Factores asociados al colgajo posicionado coronal de uno o dos dientes. Revisión de la literatura. / Factors associated with the coronally positioned flap of one or two teeth. A literature review.

Introducción: las recesiones del tejido marginal presentan problemas estéticos, sensibilidad dental, caries radicular y dificultad para hacer una adecuada higiene oral. Existen diversas técnicas de cirugía plástica periodontal para el cubrimiento radicular. El objetivo de esta revisión de literatura es evaluar los factores asociados a la técnica de colgajo posicionado coronal para el cubrimiento de recesiones gingivales, teniendo en cuenta que hay diferentes variables que pueden intervenir en el cubrimiento completo de la superficie radicular. Métodos: revisión de literatura sobre la técnica de colgajo posicionado coronal para cubrimiento de recesiones tipo I y II de Miller de uno o dos dientes. Se tomaron artículos desde el año 2000 al 2012, buscados en las bases de datos PubMed, Ebsco y Cochrane, de estudios hechos en humanos de tipo longitudinales, transversales, de cohorte, ensayos clínicos y meta análisis. Resultados y conclusiones: la altura de la papila interdental, el ancho de encía queratinizada y el espesor gingival son factores de pronóstico para el cubrimiento total radicular y su estabilidad a largo plazo. La integridad de la unión amelocementaria es importante para el diagnóstico y el éxito de la técnica, además, un pre-requisito es la modificación de la superficie radicular con técnicas mecánicas y/o químicas. La técnica de colgajo avanzado coronal combinada con tejido conectivo, matriz derivada del esmalte, colágeno porcino o matriz dérmica, son efectivas para el tratamiento de las retracciones gingivales tipo I y II de Miller, pero la de mayor predictibilidad es la técnica bilaminar con tejido conectivo.

Introduction: marginal tissue recessions produce esthetic problems, tooth sensitivity, root caries, and difficulty to perform proper oral hygiene. There are various periodontal plastic surgery techniques for root coverage. The goal of this literature review is to assess factors associated with the coronally positioned flap technique to cover gingival recessions, bearing in mind that several variables can intervene in the complete coverage of root surface. Methods: this was a literature review on the coronally positioned flap technique for coverage of Miller class I and class II recessions of one or two teeth. It included articles published between 2000 and 2012 by searching the PubMed, Ebsco, and Cochrane databases for studies performed in humans, including longitudinal, transverse, and cohort studies, as well as clinical trials and meta-analyses. Results and conclusions: interdental papilla height, keratinized gingiva width, and gingival thickness are prognostic factors for total root coverage and its long-term stability. Integrity of the cemento-enamel junction is important in diagnosis and success of the technique; moreover, modification of root surface with technical and/or chemical mechanisms is a prerequisite. The coronally advanced flap technique combined with connective tissue, enamel matrix derivative, porcine collagen, or dermal matrix is effective in the treatment of Miller class I and class II gingival recessions, but the one with the greatest predictability is the bilaminar technique with connective tissue.

Hemocianinas, una herramienta inmunológica de la biomedicina actual / Hemocyanins as immunostimulants

Hemocyanins, the giant oxygen transporter glycoproteins of diverse mollusks, are xenogenic to the mammalian immune system and they display a remarkable immuno-genicity. Therefore they are ideal non-specific immunostimulants to treat some types of cancer. They are used as an alternative therapy for superficial urinary bladder cancer (SBC), that has been traditionally treated with Bacillus Calmette-Guerin (BCG). In contrast to BCG, hemocyanins do not cause side-effects, making them ideal for long-term repetitive treatments. Hemocyanins have also been exploited as carriers to develop antibodies against hapten molecules and peptides, as carrier-adjuvants for cutting-edge vaccines against cancer, drug addiction, and infectious diseases and in the diagnosis of parasitic diseases, such as Schistosomiasis. The hemocyanin from Megathura crenulata, also known as keyhole limpet hemocyanin (KLH), has been used for over thirty years for the purposes described above. More recently, hemoc yanin from the Chilean mollusk Concholepas concholepas (CCH) has proved to be a reliable alternative to KLH, either as carrier protein, and as a likely alternative for the immunotherapy of SBC. Despite KLH and CCH differ significantly in their origin and structure, we have demonstrated that both hemocyanins stimulate the immune system of mammals in a similar way by inducing a potent Thl-polarized cellular and humoral response.