ABSTRACT
La enfermedad periodontal es una de las principales causas de pérdida dentaria. Clínicamente, esta patología, mediada por la desregulación del sistema inmune producto de una disbiosis ocurrida en el surco gingival, inicia con la inflamación de la encía y evoluciona con el daño irreversible de los tejidos que rodean el diente. El hueso alveolar es uno de los tejidos afectados esta patología, esto debido a la activación de osteoclastos por la sobreexpresión de la proteína RANKL en el huésped. El propósito de este trabajo es determinar el nivel de sobreexpresión de RANKL, en un modelo de células tumorales U2OS, frente a la infección con Porphyromonas gingivalis y Prevotella intermedia. Para identificar el nivel de RANKL, se definieron cuatro grupos: Un grupo control, no tratado; Grupo PG, tratado con P. gingivalis; Grupo PI, tratado con P. Intermedia; y un grupo PG+PI, tratado con ambas bacterias. El nivel relativo de la proteína RANKL fue determinado en el sobrenadante y en los extractos celulares de manera independiente, mediante la técnica Western blot. En sobrenadantes, el grupo PG mostró mayores niveles de RANKL comparados con PI (p < 0,05). En extractos celulares los niveles fueron mayores en el grupo PG+PI (p < 0,05). El grupo PI mostró los niveles más bajos de RANKL. La infección polimicrobiana resulta en una mayor expresión de RANKL en células tumorales U2OS, mientras que frente a la infección P. gingivalis, se observó mayor cantidad de RANKL soluble.
SUMMARY: Periodontal disease is one of the main causes of tooth loss. Clinically, this pathology, mediated by the deregulation of the immune system due to a dysbiosis occurred in the gingival sulcus, begins with the inflammation of the gum and evolves with the irreversible damage of the tissues that surround the tooth. Alveolar bone is one of the most affected tissues by this disease, due to the activation of osteoclasts by the upregulation of RANKL in the host. The aim of this study is to determine the increase of RANKL, in a U2OS tumor cells model, inoculated with Porphyromonas gingivalis and Prevotella intermedia. To identify the level of RANKL, four groups were defined: A control group, not treated; PG group, treated with P.gingivalis; PI group, treated with P. intermedia; and a PG+PI group, treated with both bacteria. The relative level of RANKL was determined in the supernatant and cell extracts independently, using the Western blot technique. In supernatants, the PG group showed higher RANKL levels compared to PI (p < 0.05). In cell extracts the levels were higher in the PG+PI group (p < 0.05.). The PI group showed the lowest levels of RANKL.Polymicrobial infection results in a greater expression of of soluble RANKL was observed.
Subject(s)
Periodontal Diseases/microbiology , Bacteria, Anaerobic/physiology , Bone Resorption/microbiology , RANK Ligand/metabolism , Cells, Cultured , Blotting, Western , Porphyromonas gingivalis/physiology , Prevotella intermedia/physiology , Cell Line, Tumor , Electrophoresis , RANK Ligand/analysisABSTRACT
Abstract Objective To determine the effectiveness of chlorhexidine 0.12% mouthwash (CHX) after tooth extraction for the prevention of alveolar osteitis (AO). Material and methods We conducted a double-blind randomised clinical trial stratified by risk factors. We enrolled a cohort of 822 patients who underwent dental extractions, and were considered to be at risk of developing AO (previous surgical site infection, traumatic extraction, and tobacco smoking). After extraction, patients were randomly allocated for CHX group or placebo group, matched by risk factors. The primary outcome was clinical diagnosis of AO: increasing postoperative pain for 4 d within and around the socket, and total or partial breakdown of the blood clot in the socket with or without bone exposure. Results Follow-up was completed by 744 participants (372 chlorhexidine and 372 placebo). We detected no significant differences between the two groups at baseline. After completed follow-up, risk factors were equally distributed between the two groups. Overall incidence of OA was 4.97%, in which 27 participants treated with placebo (7.26%) and 10 participants treated with CHX (2.69%) developed AO. CHX reduced the incidence of AO by 63% [Absolute Risk Reduction: 4.57 (95% CI 1.5-7.7), Number Needed to Treat: 21.88 (95% CI 13.0-69.3), Fisher's exact test: p=0.006]. No adverse effects were reported. Conclusion The use of chlorhexidine 0.12% mouthwash after tooth extraction is safe and effective in reducing the incidence of AO in high-risk patients.
