Evaluation of the incisive canal using cone beam computed tomography

The incisive canal is innervated by the nasopalatine nerve and irrigated by the anterior branches of the descending palatine vessels, the sphenopalatine and greater palatine artery. Sometimes, the incisor canal interferes with the placement of implants or other surgical procedures, it is necessary to resort to previous treatments in order to have the ideal conditions in the area to be treated and avoid complications. Methods: 100 cone beam computed tomography were studied evaluating the diameter, length and shape of the incisor canal, distance from the lower edge of the incisor canal to the alveolar ridge, length and width of the bone anterior to the incisor canal, and width of the palatal bone. Results and conclusions: The variables that showed a statistically significant difference comparing between male and female patients were vestibulo-palatal and incisor foramen diameter, incisor canal length, distance from the canal to the central incisor, coronal and medial width of the vestibular bone; and the width of the palatal bone at apical and mid-level; being greater in male patients.

Índice de Placa Bacteriana, Índice Gingival y Prueba de Silometría en Pacientes con Síndrome de Sjögren Primario y Secundario

RESUMEN: El síndrome de Sjögren (SS) es una enfermedad crónica autoinmune presente en el 0.1 - 3.0 % de la población, en la que se encuentran involucradas las glándulas salivales, trayendo consigo manifestaciones orales como caries dental y enfermedad periodontal. El objetivo de este trabajo fue evaluar el índice de placa, el índice gingival y la prueba de sialometría en pacientes con síndrome de Sjögren primario y secundario. Fueron evaluados clínicamente 40 pacientes con SS primario (n=20) y SS secundario (n=20), ambos grupos diagnosticados con periodontitis crónica. Se registró el índice de placa de Quigley-Hein modificado por Turesky, el índice gingival de Löe y la prueba de silometría estimulada, recolectando saliva parotídea con el dispositivo Carlson-Crittenden. Los pacientes con SS primario tuvieron un índice de placa de (3,53±0,5954) e índice gingival (2,41±0,2608). En pacientes con SS secundario el índice de placa fue (1,62±0,3795) y el índice gingival (1,48±0,3994), con diferencia significativa (p=0,0001) entre ambos grupos. El flujo salival se elevó en pacientes con SS secundario. El presente estudio concluye que el índice de placa y el índice gingival fueron mayores en pacientes con SS primario comparados con pacientes con SS secundario. La prueba de sialometría fue mayor en pacientes con SS secundario.

ABSTRACT: Sjögren's syndrome (SS) is a chronic autoimmune disease present in 0.1 - 3.0 % of the population, in which the salivary glands are involved, bringing with it oral manifestations such as dental caries and periodontal disease. The aim of the present study was to evaluate the plaque index, gingival index and the sialometry test in patients with primary and secondary Sjögren's syndrome. Forty patients with primary SS (n = 20) and secondary SS (n = 20), both groups diagnosed with chronic periodontitis, were evaluated clinically. The Quigley-Hein plaque index modified by Turesky, the gingival index of Löe and stimulated sialometry test collected from parotid gland by using Carlson-Crittenden device were recorded. The patients with primary SS had plaque index (3.53 ± 0.5954) and gingival index (2.41 ± 0.2608). The patients with secondary SS had a plaque index (1.62 ± 0.3795) and gingival index (1.48 ± 0.3994), with significant difference between both groups. The present study concludes that plaque index and gingival index were higher in patients with primary SS than patients with secondary SS. Sialometry test were higher in patients with secondary SS.

