Paleopatología dental de una muestra esquelética del área funeraria del suburbio oriental de Tarraco (siglo I-III d. C.)

Los dientes son una importante fuente de información en el estudio de poblaciones del pasado. El estudio de las enfermedades dentales en restos esqueléticos antiguos busca reconstruir la forma de vida de las poblaciones antiguas relacionadas con su estado de salud y enfermedad.

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).

Liberación de mercurio por parte de las obturaciones de amalgama dental: tipo, cantidad, método de determinación y posibles efectos adversos

Las obturaciones dentales de amalgama constituyen la fuente principal de exposición permanente de bajo nivel al vapor de mercurio (Hg°) y al mercurio inorgánico (Hg(II)) para la población general. La dosis de mercurio absorbido procedente de la amalgama es de 2.7 ¿g/día/persona para una cantidad promedio de 7.4 obturaciones. Si esta cantidad consistiera enteramente en mercurio inorgánico (Hg(II)), estaría muy por debajo de la cifra de 15 ¿g/día para una persona de 65 kg que la OMS considera como ingesta tolerable de mercurio inorgánico. En el caso de una exposición permanente a la misma cantidad, pero de vapor de mercurio (Hg0), se obtendría una concentración de 0.18 mg/m3 que puede compararse con la concentración de referencia de la EPA de 0.3 mg/m3 o con el nivel de riesgo mínimo de la ATSDR de 0.2 mg/m3. Varios estudios clínicos longitudinales y aleatorizados han evaluado la relación entre la concentración urinaria de mercurio y la exposición al mercurio procedente de las obturaciones dentales de amalgama en niños, particularmente vulnerables al Hg0, así como los posibles efectos neurológicos de tal exposición. La concentración promedio de mercurio en orina en los niños tratados con amalgama, con un promedio de 18,7 superficies obturadas, aumentó hasta un pico de 3.2 ¿g/L a los 2 años de iniciado el tratamiento y a los 7 años de seguimiento había descendido hasta los niveles basales y no se detectó ninguna alteración en las distintas exploraciones de monitorización neuropsicológica. De la misma manera, diversas investigaciones epidemiológicas no han aportado ninguna evidencia del papel de la amalgama en la posible causa o exacerbación de trastornos degenerativos como la esclerosis lateral amiotrófica, la enfermedad de Alzheimer, la esclerosis múltiple o el Parkinson. La extracción de las obturaciones de amalgama produce un aumento transitorio de los niveles de mercurio en sangre inmediatamente después de extraer las obturaciones de amalgama, pero de pequeña magnitud y que se normaliza a los 100 días, por lo que el efecto del dique de goma tiene una relevancia toxicológica menor. La conclusión de esta revisión es que la amalgama dental continúa siendo un excelente material de obturación.

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.

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

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

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

El sistema dental y su importancia en el estudio de la evolución humana: revisión bibliográfica.

La dentición ha sido durante mucho tiempo una de las estructuras biológicas mejor estudiadas, esta singularidad radica en su resistencia al paso del tiempo. El sistema dental ofrece una posibilidad incomparable para comprender mejor el origen y filogénesis de los vertebrados, entre ellos el hombre. Esta investigación, a través de una revisión bibliográfica, explora cuatro aspectos del sistema dental, como son: Su origen, el aspecto biológico, la utilidad de los rasgos dentales en los análisis poblacionales, y finalmente, intenta precisar las bases genéticas de los dientes. Con respecto a este último, lo fundamental no estaría sólo en la descripción morfológica del diente, sino el porqué de su morfología, es decir, porqué son lo que son. Por lo tanto, se puede indagar: ¿porqué se producen diferentes variedades morfológicas dentro de nuestra especie?, entre otras interrogantes

El sistema dental y su importancia en el estudio de la evolución humana: revisión bibliográfica.

La dentición ha sido durante mucho tiempo una de las estructuras biológicas mejor estudiadas, esta singularidad radica en su resistencia al paso del tiempo. El sistema dental ofrece una posibilidad incomparable para comprender mejor el origen y filogénesis de los vertebrados, entre ellos el hombre. Esta investigación, a través de una revisión bibliográfica, explora cuatro aspectos del sistema dental, como son: Su origen, el aspecto biológico, la utilidad de los rasgos dentales en los análisis poblacionales, y finalmente, intenta precisar las bases genéticas de los dientes. Con respecto a este último, lo fundamental no estaría sólo en la descripción morfológica del diente, sino el porqué de su morfología, es decir, porqué son lo que son. Por lo tanto, se puede indagar: ¿porqué se producen diferentes variedades morfológicas dentro de nuestra especie?, entre otras interrogantes

Computer-aided system for morphometric mandibular index computation (Using dental panoramic radiographs)

Objective: We propose and validate a computer aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. Study Design: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. Results: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. Conclusions: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs.

Studies on the characterization of dental whitening process by using both hyperspectral imaging and colorimeter techniques

A beautiful smile is directly related with white teeth. Nowadays oral care has increased and developed processes for beautiful smiles. Dental bleaching is frequently used in odontology, not just for health care also for aesthetic treatment. With the possibility of teeth bleaching, now the importance is in, how white the tooth is? Because color is relate to an individual perception. In order to assets teeth correct color identification has been developed many color guides, models, spaces and analytical methods. Spite all of these useful tools the color interpretation depends on environmental factors, position of the sample in the data acquisition and most importantly the instrument sensitivity. The commons methods have proved to be useful. They are easy to handle, some are portable but they do not have a high sensitivity. The present work is based on the integration of a new analytical technique for color acquisition. High spectral Image (HSI) is able to performed image analysis with high quality and efficiency. HSI is used in many fields and we used it for color image analysis within the bleaching process. The main comparison was done with the HSI and the colorimeter through the processes of two different bleaching protocols. The results showed that HSI has higher sensitivity than the colorimeter. During the analysis the dental surface with the HSI we were able to notice surface changes. These changes were analyzed by roughness studies.

Diet-related buccal dental microwear patterns in central african pygmy foragers and bantu-speaking farmer and pastoralist populations.

Pygmy hunter-gatherers from Central Africa have shared a network of socioeconomic interactions with non-Pygmy Bantu speakers since agropastoral lifestyle spread across sub-Saharan Africa. Ethnographic studies have reported that their diets differ in consumption of both animal proteins and starch grains. Hunted meat and gathered plant foods, especially underground storage organs (USOs), are dietary staples for pygmies. However, scarce information exists about forager-farmer interaction and the agricultural products used by pygmies. Since the effects of dietary preferences on teeth in modern and past pygmies remain unknown, we explored dietary history through quantitative analysis of buccal microwear on cheek teeth in well-documented Baka pygmies. We then determined if microwear patterns differ among other Pygmy groups (Aka, Mbuti, and Babongo) and between Bantu-speaking farmer and pastoralist populations from past centuries. The buccal dental microwear patterns of Pygmy hunter-gatherers and non-Pygmy Bantu pastoralists show lower scratch densities, indicative of diets more intensively based on nonabrasive foodstuffs, compared with Bantu farmers, who consume larger amounts of grit from stoneground foods. The Baka pygmies showed microwear patterns similar to those of ancient Aka and Mbuti, suggesting that the mechanical properties of their preferred diets have not significantly changed through time. In contrast, Babongo pygmies showed scratch densities and lengths similar to those of the farmers, consistent with sociocultural contacts and genetic factors. Our findings support that buccal microwear patterns predict dietary habits independent of ecological conditions and reflect the abrasive properties of preferred or fallback foods such as USOs, which may have contributed to the dietary specializations of ancient human populations.