Subject(s)
Humans , Male , Female , Adult , Postoperative Complications/prevention & control , Tooth Extraction/adverse effects , Chlorhexidine/therapeutic use , Dry Socket/prevention & control , Mouthwashes/therapeutic use , Placebo Effect , Double-Blind Method , Reproducibility of Results , Risk Factors , Treatment Outcome , Dry Socket/etiology , Middle AgedABSTRACT
To determine the prevalence of neuropathic symptoms in the orofacial region in patients referred for painful temporomandibular disorder at Hospital Base Valdivia in 2014 and 2015. Materials and method: An observational study was conducted on patients referred for painful temporomandibular disorder by general dentists working in primary dental health care at Hospital Base Valdivia, during October 2014 and March and April 2015. Patients were asked to complete the LANSS pain scale by one of the examiners. The variables age, sex and location of pain were measured and registered. Results: Of the 84 patients surveyed, 88.1 percent were women, with a mean age of 38.2 years. The median score obtained with the LANSS scale was 3.0 [0-8.75]. A 20.2 percent had neuropathic pain symptoms. They were all women with an average age of 36.7. The most recurrent painful area was the right mandibular dermatome of the trigeminal nerve in patients with neuropathic pain symptoms. Conclusion: The prevalence of symptoms of neuropathic pain was 20 percent in patients referred for painful temporomandibular disorders. Dentists should evaluate neuropathic symptoms to provide a proper management of the condition...
Determinar la prevalencia de síntomas neuropáticos orofaciales en pacientes derivados por trastorno témporomandibular doloroso al Hospital Base Valdivia en 2014 y 2015. Material y métodos: Se desarrolló un estudio observacional incluyendo pacientes derivados por trastorno témporomandibular doloroso por odontólogos generales de atención primaria en salud, al servicio dental del Hospital, durante octubre del 2014, marzo y abril del 2015. Un examinador les aplicó la escala de dolor LANSS. Se midieron las variables edad, sexo y localización del dolor. Resultados: De los 84 pacientes encuestados, el 88.1 por ciento fueron mujeres, edad promedio de 38.2 años. La mediana del puntaje obtenido en la escala fue de 3.0 [0-8.75]. Un 20.2 por ciento presentó síntomas de dolor neuropático, todos mujeres, promedio de edad de 36.7 años. El dermatoma de la rama mandibular del nervio trigémino del lado derecho fue la zona dolorosa más frecuente en pacientes con síntomas de dolor neuropático. Conclusión: La prevalencia de síntomas de dolor neuropático es de un 20 por ciento en pacientes derivados por trastornos témporomandibulares dolorosos. Odontólogos deben considerar evaluar la presencia de síntomas neuropáticos para brindar un manejo adecuado...
Subject(s)
Humans , Male , Adolescent , Adult , Female , Young Adult , Middle Aged , Aged, 80 and over , Pain Measurement/methods , Facial Pain/epidemiology , Neuralgia/epidemiology , Temporomandibular Joint Disorders/epidemiology , Chile , Observational Study , PrevalenceABSTRACT
The aim of the study is to determine the association. between abdominal obesity and periodontal disease by means of multivariate analysis. Materials and method: A cross -sectional observational study was carried out. From March to April 2014, patients admitted to the Dental SciencesBuilding at Universidad Austral de Chile were subjected to a clinical periodontalexamination. Periodontitis was defined by a probing pocket depth equal to orgreater than 4mm in at least one site of the teeth in two different quadrants,along with active bleeding within 30 seconds after probing. Abdominal obesity was defined by waist-hip ratio with values equal to or greater than 0.90 for men and 0.88 for women. Oral hygiene was assessed by Simplified Oral Hygiene Index. Smoker status was determined after undergoing an interview. Results: The sample comprised 136 participants (51 males and 85 females), with a mean age of 40.6+/-15.1 years. Prevalence of periodontal disease was 49.2 percent and obesity was 50.7 percent. A 62.3 percent of the patients showed both, periodontal disease and obesity. A statistically significant association between abdominal obesity (Odds ratio (OR)=2.4, 95 percent confidence interval (CI): 1.1, 5.1), cigarette comsumption(OR=4.0, 95 percent CI: 1.0, 16.5), poor oral hygiene (OR=2.8, 95 percent CI: 1.3, 5.9) and periodontal disease was established. Conclusion: There is a statically significant association between abdominal obesity and periodontal disease...