Ozonoterapia como adyuvante en el tratamiento periodontal no quirúrgico y quirúrgico / Ozonoterapia as adjuvant in the non-surgical and surgical periodontal treatment

Introducción: El ozono (O3) presenta múltiples acciones biológicas, entre ellas su efecto antimicrobiano, lo que ha sido beneficioso en odontología, siendo la presentación acuosa la más utilizada (20 µg/ mL), la cual presenta efectos similares a la clorhexidina. Reporte de caso: Paciente masculino de 76 años de edad, diagnosticado con periodontitis crónica moderada localizada, el cual fue tratado mediante ozonoterapia acuosa durante la fase inicial periodontal y la fase quirúrgica en colgajo por debridación. 12 semanas posteriores al acto quirúrgico se obtuvo la eliminación de las bolsas periodontales, encontrándose un surco de 3 y 2 mm y un buen control de placa dentobacteriana. Conclusión: No existen reportes acerca del uso de ozonoterapia acuosa durante un colgajo por debridación. El éxito del tratamiento periodontal consiste en la eliminación del factor causal así como en establecer y mantener un control de placa dentobacteriana adecuado (AU)

Introduction: Ozone (O3) has multiple biological actions, including its antimicrobial effect, which has been beneficial in dentistry, the aqueous presentation being the most used (20 µg/mL), which has similar effects to chlorhexidine. Case report: Male patient of 76 years of age, diagnosed with localized moderate chronic periodontitis, which was treated by aqueous ozone therapy during the initial periodontal phase and surgical phase in debridement flap. Twelve weeks after surgery, the periodontal pockets were eliminated, finding a 3 and 2 mm groove and good control of dentobacterial plaque. Conclusion: There are no reports about the use of aqueous ozone therapy during a debridement flap. The success of the periodontal treatment consists in the elimination of the causal factor, as well as establishing and maintaining an adequate control of plaque (AU)

Características anatómicas del asa mandibular evaluada por tomografía computarizada de haz cónico / Anatomical characteristics of the mandibular loop evaluated by cone beam computed tomography

Introducción: El nervio dentario inferior es una estructura anatómica de la mandíbula, la cual presenta variaciones como el asa mandibular, ambas estructuras están relacionadas con iatrogenias con tratamientos como cirugías orales, regeneraciones óseas e implantes. El objetivo del presente estudio es evaluar las características del asa mandibular y el agujero mentoniano utilizando tomografía axial computarizada de haz cónico (CBCT) en pacientes del Postgrado de Periodoncia de la Universidad Autónoma de Nuevo León. Material y métodos: Se analizaron un total de 110 CBCT, de los cuales 61 entraron al estudio cumpliendo con los criterios de inclusión, se realizaron cortes transversales utilizando el software On Demand® para identifi car y medir el asa mandibular y localizar la posición del agujero mentoniano de ambos lados separando los grupos por género. Resultados: La prevalencia del asa mandibular fue de 32.8% de 61 CBCT que se analizaron, se observó más comúnmente en hombres y de manera bilateral, y cuando fue unilateral sólo se encontró en el lado derecho, la longitud promedio fue de 6 ± 1 mm. El agujero mentoniano se detectó en mayor porcentaje apical al segundo premolar inferior con un diámetro promedio de 3.5 ± 0.5 mm, alejándose de la raíz del diente adyacente en un promedio de 6 ± 1 mm y del borde de la mandíbula 12.5 mm ± 0.5 mm. Conclusión: Es de suma importancia identifi car las características anatómicas del asa mandibular y localizar la posición del agujero mentoniano durante la planifi cación del tratamiento para evitar complicaciones durante y después del acto quirúrgico (AU)

Introduction: The inferior dental nerve is an anatomical structure of the mandible which presents variations such as the anterior loop, both structures are related to iatrogenies with treatments such as oral surgeries, bone regenerations and implants. The aim of the present study is to evaluate the characteristics of the anterior loop and the mental foramen using cone beam computed tomography (CBCT) in patients of the Graduate Periodontics Program, School of Dentistry, Universidad Autónoma de Nuevo León. Material and methods: 110 CBCT were analyzed of which 61 entered the study fulfi lling the inclusion criteria, cross sections were made using the On Demand® software to identify and measure the anterior loop and locate the position of the mental foramen both sides separating our groups by gender. Results: The prevalence of the anterior loop was 32.8% of 61 CBCT that were analyzed, it was found more commonly in men and bilaterally, and when it was unilateral only found on the right side, the average length was 6 ± 1 mm. The mental hole was found in greater percentage apical to the second lower premolar with an average diameter of 3.5 ± 0.5 mm, moving away from the root of the adjacent tooth by an average of 6 ± 1 mm and from the edge of the mandible 12.5 ± 0.5 mm. Conclusion: It is very important to locate these anatomical structures during treatment planning and avoid complications during and after the surgical act (AU)

