriana a los materiales de sutura que suelen emplearse en la práctica odontológica, comprobar si dicha agregación está relacionada con la inflamación que sucede al acto quirúrgico y por último dar recomendaciones sobre què tipo de sutura se adapta mejor para la prevención de la adherencia bacteriana. Material y mètodo: Búsqueda bibliográfica a travès de las bases de datos PubMed, Cochrane y Scielo empleando las palabras clave: surgical sutures, bacterial adherence. Como criterios de inclusión se aceptaron los estudios publicados en los últimos 15 años, in vivo o in vitro en relación con la cirugía oral y con un nivel de evidencia científico superior a 3 según los criterios de evidencia científica. Fueron excluidas todas aquellas publicaciones que no tenían como objeto de estudio las sutura seda, Nylon™, Supramid™, Monocryl™, Vicryl™ o Vicryl Plus™. Tambièn se excluyeron todas aquellas publicaciones que no relacionaban los materiales de sutura a la agregación bacteriana. Resultados: Un total de 9 publicaciones se organizaron en función del tipo de sutura empleada, si eran estudios in vivo o in vitro, el número de pacientes/muestras, tiempo transcurrido hasta la remoción de las suturas, si se realizaron controles, si existió algún tipo de reacción inflamatoria, que tipo de bacterias se agregaron y que material obtuvo mayor agregación. Discusión: Los materiales de sutura que mayor acúmulo de placa bacteriana presentan bajo las mismas condiciones de tiempo de exposición a bacterias, son los de tipo multifilamento reabsorbible no tratados con antimicrobianos. ABSTRACT Objective: To demonstrate the existence of bacterial aggregation to the suture materials that are usually used in dental practice, to verify if aggregation is related to the inflammation that occurs after the surgical act and finally give recommendations on what type of suture is best suited for the prevention of bacterial adhesion. Material and method: Bibliographic search through PubMed, Cochrane and Scielo databases using the keywords: surgical sutures, bacterial adherence. Inclusion criteria were accepted studies published in the last 15 years, in vivo or in vitro in relation to oral surgery and with a level of scientific evidence of more than 3 according to the criteria of scientific evidence. All those publications that did not have the suture subject Silk, Nylon™, Supramid™, Monocryl™, Vicryl™ or Vicryl Plus™ were excluded. All publications that did not relate suture materials to bacterial aggregation were also excluded. Results: A total of 9 publications were organized according to the type of suture used, whether they were in vivo or in vitro studies, the number of patients/samples, time elapsed until removal of the sutures, controls if they were performed, any type of inflammatory reaction, which type of bacteria were added and which material obtained greater aggregation. Discussion: The suture materials with the greatest accumulation of bacterial plaque present under the same conditions of exposure to bacteria, are the reabsorbable multifilament type not treated with antimicrobials.

RESUMEN La extracción del tercer molar es un procedimiento común en cirugía oral. Una de las complicaciones es la fractura mandibular. Con una incidencia postoperatoria menor a un 0.005%. Los factores que contribuyen al riesgo de fractura del ángulo mandibular después de una extracción del tercer molar incluyen el nivel de impactación, la anatomía del diente, infecciones locales previas, edad, sexo, presencia de formaciones quísticas y bruxismo entre otras. Presentamos un caso clínico de fractura mandibular postoperatoria a las cinco semanas tras la exodoncia del 47 y 48 incluidos en posición horizontal. El objetivo final del tratamiento de una fractura mandibular es la consolidación ósea manteniendo la oclusión dental. En nuestro caso, al no tratarse de una fractura que sobrepasaba las corticales y sin desplazamiento mandibular, no fue subsidiaria de un tratamiento quirúrgico y se resolvió con reposo funcional. ABSTRACT The lower third molar extraction is a common procedure in oral surgery. One of its complications, although uncommon, is the mandibular fracture. Postoperatively, it has an incidence lower than 0.005%. The factors that may contribute to the risk of the mandibular angle fracture after an extraction of the third molar include the level of impaction are the anatomy of the tooth, previous local infections, age, sex, cysts and bruxism among others. We present a clinical case of postoperative mandibular fracture at five weeks after the extraction of 47 and 48 included in horizontal position. The ultimate treatment goal of a mandibular fracture is to reach a bone consolidation with the premorbid dental occlusion. In our case, as it was not a fracture that surpassed the cortical and there was not a mandibular displacement, it was not need a surgical treatment so it was resolved with functional rest.