El objetivo es determinar la asociación de la obesidad abdominal y la enfermedad periodontal por medio de un análisis multivariado. Material y métodos: Se realizó un estudio observacional de corte transversal en donde se evaluaron pacientes ingresados al Edificio de las Ciencias Odontológicas de la Universidad Austral de Chile en los meses de marzo y abril del año 2014. Fueron sometidos a un examen clínico periodontal. La periodontitis se determinó con una profundidad al sondaje igual o superior a 4 mm. en al menos un sitio del diente en dos cuadrantes diferentes con sangrado activo hasta 30 segundos luego del sondaje; y la obesidad abdominal mediante el Índice cintura/cadera con valores igual o mayores a 0.9 en hombres y 0.88 en mujeres. Se evaluó la higiene oral mediante el Índice de Higiene Oral Simplificado; y la condición de fumador mediante un interrogatorio. Resultados: Se incluyeron 136 participantes (51 hombres y 85 mujeres) con una edad media de 40.6 años +/- 15.1 DE. La prevalencia de periodontitis fue 49.2 por ciento y de obesidad 50.7 por ciento. Un 62.3 por ciento presentó periodontitis y obesidad abdominal. Se estableció una asociación estadísticamente significativa entre obesidad abdominal (Odds ratio = 2.4, 95 por ciento Intervalo de confianza: 1.1, 5.1], consumo de tabaco (Odds ratio = 4.0, 95 por ciento Intervalo de confianza: 1.0, 16.5), higiene oral pobre (Odds ratio = 2.8, 95 por ciento Intervalo de confianza: 1.3, 5.9) y enfermedad periodontal. Conclusión: Existe una asociación estadísticamente significativa entre la obesidad abdominal y la enfermedad periodontal...
Subject(s)
Humans , Male , Adolescent , Adult , Female , Young Adult , Middle Aged , Periodontal Diseases/epidemiology , Obesity, Abdominal/epidemiology , Adipose Tissue , Age and Sex Distribution , Cross-Sectional Studies , Multivariate Analysis , Waist-Hip RatioABSTRACT
Abstract: aim: to determine differences in marginal adaptation between a conventional composite resin and a monoincremental resin with sonic activation. Materials and methods: 32 composite resin discs of 2.5mm in diameter and 2mm thick were fabricated in a propylene matrix and distributed in 2 groups of 16 samples each. Groups 1 FiltekTMZ350XT resin; Group 2 SonicFillTM resin with sonic activation. The gap generated between the resin and the matrix as a result of the polymerization shrinkage was analyzed in microns using a microscope at a magnification of 40X. The percentage of the lineal polymerization shrinkage was also calculated. To calculate differences in marginal adaptation between the two resins statistical analysis was performed using the unpaired t-test. Results: The extent of the gaps measured in microns and their respective standard deviations were SonicFillTM 9.95 more less 3.05 and FiltekTMZ350XT 10.21 more less5.14 (p=.86). Conclusion: The use of the monoincremental resin system with sonic activation shows a marginal adaptation similar to that of conventional resin composites, with no statistically significant differences between the studied resins.
Resumen: determinar diferencias de adaptación marginal entre una resina compuesta convencional y una resina monoincremental activada sónicamente. Material y métodos: 32 discos fabricados de resina compuesta de 2.5 mm de diámetro y 2 mm de grosor en una matriz de propileno se distribuyeron en 2 grupos de 16 muestras cada uno: grupo 1 resina FiltekTM Z350X; grupo 2 resina SonicFillTM activada sónicamente. La brecha generada entre la resina y la matriz producto de la contracción de polimerización se midió en micrones en un microscopio con magnificación 40x. Para evaluar las diferencias de adaptación marginal entre las dos resinas se realizó análisis estadístico con un t-test de muestras no pareadas. Resultados: La amplitud de las brechas medidas en micrones y sus respectivas desviaciones estándar fueron: SonicFillTM 9.95 más menos 3.05 y FiltekTM Z350X 10.21 más menos 5.14 (p=.86). Conclusión: El uso del sistema de resina monoincremental activado sónicamente presenta similar adaptación marginal que la resina convencional, no existiendo diferencias estadísticamente significativas entre las resinas estudiadas.