Pautas de conducta frente a los pacientes bajo tratamiento anticoagulante en la clínica dental.

Nuestro trabajo pretende dar unas ideas básicas para el manejo de pacientes sometidos a tratamiento anticoagulante dando a conocer las posibles pautas a seguir respecto a su medicación: mantener intacta la terapia anticoagulante, modificar la terapia anticoagulante o realizar tratamiento combinado de heparina con anticoagulantes orales. La decisión deberá tomarse conjuntamente con el hematólogo responsable del paciente valorando cada caso según la morbilidad intrínseca de la intervención, el riesgo de tromboembolismo en función de la patología de base que presente el paciente y el grado de coagulación determinado mediante estudios de laboratorio (tiempo de protrombina e índice de trombotest).

Histopathological evaluation of root canal filling materials for primary teeth

This study aimed to assess the response of apical and periapical tissues of dogs¿ teeth after root canal filling with different materials. Forty roots from dogs¿ premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen®) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort® and camphorated amonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.

FiltekTM Silorane and FiltekTM Supreme XT resins: tissue reaction after subcutaneous implantation in isogenic mice

The aim of this study was to evaluate the tissue compatibility of a silorane-based resin system (FiltekTM Silorane) and a methacrylatebased nanoparticle resin (FiltekTM Supreme XT) after implantation in the subcutaneous connective tissue of isogenic mice. One hundred and thirty five male isogenic BALB/c mice were randomly assigned to 12 experimental and 3 control groups, according to the implanted material and the experimental period of 7, 21 and 63 days. At the end of each period, the animals were killed and the tubes with the surrounding tissues were removed and processed for microscopic analysis. Samples were subjected to a descriptive and a semi-quantitative analyses using a 4-point scoring system (0-3) to evaluate the collagen fiber formation and inflammatory infiltrate. Data were statistically analyzed using the Kruskal Wallis test (a=0.05). The results showed that there was no significant difference between the experimental and control groups considering the three evaluation periods (p>0.05). The silorane-based and the methacrylate-based nanoparticle resins presented similar tissue response to that of the empty tube (control group) after subcutaneous implantation in isogenic mice.

Habitos de higiene en la población escolar y adulta española

De acuerdo a la evidencia científica existente, el control de la placa bacteriana (mecánico y químico) acompañado del uso de fluoruros tópicos se establece como la base en el mantenimiento de una dentadura sana. La Federación Dental Internacional (FDI) establece el cepillado dental con una pasta dental fluorada dos veces por día como el patrón básico de higiene dental personal, pudiendo ser mejorado con el uso de elementos adicionales de higiene interproximal (como la seda dental o los cepillos interproximales) o de colutorios (antisépticos o fluorados). Material y método: se recopila información acerca de los hábitos de higiene oral de la población española (escolar y adulta) provenientes de cuestionarios de salud junto a datos de estudios de mercado de venta de productos (cepillos y colutorios) y se relacionan con la epidemiología de caries y enfermedad periodontal. Resultados: los hábitos de higiene dental personal en España, pese a una positiva evolución en los últimos años, aún se encuentran lejos del patrón de excelencia deseable y a la cola de los países desarrollados. Conclusión: para conseguir una mejor salud oral de la población española deben mejorarse los hábitos de higiene oral.

Restauraciones fototermocuradas en dentición temporal

La restauración de lesiones proximales en molares deciduos es problemática, no existe un material ideal para reparar este tipo de lesiones. Por otra parte en dientes temporales debilitados tras una pulpotomía, la restauración de elección es la corona metálica preformada. Con la introducción de los nuevos sistemas de adhesión una posible alternativa en el tratamiento de estas situaciones en dentición temporal, serian las incrustaciones para molares y las coronas para incisivos confeccionadas con material composite fototennocurado. En este arüculo se analiza la técnica de preparación de estas restauraciones, sus indicaciones, ventajas e inconvenientes.