Acondicionamiento radicular en el tratamiento periodontal no quirúrgico y quirúrgico / Root conditioning in non-surgical and surgical periodontal therapy

La instrumentación mecánica durante el tratamiento periodontal trae consigo la formación de escombros microcristalinos que inhiben la adhesión tisular a la superfi cie radicular y favorece la proliferación bacteriana, lo cual perjudica los resultados del tratamiento periodontal a corto y largo plazo. Hoy en día el acondicionamiento radicular con el uso de biomodifi cadores es una opción de tratamiento adicional en el tratamiento de la periodontitis y el tratamiento de cobertura radicular. El objetivo del presente estudio es realizar una revisión de la literatura acerca de las aplicaciones y del acondicionamiento radicular con ácido cítrico, tetraciclina, EDTA y láser en el tratamiento periodontal no quirúrgico y quirúrgico (AU)

Mechanical instrumentation during periodontal treatment brings the formation of microcrystalline debris that inhibits tissue adhesion to the root surface and favors bacterial proliferation, which harms the results of the short and long term periodontal treatment. Nowadays, root conditioning with the use of biomodifi cators is an additional treatment option in the treatment of periodontitis and root coverage therapy. The aim of the present study is to conduct a literature review about the applications and the root conditioning with citric acid, tetracycline, EDTA and laser in the non surgical and surgical periodontal treatment (AU)

Salivary rheumatoid factor in primary and secondary Sjögren's syndrome / Factor reumatoide salival en síndrome de Sjögren primario y secundario

Sjögren's syndrome is a chronic autoimmune disease, characterized by the presence of hyposalivation and xerophthalmia, which in addition to other factors is diagnosed by the presence of rheumatoid factor in blood. The objective of the present study is to evaluate the presence of rheumatoid factor (IgG-IgM) in the saliva of patients with primary and secondary Sjögren's syndrome. Materials and methods: Forty samples from patients with primary and secondary Sjögren's syndrome previously diagnosed by the Arthritis and Rheumatism Specialist Center of the Autonomous University of Nuevo Leon were analyzed. Samples were taken from the saliva using the Carlson-Crittenden device to evaluate the IgG-IgM immunocomplex using the ELISA method. Results: No significant difference was found between the presence of IgM in primary (0.099±0.016) and secondary Sjögren syndrome (0.098±0.017), however, a high presence of IgG was found in the group of patients with secondary Sjögren's syndrome (0.134±0.054). Conclusion: The search for diagnostic tools using salivary biomarkers has come with economic and clinical advantages, however, in the present study no significant changes were found in salivary rheumatoid factor between both groups.

El síndrome de Sjögren es una enfermedad autoinmune crónica, caracterizada por la presencia de hiposalivación y xeroftalmia, la cual además de otros factores es diagnosticada por la presencia del factor reumatoide en sangre. El objetivo del presente estudio es evaluar la presencia del factor reumatoide (IgG-IgM) en saliva parotídea de pacientes con síndrome de Sjögren primario y secundario. Materiales y métodos: Se analizaron 40 muestras de pacientes con síndrome de Sjögren primario y secundario previamente diagnosticados por el Centro de Especialistas en Artritis y Reumatismo de la Universidad Autónoma de Nuevo León, a los cuales se les tomó una muestra de saliva parotídea mediante el dispositivo Carlson-Crittenden para evaluar mediante el método ELISA el inmunocomplejo IgG-IgM. Resultados: No se encontró diferencia significativa entre la presencia de IgM en el síndrome de Sjögren primario (0.099±0.016) y secundario (0,098±0,017), sin embargo en cuanto a la presencia de la IgG se encontró elevada en el grupo de pacientes con síndrome de Sjögren secundario (0,134±0,054). Conclusión: La búsqueda de herramientas diagnósticas mediante biomarcadores salivales ha traído consigo ventajas económicas y clínicas, sin embargo en el presente estudio no se encontró un cambio significativo en el factor reumatoide salival entre ambos grupos.