Background The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. Material and Methods In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. Results The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 – 3.09; p = 0.31). Conclusions The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Key words:Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.

Background Clinical examination is the gold-standard approach for surveillance of periodontitis; however, it requires large resources. Several self-reported measures have been developed and tested in diverse scenarios with results suggesting that it may be a useful tool for screening periodontal disease in different populations; yet they have not being tested in Spanish population. We aimed to assess the validity of a self-reported questionnaire for periodontitis in a Spanish population from Barcelona during 2018. Methods One hundred and twelve participants were enrolled in the study and, in one appointment; a dentist performed the self-reported questionnaire and a full-mouth periodontal examination. Periodontitis was defined as at least mild periodontitis according to three criterion of classification. Receiver-operating characteristics curve analyses were used to test the discriminatory capability, sensitivity and specificity of the self-reported questionnaire and logistic regression models were adjusted to estimate the minimal-set of questions associated with periodontitis. Results The self-reported questionnaire had a useful discriminative capability for detecting individuals with periodontitis (area under the curve [AUC] = 0.85 95% CI 0.78-0.92) and its moderate/severe form (AUC = 0.86 95% CI 0.79-0.04) with sensitivity and specificity of 77% and 74% and 73% and 87%, respectively; representing moderate validity. The combination of four-specific questions had high accuracy (AUC = 0.88 95% CI 0.81-0.94) and validity (sensitivity = 92.2%) and was strongly associated with moderate/severe periodontitis after adjusting by socio-demographic factors. Conclusions The use of several self-reported questions proved to have a good performance for screening periodontitis in the population under study; specifically, those related with tooth mobility and gum migration. Large community-based studies are needed to test its validity and predictive capability.

This article belongs to the Special Issue Oral Health and Systemic Diseases., [Objective] Investigate if there is an association between apical periodontitis and diabetes mellitus., [Material and methods] A bibliographic search was performed on Medline/PubMed, Scopus and Cochrane databases using the keywords apical periodontitis and diabetes mellitus. Published papers written in English and performed on animals or humans were included. Meta-analysis was performed using the OpenMeta (analyst) tool for the statistical analysis. The variables analyzed were the prevalence of Apical Periodontitis (AP) among teeth and patients with Diabetes Mellitus (DM)., [Results] Of the total studies found, only 21 met the inclusion criteria. Ten clinical studies on animals, ten studies on humans and a systematic review were included. Meta-analysis shows that the prevalence of teeth with apical periodontitis among patients with diabetes mellitus has an odds ratio of 1.166 corresponding to 507 teeth with AP + DM and 534 teeth with AP without DM. The prevalence of patients with AP and DM shows an odds ratio of 1.552 where 91 patients had AP + DM and 582 patients AP without DM., [Conclusion] Scientific evidence suggests that there could be a common physiopathological factor between apical periodontitis and diabetes mellitus but more prospective studies are needed to investigate the association between these two diseases.

espanolIntroduccion: la sifilis es una infeccion bacteriana, que se puede transmitir por contacto sexual o de forma congenita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. Material y metodo: se realizo una busqueda en la base de datos PubMed, utilizandose como palabras clave: “sexually transmitted diseases”, “venereal diseases”, “syphilis”, “primary syphilis”, “secondary syphilis”, “tertiary syphilis”, “oral manifestations”, “oral lesions”. Como criterios de inclusion se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sifilis y trabajos en ingles y espanol. No hubo restriccion por fecha. Resultados: se seleccionaron un total de 18 articulos, la N total de pacientes fue de 201. El 10,05% padecia sifilis primaria, el 52,76% sifilis secundaria y el 36, 68% sifilis terciaria. Las lesiones orales predominantes de la sifilis primaria fueron ulceras, inflamacion, chancro sifilitico; en la sifilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamacion, lesiones papulares, lesiones maculares, lesiones erosivas; en la sifilis terciaria aparecen gomas sifiliticos, lesiones leucoplasicas y atrofia lingual. Discusion: la sifilis es una infeccion bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnostico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomatica. EnglishIntroduction: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. Material and method: a search was made in the PubMed database, using as keywords: “sexually transmitted diseases”, “venereal diseases”, “syphilis”, “primary syphilis”, “secondary syphilis”, “tertiary syphilis”, “Oral manifestations”, “oral lesions”. The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. Results: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. Discussion: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form.