Influencia de diferentes sistemas de profilaxis en la adhesión de un sellador de fisuras al esmalte

Introducción: La adhesión de las resinas dentales al esmalte no depende solamente del grabado ácido del esmalte. Otros factores, como el pulido de la superficie del esmalte pueden influir en la fuerza de adhesión de las resinas. El objetivo de este estudio es evaluar la adhesión de un sellador de fisuras fotopolimerizable tras la utilización previa de distintos métodos de profilaxis y dos diferentes tiempos de grabado. Material y método: Ochenta terceros molares extraídos quirúrgicamente se seccionaron en dos mitades (vestibular y lingual). Los dientes se dividieron en ocho grupos de 20 muestras cada uno, de acuerdo con los métodos de profilaxis: polvo de piedra pómez, pasta fluorada, espray de bicarbonato y control (sin profilaxis); y dos tiempos de grabado: 15 y 30 segundos. Se midió la fuerza de adhesión mediante una prueba de tracción en una máquina de ensayos universal INSTRON. Resultados y conclusión: Se utilizó el test estadístico ANOVA, detectándose diferencias significativas en la resistencia a la tracción; el posterior test de Dunnett encontró estas diferencias entre los grupos control y de profilaxis con piedra pómez para 15 y 30 segundos de grabado respecto de los grupos tratados con pasta fluorada y espray de bicarbonato, para los mismos tiempos de grabado (p<0,05), siendo esta diferencia mayor en el grupo de espray con bicarbonato.

Riesgo de transmisión de enfermedades infecciosas en la clínica dental

Se presenta en este artículo una revisión del riesgo de transmisión de enfermedades infecciosas en la clínica dental. Las hepatitis víricas, en especial la hepatitis B y la C, la infección por el virus de la inmunodeficiencia humana, la tuberculosis, y otras enfermedades infecciosas pueden ser potencialmente transmitidas en el ejercicio de la profesión, tanto a los pacientes como a los profesionales. El conocimiento de la probabilidad de transmisión y sus características son la base sobre la que desarrollarán las medidas preventivas de control de infección que intentan evitar o por lo menos minimizar la probabilidad de adquirir estas enfermedades en el ámbito laboral.

Estudi de la capacitat del suro com a material adsorbent de pesticides

La presència de pesticides en el medi ambient pot comportar efectes nocius pel propi medi i la salut humana, fet que, en alguns casos, converteix en necessària la seva eliminació. Un dels mètodes utilitzats per dur a terme aquesta eliminació és la sorció de contaminats sobre materials adsorbents. Per tal de fer d’aquest mètode un procés sostenible cal investigar nous materials capaços de retenir els contaminants. El suro és la part més externa de l’escorça de l’alzina surera: Quercus Suber L. S’extreu cada 5- 10 anys depenent de la regió i es caracteritza per ser una font natural, renovable i biodegradable amb una heterogènia composició química que el converteix en un material potencialment apte com a adsorbent d’un ampli rang de contaminants. En aquest context, l’objectiu principal d’aquest treball és investigar l’afinitat d’adsorció del suro amb quatre pesticides de diferent hidrofobicitat i estructura química i estudiar el paper que hi juguen els seus compostos químics (extractius, suberina, lignina i polisacàrids) en aquest procés de sorció. Els pesticides investigats han estat: Metamitron: poc hidrofòbic (logKow = 0.83) i de caràcter molecular, Alaclor: moderadament hidrofòbic (logKow = 2.80) i de caràcter iònic (pKa = 0.62), 2,4-D: moderadament hidrofòbic (logKow = 2.81) i de caràcter iònic (pKa = 2.64) i Clorpirifos: molt hidrofòbic (logKow = 4.92) i de caràcter molecular

La cultura material de Tarraco - Tarracona (Hispania Tarraconensis - Regnum Visigothorum): cerámica común y ánforas

Síntesis actualizada de los estudios monográficos realizados sobre las cerámicas comunes y ánforas de la ciudad de Tarraco desde finales del s. IV hasta inicios del s. VIII. Se hace especial hincapié en los últimos hallazgos del siglo VII que reflejan una intensificación de la presencia de materiales orientales en la ciudad.

Diseño e implementación de un serious game para el aprendizaje del material quirúrgico y desarrollo de una operación

En este trabajo se recoge información útil que se debe tener en cuenta para desarrollar un serious game pertinente para el entrenamiento de profesionales de la salud, que aporte destrezas y habilidades necesarias para afrontar las cirugías reales. Se propone un serious game a modo de simulador de diferentes operaciones quirúrgicas traumatológicas, que permite al usuario las etapas preoperatorias, intraoperatorias y postoperatorias de una cirugía, en las que se debe describir qué acciones se llevan a cabo, quiénes la realizan y si es necesario algún material específico.