Terapia farmacológica y avances terapéuticos en xerostomía e hiposalivación / Pharmacological therapy and therapeutic advancesin xerostomy and hyposalivation

La saliva juega un rol determinante en el mantenimiento y función de los tejidos orales, donde un decremento en los niveles del flujo salival conllevan a una hiposalivación o hiposialia, trayendo consigo una serie de características que propician un ambiente ideal para la instalaciónde microorganismos oportunistas y condiciones nocivas para la saludoral y sistémica de los pacientes. Hoy en día existen múltiples causas que conllevan a una hiposialia, entre ellas el síndrome de Sjõgren, la radioterapia de haz externo, entre otras, los cuales se han puesto a prueba mediante sialogogos farmacológicos como pilocarpina, cevimelina, betanecoly carbacolina, además de alternativas terapéuticas para revertir los signos obtenidos por la hiposalivación y mitigar los síntomas de xerostomía. El objetivo del presente es realizar una revisión de literatura sobre el tratamiento farmacológico en hiposalivación y xerostomía ensíndrome de Sjõgren y radioterapia de haz externo.

Saliva plays a determinant role in the maintenance and function of oral tissues, where a decrease in salivary flow levels leads to hyposalivation or hyposialia, bringing with it a series of characteristics that provide anideal environment for the installation of opportunistic microorganisms and conditions harmful to the oral and systemic health of patients.Today there are many causes that lead to hyposialia, including Sjögren’ssyndrome, external beam radiotherapy, among others, which have beentested by pharmacological sialogogs such as pilocarpine, cevimelin, betanecol and carbacoline, in addition to therapeutic alternativesto reverse the signs obtained by hyposalivation and to mitigate the symptoms of xerostomia. The objective of the present is to make a reviewof the literature on the pharmacological treatment in hyposalivation and xerostomia in Sjögren’s syndrome and external beam radiotherapy.

Salivary stimulation by prolonged release of pilocarpine in sjõgren’ syndrome

Introduction: Prolonged drug delivery in the oral cavity offers many advantages, such as reducing adverse effects. Pilocarpine is an FDA-approved parasympathomimetic drug for the treatment of glandular hypofunction; however, its adverse effects limit its use. Objective: To evaluate the stimulation of salivary flow by the use of pilocarpine-releasing films, as well as their effects on the symptoms of xerostomia and adverse effects in patients with Sjõgren’s syndrome (SS). Materials and methods: Hydroxypropylmethylcellulose (Methocel K4MCR) films were prepared in 1 percent acetic acid and pilocarpine was added under magnetic stirring. The pH and thickness, as well as diffusion uniformity and kinetics of drug release per cm2 were evaluated by spectrophotometry. The films were tested sublingually in 40 patients with Sjõgren’s syndrome for a period of two weeks. Changes in their salivary flow were evaluated by analyzing samples of total saliva. Additionally, patients were screened for symptoms of xerostomia and adverse effects. Results: The films had a pH of 2.91 +/- 0.035, a thickness of 0.06866 +/- 0.00152μm, and a diffusion uniformity of 91 percent per cm2. Use of the films resulted in an increase in salivary flow in both primary and secondary Sjõgren’s syndrome, but this increase was only significant in primary SS. Conclusion: Films showed optimal physicochemical properties for their administration, and proved effective in stimulating salivary flow without causing adverse effects during their administration.