An epidemiological study of dental agenesis in a primary health area in Spain: estimated prevalence and associated factors

Objectives: To evaluate the prevalence of dental agenesis and its possible association with other developmental dental anomalies and systemic entities. Setting and Sample Population: Descriptive transversal study, for which 1518 clinical records, of patients visited by the Odontological Service of the Primary Health Centre of Cassà de la Selva (Girona-Spain) between December 2002 and February 2006 were reviewed. The data were recorded in relation to the oral and dental anomalies and the associated systemic entities, between the ones referred as concomitant in literature. Results: Values of 9.48% (7.25% excluding the third molars) for dental agenesis and 0.39% for oligodontia were obtained. The presence of dental agenesis concomitant with some other forms of oral and dental anomalies was observed. Attention must be drawn to the fact that a greater number of concomitant systemic entities were observed in those patients that presented a severe phenotypical pattern of dental agenesis. Conclusions: The results of the present study do not differ from the ones reported in studies of similar characteristics among Occidental and Spanish populations. The relationship observed between certain systemic entities and developmental dental anomalies suggest a possible common genetic etiology

Aggregate material formulated with MSWI bottom ash and APC fly ash for use as secondary building material

The main goal of this paper is to obtain a granular material formulated with Municipal Solid Waste Incinerarion (MSWI) bottom ash (BA) and air pollution control (APC) ash to be used as secondary building material. Previously, an optimum concrete mixture using both MSWI residues as aggregates was formulated. A compromise between the environmental behaviour and the economy of the process was considered. Unconfined compressive strength and abrasion resistance values were measured in order to evaluate the mechanical properties. From these results, the granular mixture was not suited for certain applications owing to the high BA/APC content and low cement percentages used to reduce the costs of the final product. Nevertheless, the leaching test performed showed that the concentrations of all heavy metals were below the limits established by the current Catalan legislation for their reutilization. Therefore, the material studied might be mainly used in embankments, where high mechanical properties are not needed and environmental safety is assured.

A comparison of the dental status and treatment needs of older adults with and without chronic mental illness in Sevilla, Spain

Objectives: To study the dental status and treatment needs of institutionalized older adults with chronic mental illness compared to a non-psychiatric control sample. Study Design: The sample size was 100, in which 50 were psychogeriatric patients (study group; SG) classified according to DSM-IV, with a mean age of 69.6 ± 6.7 years, and 50 non-psychiatric patients (control group; CG), with a mean age of 68.3 ± 6.9 years. Clinical oral health examinations were conducted and caries were recorded clinically using the Decayed, Missing and Filled Teeth Index (DMFT). Results were analyzed statistically using the Student"s t-test or analysis of variance. Results: Caries prevalence was 58% and 62% in SG and CG, respectively. DMFT index was 28.3 ± 6.6 in SG and 21.4 ± 6.07 in CG (p < 0.01). Mean number of decayed teeth was higher in SG (3.1) compared to CG (1.8) (p=0.047). Mean number of missing teeth were 25.2 and 16.4 in SG and CG respectively (p<0.05). DMFT scores were higher in SG in all the age groups (p < 0.01). Mean number of teeth per person needing treatment was 3.4 in SG and 1.9 in CG (p= 0.037). The need for restorative dental care was significantly lower in the SG (0.8 teeth per person) than in the CG (1.7 teeth per person) (p = 0.043). Conclusions: Institutionalized psychiatric patients have significantly worse dental status and more dental treatment needs than non-psychiatric patients.

Buccal dental microwear and stable isotopes of El Collado: A mesolithic site from Spain,

This study examines the correlation between buccal dental microwear and stable isotopes. The buccal surface of post-canine teeth casts from El Collado, the largest Mesolithic site in Spain, were examined under Scanning Electron Microscope; photomicrographs were taken from the middle third of the buccal surface with magnification 100X. Only six individuals passed the criteria for buccal dental microwear analysis. The photomicrographs were treated by adobe Photoshop 8.01 to cover an area 0.56 mm² of middle third of buccal surface, the output photomicrographs were digitized using Sigmascan Pro 5 by SPSS. Then the correlation between buccal microwear pattern and stable isotopes of the same individuals, of the previous study of Guixe et al., 2006, was examined using a Pearson test. Statistical analysis revealed that there is no significant correlation between stable isotopes and buccal dental microwear of the people of the Mesolithic site of El Collado. The historical and archaeological documentation suggest that the Mesolithic people tended to consume marine food. Fish-drying techniques were used during the Mesolithic period which allowed the introduction of dust and sand to the fish. These abrasive particles affected the buccal dental microwear pattern, so that no correlation between the isotopes and microwear may be expected. This also suggests that the buccal dental microwear pattern exceeds dietary reconstruction to reconstruct food processing techniques.

Dental implications in oral cancer patients

Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Maxillofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus excluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, xerostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Conclusions. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives