Diabetes tipo II. A terapia periodontal não cirúrgica pode favorecer o controle glicêmico do paciente? / Type II Diabetes. Does nonsurgical periodontal therapy improve glycemic control in patientes? / Diabetes tipo II. ¿Puede la terapia periodontal no quirúrgica mejorar el control glicémico del paciente?

Introdução:A doença periodontal corresponde àcondição que acomete os tecidos de proteção e/ou suporte do dente através de uma inflamação crônica causadapor patógenos.Estacondição pode ser modificada ou associada às doenças sistêmicas, como por exemplo, o diabetes mellitus tipo II (DM2).Objetivo:Avaliar quais os efeitos da terapia periodontal não cirúrgica sobre o controle glicêmico de pacientes diagnosticados com DM2.Metodologia:Revisão integrativa elaborada a partir de pesquisas clínicas randomizadas indexadas nas bases de dados Pubmed, Embase, Cochrane, Web of Science e BVS, na qual foram utilizados os descritores "periodontal diseases treatment", "glycemic control" e "metabolic control".Resultados:Dos trabalhos avaliados, seis foram selecionados para compor a revisão, tendo em vista os critérios de inclusão e exclusão estabelecidos. Logo, é notório que a terapia periodontal básica indica melhora no controle glicêmico dos pacientes com DM2, de acordo comanálise da HbA1c e PCR,portanto, com base nos resultados dessa pesquisa, o tratamento periodontal não cirúrgico parece contribuir para o controle metabólico. Apesar disso, alguns estudos se opõem aoresultadodo controle glicêmicodesses pacientes, reforçando a existência de variáveis que interferem nos resultados da pesquisa, como os níveis de hemoglobina, estágio da doença periodontal, amostra, dietae atividade física dos pacientes.Conclusões:O resultado deverá ser avaliado com maior cautela, tendo em vista as possibilidades de variáveis presentes nesse tipo de pesquisa. Por fim, ensaios controlados devem ser realizados para alcançar um maior esclarecimento a respeito dos efeitos da terapia periodontal não cirúrgica no controle glicêmico de pacientes com DM2 (AU).

Introduction:Periodontal disease is a condition in which protective or supportive tissues of the tooth are affected by chronic inflammation caused by pathogens. This condition may be modified or associated with systemic diseases such as type 2 diabetes mellitus (T2DM).Objective:To evaluate the effects of nonsurgical periodontal therapy on glycemic control in patients diagnosed with T2DM. Methodology:An integrative review was performed using randomized clinical trials indexed in PubMed, Embase, Cochrane, Web of Science, and BVS databases. The descriptors "periodontal disease treatment," "glycemic control," and "metabolic control" were used. Results:From the reviewed studies, six were selected for the review considering the established inclusion and exclusion criteria.Basic periodontal therapy improves glycemic control in patients with T2DM, as evidenced by analysis of glycated hemoglobin (HbA1c) and polymerase chain reaction (PCR). Therefore, based on the results of this research, nonsurgical periodontal treatment contributes to metabolic control. However, some studies contradict the effect of glycemic control in these patients, reinforcing the presence of variables that interfere with research results, such as hemoglobin levels, stage of periodontal disease, sample, dietand physical activity of patients. Conclusions:The results should be evaluated with more caution considering the potential variables present in this type of research. Finally, controlled trials should be conducted to understand better the effects of nonsurgical periodontal therapy on glycemic control in patients with T2DM (AU).

Introducción: La enfermedad periodontal es una condición en la cual los tejidos protectores o de soportedel diente se ven afectados por una inflamación crónica causada por patógenos. Esta condición puede modificarse o asociarse a enfermedades sistémicas como la diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de la terapia periodontal no quirúrgica en el control glucémico en pacientes diagnosticados con DM2. Metodología: Se realizó una revisión integradora utilizando ensayos clínicos aleatorizados indexados en las bases de datos de PubMed, Embase, Cochrane, Web of Science y BVS. Se utilizaron los descriptores "tratamiento de enfermedades periodontales", "control glucémico" y "control metabólico". Resultados: De los estudios revisados, se seleccionaron seis para la revisión, considerando los criterios de inclusión y exclusión establecidos. La terapia periodontal básica mejora el control glucémico en pacientes con DM2, como se evidencia en el análisis de la hemoglobina glicosilada (HbA1c) y la reacción en cadena de la polimerasa (PCR). Por lo tanto, basándose en los resultados de esta investigación, el tratamiento periodontal no quirúrgico contribuye al control metabólico. Sin embargo, algunos estudios contradicen el efecto del control glucémico en estos pacientes, lo que refuerza la presencia de variables que interfieren en los resultados de la investigación, como los niveles de hemoglobina, el estadio de la enfermedad periodontal, la muestra, la dieta y la actividad física de los pacientes. Conclusiones: Los resultados deben evaluarse con mayor precaución, considerando las posibles variables presentes en este tipo de investigación. Por último, se deben realizar ensayos controlados para comprender mejor los efectos de la terapia periodontal no quirúrgica en el control glucémico en pacientes con DM2 (AU).

Camellia sinensis, a natural product to support the treatment of medical and stomatological conditions / Camellia sinensis, un producto natural de apoyo al tratamiento de afecciones médicas y estomatológicas - revisión sistemática

Introduction: The tea plant, Camellia sinensis, is one of the most popular non-alcoholic beverages in the world. The main components of Camellia sinensis include amino acids, fatty acids, phenolic compounds, flavins and purine alkaloids (xanthines). For this reason, in the field of medicine, Camellia sinensis has been used as an anticancer, anxiolytic, antidiabetic, antiobesity, anti-inflammatory, analgesic, antipyretic, chemopreventive, cytotoxic and apoptogenic, genoprotective, hepatoprotective, nephroprotective, hemato-protective, and in wound healing, among other uses. Objective: To carry out a systematic review of the use of C. sinensis as supportive therapy in the treatment of oral disorders. Materials and Methods: This systematic review was carried out following the PRISMA guidelines. The search was carried out in the PubMed, ScienceDirect and Google Academic databases. Articles from studies of Camellia sinensis were reviewed and those from a secondary source, such as literature review articles, were excluded Results: A total of 12 full-text articles were selected for review, in which the properties of Camellia sinensis are detailed. Conclusions: According to the bibliography reviewed, C. sinensis exhibits anticariogenic properties, applications in the treatment of dental erosion, applications in the treatment of gingivitis and bacterial plaque, and applications in the prevention of oral cancer; however, more controlled clinical trials are needed to confirm its effectiveness and safety of use.

Introducción: La planta del té es una de las bebidas no alcohólicas más populares en todo el mundo. Entre los principales componentes de Camellia sinensis tenemos los aminoácidos, ácidos grasos, compuestos fenólicos, flavinas y alcaloides de purina (xantinas). Por ello en medicina, la Camellia sinensis se ha utilizado como anticancerígeno, ansiolítico, antidiabético, antiobesidad, antiinflamatorio, analgésico, antipirético, quimiopreventivo, citotóxico y apoptógeno, genoprotector, hepatoprotector, nefroprotector, hematoprotector, cicatrizantes de heridas, entre otros. Objetivo: Realizar una revisión sistemática del uso de C. sinensis como apoyo en el tratamiento de afecciones bucales. Materiales y Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed, Science Direct y Google Academic. Se revisaron los artículos de estudios de Camellia sinensis y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura. Resultados: Se seleccionaron un total de 12 artículos de texto completo para la revisión. En los que se detalla las propiedades de la Camellia sinensis. Conclusión: De acuerdo a la bibliografía revisada, la C. sinensis exhibió efecto anticariogénico, aplicación en el tratamiento de la erosión dental, aplicación en el tratamiento de gingivitis y placa bacteriana, y aplicación en la prevención del cáncer bucal, sin embargo, se necesitan realizar más ensayos clínicos controlados que confirmen su efectividad y seguridad de uso.

Efeitos da nanopartícula de ácido poli lático-co-glicólico (PLGA) associada ao cloridrato de metformina na doença periodontal em ratos diabéticos / Effects of polylactic-co-glycolic acid (PLGA) nanoparticle associated with metformin hydrochloride on periodontal disease in diabetic rats

Existe uma associação entre diabetes e a periodontite, e a Metformina (MET) além de controlar os níveis glicêmicos, tem apresentado efeitos antiinflamatórios e na diminuição da perda óssea periodontal. Ao se veicular a MET a um sistema de nanopartículas pode-se apresentar a vantagem de aumento da eficácia terapêutica. Objetivos: esse estudo consistiu na avaliação dos efeitos antiinflamatórios, perda óssea e disponibilidade in vitro/in vivo de uma nanopartícula de ácido poli lático-co-glicólico (PLGA) associada à MET em um modelo de periodontite induzida por ligadura. Materiais e métodos: o PLGA carreado com diferentes doses da MET foi caracterizado pelo seu diâmetro médio, tamanho da partícula, índice de polidispensão e eficiência de aprisionamento. Foram utilizados ratos machos da linhagem Wistar, divididos aleatoriamente, em grupos controles e experimentais com diferentes doses de MET associadas ou não ao PLGA, os quais receberam diferentes tratamentos. Amostras de maxilas e tecidos gengivais foram utilizadas para avaliação de perda óssea e inflamação, por meio da microtomografia computadorizada, histopatológico, imunohistoquímica, análise de citocinas inflamatórias e expressão gênica de proteínas por RT-PCR quantitativo. Para o ensaio de liberação in vitro, utilizou-se o dispositivo de células de difusão vertical de Franz estáticas. Para a disponibilidade in vivo, as amostras de sangue foram coletadas em diferentes intervalos de tempo e analisadas por cromatografia líquida de alta eficiência acoplado a espectrometria de massas (HPLC-MS/MS). Resultados: o diâmetro médio das nanopartículas de PLGA carreadas com MET estava em um intervalo de 457,1 ± 48,9 nm (p <0,05) com um índice de polidispersidade de 0,285 (p <0,05), potencial Z de 8,16 ± 1,1 mV (p <0,01) e eficiência de aprisionamento (EE) de 66,7 ± 3,73. O tratamento com a MET 10 mg / kg + PLGA mostrou uma baixa concentração de células inflamatórias, fraca imunomarcação para RANKL, Catepsina K, OPG e osteocalcina. Diminuição dos níveis de IL-1ß e TNF-α (p <0,05), aumento da expressão gênica do AMPK (p <0,05) e diminuição do NF-κB p65, HMGB1 e TAK-1 (p <0,05). O 10 mg/kg MET + PLGA foi liberado no ensaio in vitro sugerindo um modelo cinético de difusão parabólica com um perfil de liberação que atinge 50% de seu conteúdo em 2h e permanece em liberação constante em torno de 60% até o final de 6h. O ensaio in vivo mostrou o volume aparente de distribuição Vz/F (10 mg/kg MET + PLGA, 46,31 mL/kg vs. 100 mg/kg MET + PLGA, 28,8 mL/kg) e o tempo médio de residência MRTinf (PLGA + MET 10 mg /kg, 37,66h vs. MET 100 mg/kg, 3,34h). Conclusão: o PLGA carreado com MET diminuiu a inflamação e a perda óssea na periodontite em ratos diabéticos. O 10 mg/kg MET + PLGA teve uma taxa de eliminação mais lenta em comparação com o MET 100 mg/kg. A formulação modifica os parâmetros farmacocinéticos, como volume de distribuição aparente e tempo médio de residência (AU).

There is an association between diabetes and periodontitis, and Metformin (MET) in addition to controlling glycemic levels, has shown anti-inflammatory effects and decreased periodontal bone loss. By transferring MET to a nanoparticle system, the advantage of increasing therapeutic efficacy can be presented. Objectives: this study consisted of evaluating the antiinflammatory effects, bone loss and in vitro/in vivo availability of a polylactic-co-glycolic acid (PLGA) nanoparticle associated with MET in a ligature-induced periodontitis model. Materials and methods: PLGA loaded with different doses of MET was characterized by its mean diameter, particle size, polydispension index and entrapment efficiency. Male Wistar rats were used, randomly divided into control and experimental groups with different doses of MET associated or not with PLGA, which received different treatments. Samples of jaws and gingival tissues were used to assess bone loss and inflammation, using computed microtomography, histopathology, immunohistochemistry, analysis of inflammatory cytokines and gene expression of proteins by quantitative RT-PCR. For the in vitro release assay, the static Franz vertical diffusion cell device was used. For in vivo availability, blood samples were collected at different time intervals and analyzed by high performance liquid chromatography coupled with mass spectrometry (HPLC-MS/MS). Results: the mean diameter of MET-loaded PLGA nanoparticles was in the range of 457.1 ± 48.9 nm (p <0.05) with a polydispersity index of 0.285 (p <0.05), Z potential of 8.16 ± 1.1 mV (p <0.01) and trapping efficiency (EE) of 66.7 ± 3.73. Treatment with MET 10 mg/kg + PLGA showed a low concentration of inflammatory cells, weak immunostaining for RANKL, Cathepsin K, OPG and osteocalcin. Decreased IL-1ß and TNF-α levels (p <0.05), increased AMPK gene expression (p <0.05) and decreased NF-κB p65, HMGB1 and TAK-1 (p <0. 05). The 10 mg/kg MET + PLGA was released in the in vitro assay suggesting a kinetic model of parabolic diffusion with a release profile that reaches 50% of its content in 2h and remains in constant release around 60% until the end of 6h . The in vivo assay showed the apparent volume of distribution Vz/F (10 mg/kg MET + PLGA, 46.31 mL/kg vs. 100 mg/kg MET + PLGA, 28.8 mL/kg) and the mean MRTinf residency (PLGA + MET 10 mg/kg, 37.66h vs. MET 100 mg/kg, 3.34h). Conclusion: MET-loaded PLGA decreased inflammation and bone loss in periodontitis in diabetic rats. 10 mg/kg MET + PLGA had a slower rate of elimination compared to 100 mg/kg MET. The formulation modifies pharmacokinetic parameters such as apparent volume of distribution and mean residence time (AU).

Evaluation of pain perception on periodontal probing in patients with dental plaque induced gingivitis and chronic periodontitis - a cross sectional study, part I / Evaluación de la percepción del dolor al sondaje periodontal en pacientes con gingivitis inducida por placa dental y periodontitis crónica: un estudio transversal, parte I

Background: Probing of periodontal pockets is an essential part in the diagnosis of periodontal disease. Fifteen to seventy seven percent of untreated periodontal patients experience pain during probing. Hence the aim of this study is to evaluate the pain perceived by patients with gingivitis and periodontitis during periodontal probing. The goals of this study were to compare the patients' pain perception when using a conventional UNC15 probe and a manual pressure sensitive periodontal probe, and to relate the clinical features of gingivitis and periodontitis to the discomfort associated with periodontal probing. Material and Methods: A total of 475 subjects were recruited into the study. The subjects were initially divided into two groups ­ Group ­ A (Gingivitis group - 275 patients) and Group ­ B (Chronic Periodontitis group -200 patients) according to the AAP 1999 Classification. These two groups were further subdivided into two groups each (Gingivitis ­ Conventional Probe ­ GCP, Gingivitis ­ Manual Pressure Sensitive Probe ­ GMPS, Periodontitis - Conventional Probe ­ PCP, Periodontitis ­ Manual Pressure Sensitive Probe ­ PMPS) using a computer generated program of random numbers. Results: A significant difference was noted in pain perception when pressure sensitive probe was used compared to conventional UNC-15 probe. Reduced Bleeding on Probing and Pain scores were noted in Chronic periodontitis subjects with use of pressure sensitive probe, which was statistically significant (p<0.001). Conclusion: Dentistry has changed its focus towards painless dentistry. In this context, the present study presents data towards use of manual pressure sensitive probes, which offers an advantage of low cost when compared to more advanced computerized systems with reduced pain during periodontal examination. It could result in a positive attitude of the patients towards continuous supportive periodontal therapy thereby monitoring periodontal health.

Antecedentes: El sondaje de los sacos periodontales es una parte esencial en el diagnóstico de la enfermedad periodontal. Del quince al setenta y siete por ciento de los pacientes periodontales no tratados experimentan dolor durante el sondaje. De ahí que el objetivo de este estudio fué evaluar el dolor percibido por pacientes con gingivitis y periodontitis durante el sondaje periodontal. Los objetivos de este estudio fueron comparar la percepción del dolor de los pacientes al usar una sonda UNC15 convencional y una sonda periodontal sensible a la presión manual, y relacionar las características clínicas de la gingivitis y la periodontitis con la incomodidad asociada con el sondaje periodontal. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron inicialmente en dos grupos - Grupo - A (grupo de Gingivitis - 275 pacientes) y Grupo - B (grupo de Periodontitis Crónica - 200 pacientes) de acuerdo con la Clasificación AAP 1999. Estos dos grupos se subdividieron en dos grupos cada uno (Gingivitis - Sonda convencional - GCP, Gingivitis - Sonda manual sensible a la presión - GMPS, Periodontitis - Sonda convencional - PCP, Periodontitis - Sonda manual sensible a la presión - PMPS) usando un programa generado por computadora de datos aleatorios. números. Resultados: Se notó una diferencia significativa en la percepción del dolor cuando se usó una sonda sensible a la presión en comparación con la sonda UNC-15 convencional (p<0,001). Conclusion: La odontología ha cambiado su enfoque hacia una odontología sin dolor. En este contexto, el presente estudio presenta datos hacia el uso de sondas manuales sensibles a la presión, que ofrece una ventaja de bajo costo en comparación con sistemas computarizados más avanzados con reducción del dolor durante el examen periodontal. Podría resultar en una actitud positiva de los pacientes hacia la terapia periodontal de apoyo continuo, monitoreando así la salud periodontal.

Terapêutica adjuvante na modulação da resposta imune no tratamento da doença periodontal: uma revisão de literatura / Adjuvant therapeutic in the modulation of the immune response in the treatment of periodontal disease: a literature review

Introdução: A Doença Periodontal tem caráter multifatorial, já que depende de condições microbiológicas, imunogenéticas e sistêmicas do hospedeiro. Representa inflamação crônica das estruturas de suporte e proteção dental. Desencadeia uma complexa estimulação imunológica, bem como a produção de citocinas inflamatórias, que mediam a destruição óssea e de tecido conjuntivo, provocando perda dental e complicações à distância. A compreensão da etiopatogênese, permitiu os conceitos de modulação, que referem-se às modificações dos aspectos danosos da resposta inflamatória. Objetivo: O presente artigo tem como objetivo realizar uma revisão dos estudos sobre as principais terapêuticas adjuvantes na modulação da resposta imune frente à doença periodontal. Revisão de Literatura: Foi realizada uma revisão da literatura, onde foram selecionados artigos científicos em inglês, publicados entre os anos 2005 a 2020, por meio das bases de dados PubMed e ScienceDirect. No decorrer das buscas, foram utilizadas as palavraschaves "Inflamation", "Periodontal Disease", "Subantimicrobial Dose of Doxycycline", "Periodontal Disease", "Host Response Modulation". Resultados e Conclusão: A literatura é bem promissora em relação à terapia de controle complementar da doença periodontal. Dessa forma, novas pesquisas nessa área podem trazer inúmeros beneficos aos pacientes, sendo, assim, um novo caminho para o contorno da resistência bacteriana(AU)

Introduction: Periodontal disease has a multifactorial character, depending on the host's microbiological, immunogenetic and systemic conditions. It represents chronic inflammation of dental support and protection structures. It triggers a complex immune stimulation, as well as the production of inflammatory cytokines, which mediate bone and connective tissue destruction, causing tooth loss and complications at a distance. The understanding of etiopathogenesis allowed the concepts of modulation, which refers to the modifications of the harmful aspects of the inflammatory response. This article has the escape of conducting a review of studies on the main mechanisms of modulation against periodontal disease. Objective: This article aims to rev iew the studies on the main modulation mechanisms in the face of periodontal disease. Literature Review: A literature review was carried out in which scientific articles were selected in English, published between 2005 and 2020, through the PubMed and ScienceDirect databases. During the searches, the keywords "Inflammation", "Periodontal Disease", "Subantimicrobial Dose of Doxycycline", "Periodontal Disease", "Host Response Modulation". Results and Conclusion: The literature is very promising with complementary control therapy for periodontal disease. Thus, new research in this area can bring countless benefits to patients, thus being a new way to bypass bacterial resistance(AU)

Guía clínica para el tratamiento de lesiones endoperiodontales sin compromiso radicular en pacientes periodontales / Clinical practice guide for the treatment of endoperiodontal lesions without root compromise in periodontal patients

La comunicación patológica entre la pulpa y el pe-riodonto se denomina lesión endoperiodontal. Puede presentarse de forma aguda o crónica, y su mani-festación más común es la presencia de un absceso acompañado de dolor. Es importante realizar una detenida evaluación clínica y radiográfica para esta-blecer un correcto diagnóstico y plan de tratamiento. Por este motivo, el objetivo de esta guía es presentar un protocolo consensuado entre las Cátedras de Pe-riodoncia y Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), para su tratamiento (AU)

The pathological communication between the pulp and the periodontium is called Endoperiodontal Lesion. It can be presented in an acutely or chronically form and its most common manifestation is the presence of an abscess accompanied by pain. It is important to carry out a careful clinical and radiographic evaluation to establish a correct diagnosis, prognosis, and treatment plan. For this reason, the objective of this guide is to present a consensus protocol between Periodontics and Endodontics Departments of the Faculty of Dentistry of the University of Buenos Aires (FOUBA) for their treatment (AU)

Terapia regenerativa con plasma rico en plaquetas en adultos afectados por lesiones endoperiodontales / Regenerative therapy with platelets rich-plasm in adults affected by endoperiodontal lesions

Introducción: El uso de plasma rico en plaquetas para la regeneración de defectos óseos periodontales constituye una terapéutica eficaz. Objetivo: Identificar la evolución de pacientes con lesiones endoperiodontales tratados con plasma rico en plaquetas. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 11 adultos con enfermedad endoperiodontal y tratamiento endodóntico finalizado, atendidos en la consulta de Periodoncia y Medicina Regenerativa del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde febrero del 2018 hasta diciembre del 2019, quienes requerían intervención quirúrgica periodontal y cumplían los criterios para recibir plasma rico en plaquetas. A tal efecto, se analizaron variables sociodemográficas, clínicas, radiográficas y de respuesta terapéutica, las que fueron expresadas estadísticamente por medio de frecuencias absolutas y relativas y de la media aritmética. Resultados: En la serie resultaron más frecuentes, antes de la terapia, el sangrado al sondaje (81,8 %), las características alteradas de las encías (72,7 %), la movilidad dentaria (72,7 %) y las bolsas periodontales de 7 a 9 milímetros, con pérdida ósea en el tercio apical (63,6 %); todo lo cual se revirtió a menores porcentajes luego de 6 meses de tratamiento. Conclusiones: La evolución de los pacientes afectados por lesiones periodontales fue satisfactoria con el empleo del plasma rico en plaquetas, lo que se evidenció clínica y radiográficamente.

Introduction: The use of platelets rich-plasm for the regeneration of periodontal bony defects constitutes an effective therapy. Objective: To identify the clinical course of patients with endoperiodontal lesions treated with platelets rich-plasm. Methods: An observational, descriptive and longitudinal study of 11 adults with endoperiodontal disease and concluded endodontics treatment was carried out. They were assisted in the Periodontics and Regenerative Medicine Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from February, 2018 to December, 2019; who required periodontal surgical intervention and fulfilled the approaches to receive platelets rich-plasm. To such an effect, sociodemographic, clinical, radiographic and of therapeutic response variables were analyzed, which were statistically expressed by means of absolute and relative frequencies and of mean arithmetic. Results: In the series, bleeding on probing (81.8 %), altered characteristics of the gums (72.7 %), dental mobility (72.7 %) and 7 to 9 millimeters periodontal bags, with bony loss in the third apical (63.6 %) were more frequent before therapy; all of which was reverted to lower percentages after 6 months of treatment. Conclusions: The clinical course of the patients affected by periodontal lesions was satisfactory with the use of platelets rich-plasm, which was clinical and radiographically evidenced.

La higiene oral y los efectos de la terapia periodontal mecánica / Oral hygiene and effects of mechanical periodontal therapy

Introducción: Las enfermedades periodontales junto con la caries dental son las patologías más frecuentes que afectan los dientes y tejidos circundantes. El principal agente etiológico es el acúmulo de biopelícula dental bacteriana ya sea en las fosas y fisuras de los dientes como en el surco gingival. Objetivo: La presente revisión narrativa tuvo por objetivo sintetizar los resultados de la terapia mecánica sobre la higiene oral al ser indicadas en pacientes con diagnóstico de periodontitis. Material y Métodos: Se realizó un estudio descriptivo que se basó en una revisión crítica de las publicaciones relacionadas a la terapia periodontal mecánica en las bases de datos: Scopus, SciELO (Scientific Electronic Library Online), MEDLINE (Pubmed), ScienceDirect así como el buscador Google académico. En cada base de datos se realizó una búsqueda libre de la información con un límite de 10 años de antigüedad de las fuentes de información para analizar tanto fuentes antiguas como actuales. Resultados: De una búsqueda inicial de 678 artículos se incluyeron 52 estudios que compararon técnicas de higiene oral, así como revisiones sistemáticas que sintetizaron el efecto de la terapia mecánica periodontal. Conclusiones: El tratamiento periodontal debe ser considerado la terapia inicial para la periodontitis, debe incluir instrucción en técnicas de higiene para el control de la biopelícula dental y el debridamiento mecánico de las zonas afectadas. No se ha demostrado que una técnica de cepillado manual específica sea superior a otras, por tanto, se debería aplicar aquella que mejor pueda manejar el paciente. No se encontró evidencia que demuestre que el uso del hilo dental disminuya eficientemente los índices de biopelícula dental y parámetros gingivales debido a la dificultad por parte del paciente para emplear adecuadamente la técnica(AU)

Introduction: Periodontal diseases together with dental caries are the most frequent pathologies affecting the teeth and surrounding tissues. The main etiological agent is the accumulation of bacterial dental biofilm in the pits and fissures of the teeth and the gingival sulcus. Objective: The present narrative review aimed to synthesize the results of mechanical therapy on oral hygiene when it is indicated in patients with the diagnosis of periodontitis. Material and methods: A descriptive study was conducted. It was based on a critical review of some articles related to mechanical periodontal therapy published in databases such as Scopus, SciELO (Scientific Electronic Library Online), PubMed/ MEDLINE and ScienceDirect. Google search engine was also used. A free search for information was carried out in each database. An age limit of 10 years was established for the analysis of both old and current sources. Results: The initial search included 678 articles. Of these, 52 studies that compared oral hygiene techniques as well as systematic reviews that synthesized the effect of mechanical periodontal therapy were included. Conclusions: Periodontal treatment should be considered as the initial therapy for the treatment of periodontitis. It should include oral hygiene instructions for the control of dental biofilm and mechanical debridement of the affected areas. A specific manual brushing technique has not been proven to bebetter than others; therefore, the one that can best be performed by the patient should be used. There was no proven evidence that effective flossing reduces dental biofilm indexes and gingival parameters due to the patient difficulty to adequately perform the technique(AU)

Standard of periodontal examination and evaluation during oral diagnosis and treatment / 中华口腔医学杂志

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.

Focus on periodontal engineering by 3D printing technology ­ a systematic review / Enfoque en la ingeniería periodontal mediante la tecnología de impresión 3D: una revisión sistemática

Three-dimensional (3D) bioprinting of cells is an emerging area of research but has not been explored yet in the context of periodontal tissue engineering. Objetive: This study reports on the optimization of the 3D bioprinting scaffolds and tissues used that could be applied clinically to seniors for the regenerative purpose to meet individual patient treatment needs. Material and Methods: We methodically explored the printability of various tissues (dentin pulp stem/progenitor cells, periodontal ligament stem/progenitor cells, alveolar bone stem/progenitor cells, advanced platelet-rich fibrin and injected platelet-rich fibrin) and scaffolds using 3D printers pertaining only to periodontal defects. The influence of different printing parameters with the help of scaffold to promote periodontal regeneration and to replace the lost structure has been evaluated. Results: This systematic evaluation enabled the selection of the most suited printing conditions for achieving high printing resolution, dimensional stability, and cell viability for 3D bioprinting of periodontal ligament cells. Conclusion: The optimized bioprinting system is the first step towards the reproducible manufacturing of cell laden, space maintaining scaffolds for the treatment of periodontal lesions.

La bioimpresión tridimensional (3D) de células es un área emergente de investigación, pero aún no se ha explorado en el contexto de la ingeniería de tejidos periodontales. Objetivo: Este estudio informa sobre la optimización de los tejidos y andamios de bioimpresión 3D utilizados que podrían aplicarse a personas mayores en el entorno clínico con fines regenerativos para satisfacer las necesidades de tratamiento de cada paciente. Material y Métodos: Exploramos metódicamente la capacidad de impresión de varios tejidos (células madre / progenitoras de la pulpa de dentina, células madre / progenitoras del ligamento periodontal, células madre / progenitoras de hueso alveolar, fibrina rica en plaquetas avanzada y fibrina rica en plaquetas inyectada) y andamios utilizando impresoras 3D que pertenecen solo a defectos periodontales. Se ha evaluado la influencia de diferentes parámetros de impresión con la ayuda de andamios para promover la regeneración periodontal y reemplazar la estructura perdida. Resultados: Esta evaluación sistemática permitió la selección de las condiciones de impresión más adecuadas para lograr una alta resolución de impresión, estabilidad dimensional y viabilidad celular para la bioimpresión 3D de células del ligamento periodontal. Conclusión: El sistema de bioimpresión optimizado es el primer paso hacia la fabricación reproducible de andamios de mantenimiento de espacio cargados de células para el tratamiento de lesiones periodontales

Orthodontic treatment of periodontal patients: challenges and solutions, from planning to retention

ABSTRACT Introduction: There is an increasing number of adult patients with sequelae of periodontal diseases seeking orthodontic treatment to improve their occlusion and quality of life. However, it is important to highlight that the patient who has vertical bone loss has unique needs, arising from the frequent related pathological migrations. Therefore, it requires an individualized orthodontic treatment in terms of anchorage, biomechanics, and multidisciplinary planning, which raises doubts in the hierarchy of priorities and organization of the treatment plan. Objectives: It was proposed a stratified hierarchy of the needs of orthodontic-periodontal treatment in six levels, which were illustrated with examples of clinical cases in which biomechanical planning and a multidisciplinary approach made it possible to obtain a balanced occlusion, aesthetic improvement and stabilization of the results. Conclusion: Orthodontic treatment of periodontal patients with a multidisciplinary approach is increasingly frequent and should be planned individually, considering bone losses suffered by each patient. Respecting some limitations, it is possible to improve the level of bone insertion, smile aesthetics and masticatory function, to facilitate oral hygiene through the orthodontic treatment of adult patients with little bone support. It is also important to highlight that there are unique aspects in the orthodontic retention in these cases.

RESUMO Introdução: É crescente o número de pacientes adultos portadores de sequelas de doenças periodontais que buscam tratamento ortodôntico para melhorar sua oclusão e qualidade de vida. Contudo, é importante destacar que o paciente que apresenta perda óssea vertical possui necessidades únicas, advindas das frequentes migrações patológicas relacionadas. Logo, requer um tratamento ortodôntico individualizado quanto a quesitos de ancoragem, biomecânica e planejamento multidisciplinar, o que gera dúvidas na hierarquização de prioridades e organização do plano de tratamento. Objetivos: Foi proposta uma hierarquização estratificada das necessidades do tratamento ortodôntico-periodontal em seis níveis, os quais foram ilustrados com exemplos de casos clínicos nos quais o planejamento biomecânico e a abordagem multidisciplinar possibilitaram a obtenção de uma oclusão equilibrada, melhora estética e estabilização dos resultados obtidos. Conclusão: O tratamento ortodôntico de pacientes periodontais com abordagem multidisciplinar é cada vez mais frequente e deve ser planejado de forma individualizada, considerando as perdas de inserção sofridas por cada paciente. Respeitando-se algumas limitações, é possível melhorar o nível de inserção óssea, a estética do sorriso e a função mastigatória, além de facilitar a higiene bucal, por meio do tratamento ortodôntico de pacientes adultos com pouco suporte ósseo. Também é importante destacar que há aspectos únicos na contenção ortodôntica desses casos.

Utilización de biomateriales e injertos óseos autólogos en pacientes con atrofia alveolar / Bibliographic update on the use of biomaterials and autologous bone grafts in patients with alveolar atrophy

RESUMEN El material de elección para el reemplazo del hueso perdido por traumatismos, procesos patológicos congénitos o adquiridos y atrofia, son los injertos óseos autógenos o autólogos (hueso del propio paciente). A partir de la introducción del concepto de osteointegración por Branemark, los implantes dentales son parte de la terapéutica diaria para rehabilitar áreas edéntulas. La atrofia alveolar es quizás una de las condiciones bucales más incapacitantes; la razón reside en que es crónica, progresiva, acumulativa e irreversible, altera las relaciones maxilomandibulares, reduce la cantidad de hueso del área dentosoportada y la profundidad del surco. El material de injerto óseo ideal no debería ser sólo un sustituto óseo, sino un material de regeneración que se reabsorba completamente de modo simultáneo a la formación de hueso nuevo. Evaluar el éxito y fracaso de una terapia permite tomar decisiones para un mejoramiento continuo de la práctica clínica. El objetivo de la investigación fue demostrar la importancia de la utilización de biomateriales e injertos óseos autólogos en pacientes con atrofia alveolar (AU).

SUMMARY The elective material for replacing the bone lost by trauma, congenital or acquired pathological processes and atrophy are the autogenic or autologous bone grafts (the patient´s own bones). From the introduction of the concept of osseointegration by Branemark on, dental implants are part of the daily therapeutic for rehabilitating edentulous areas. Alveolar atrophy is perhaps one of the most disabling oral conditions, because it is chronic, progressive, cumulative and irreversible. It alters maxilla-mandibular relations, reduces the bone quality of the dentosupported area and the depth of the sulcus. The ideal bone graft material should not be only a bone substitute, by a regenerative material that could be completely reabsorbed simultaneously with the new bone formation. To assess the success and failure of a therapy allows taking decisions for the continuous improvement of the clinical practice. The aim of the research was to prove the importance of using biomaterials or autologous bone grafts in patients with alveolar atrophy (AU).

Terapia fotodinâmica como adjuvante no tratamento da doença periodontal em equinos / [Adjunctive photodynamic therapy as a treatment for periodontal disease in equines]

A doença periodontal é uma afecção comum, relacionada ao aprisionamento de alimentos em diastemas não fisiológicos, em equinos. O tratamento consiste na correção da causa primária, limpeza e desbridamento do sulco gengival, denominado tratamento convencional (TC). Frequentemente antimicrobianos são necessários, pela gravidade ou patogenicidade dos agentes. A terapia fotodinâmica adjuvante (TF) tem sido estudada pelo seu potencial combate bacteriano, sem causar resistência bacteriana. O objetivo deste estudo foi analisar o uso da TF na doença periodontal, experimentalmente induzida, em dentes incisivos de equinos, e compará-la com o TC. O TC não resultou em melhora clínica estatisticamente, tanto em graus como em profundidade, apenas numérica na profundidade aos 30 dias. A TF foi empregada em dentes com profundidade maior da bolsa periodontal que a do grupo TC e, mesmo assim, apresentou melhora clínica já com sete dias, e mais efetiva aos 30, atingindo, em média, o valor considerado normal, três milímetros. A TF apresentou potencial para ser aplicada na rotina, pelo incremento nos resultados, sem causar efeitos colaterais.(AU)

Periodontal disease is a common condition, related to the entrapment of food in non-physiological diastemas in horses. Treatment consists of correction of the primary cause, cleansing and debridement of the gingival sulcus, called Conventional Therapy (CT). Often antimicrobials are requested due to the severity or pathogenicity of the agents. Adjuvant Photodynamic Therapy (PDT), has been studied for its potential bacterial combat, without causing bacterial resistance. The objective of this study was to analyze the use PDT with the experimentally induced periodontal disease in the incisor teeth of horses, and to compare with the CT. The CT did not result in clinical improvement, either in degrees or millimeters. The PDT was used in teeth with a greater depth of the periodontal pocket than the TC group, and even then, showed clinical improvement in only seven days, and more effective at 30, reaching the three millimeter value considered normal on average. The PDT presented the potential to be applied in the routine by the increase in the results without causing side effects.(AU)

Uso de agentes antimicrobianos como solução refrigerante no ultrassom para tratamento das doenças periodontais: uma revisão de literatura / The use of antimicrobial agents as a cooling solution in ultrasound devices for periodontal diseases treatment: a literature review

Objetivo: revisar a literatura quanto ao uso de soluções no reservatório líquido do ultrassom (US) para o tratamento das doenças periodontais, avaliando as contribuições dessa associação e as soluções mais eficazes para essa terapêutica. Métodos: foi realizada pesquisa bibliográfica nas bases de dados Public Medline (PubMed), Lilacs, Science Direct e ISI web of knowledge. As palavras-chave utilizadas foram: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial" e "irrigation". Como critérios de inclusão, foram selecionados estudos prospectivos, retrospectivos, caso controle, transversal e relatos de casos, publicados em inglês. Resultados: após pesquisa e minuciosa revisão por título e resumo de cada estudo, 15 estudos foram selecionados para avaliação dos desfechos investigados. As principais soluções associadas ao US foram povidono-iodo (PVPI), clorexidina, óleos essenciais, bicarbonato de sódio. O irrigante mais utilizado foi o PVPI, seguido por clorexidina e óleos essenciais. Os agentes podem conferir discretas melhoras no nível clínico de inserção e profundidade de sondagem, porém os resultados são controversos, já que nem todos os ensaios demonstraram efeitos positivos. Uma importante evidência observada foi em relação à redução dos níveis de microrganismos derivados do aerossol do US quando essas substâncias foram utilizadas no reservatório de água, sendo esse um aspecto positivo de seu uso como solução refrigerante ao US. Considerações finais: de modo geral, não puderam ser confirmados benefícios adicionais dos irrigantes antimicrobianos nos principais parâmetros periodontais avaliados, porém não se pode descartar o potencial uso desses agentes para a redução da dispersão de microrganismos advindos do aerossol, promovendo assim maior proteção ao paciente e ao profissional.(AU)

Objective: to review the literature regarding the use of solutions in the liquid ultrasonic (US) reservoir devices for the treatment of periodontal diseases, evaluating the benefits of this association, and the most effective solution for this therapy. Methods: bibliographic research was carried out in the Public Medline (PubMed), Lilacs, Science Direct, and ISI web of knowledge databases. The keywords used were: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial", and "irrigation". Inclusion criteria were prospective, retrospective, case-control, cross-sectional studies, and case reports published in English. Results: after a meticulous analysis of each paper by title and summary, 15 studies were selected for further investigation of clinical outcomes. The main solutions associated with US devices as coolant were PVPI, Chlorhexidine, Essential Oils and Sodium Bicarbonate. The most used coolant agent was PVPI, followed by chlorhexidine and essential oils. It has been shown that irrigating solutions can provide improvements in the clinical attachment level and probing depth, but the results are controversial since not all trials showed positive effects. Important evidence observed was the reduction of the levels of microorganisms derived from the US aerosol when these substances were used as a cooling solution. Conclusions: in general, additional benefits of coolant solutions could not be confirmed in the main periodontal parameters evaluated, however, the potential use of these agents to reduce the dispersion of microorganisms derived from the aerosol cannot be ruled out, thus promoting additional protection to the patient and professional.(AU)

Uso de fibrina rica em plaquetas na periodontia: uma revisão de literatura / Use of platelet-rich fibrin in periodontia: a literature review

Fibrina rica em plaquetas (PRF) é um concentrado plaquetário de uso autólogo cuja implicação é promover uma melhor e mais rápida cicatrização além de reparo das lesões cirúrgicas, isso devido à sua disponibilidade ilimitada e ao seu potencial regenerativo com liberação de fatores de crescimento. Objetivo: fazer uma revisão de literatura sobre a utilização da PRF na periodontia. Metodologia: o estudo caracterizou-se como revisional, a partir de busca na literatura selecionando estudos transversais, longitudinais, casos clínicos e revisões sistemáticas, em português e inglês, indexados nas bases de dados portal de periódico da Capes, Medline e PubMed. Revisão: PRF tem sido utilizada na regeneração periodontal por sua capacidade de cicatrização e por conter proteínas biologicamente ativas que se ligam a uma malha de fibrina em desenvolvimento ou à matriz extracelular. Conclusão: observa-se que há uma melhora expressiva no processo de regeneração tecidual e na cicatrização quando se utiliza também a PRF no tratamento, o que a torna uma importante aliada na terapia periodontal.(AU)

Platelet Rich Fibrin is an autologous platelet concentrate whose implication is to promote better and faster healing and repair of surgical lesions. The aim of this study was to review the literature on the use of PRF in periodontics. Methodology: the study was characterized as a review, based on a search in the literature, selecting cross-sectional, longitudinal studies, clinical case and systematic reviews, in Portuguese and English, indexed in the Capes, Medline and PubMed journal databases. Review: PRF has been used in periodontal regeneration for its healing capacity and for containing biologically active proteins that bind to a developing fibrin mesh or the extracellular matrix. Conclusion: it is observed that there is an expressive improvement in the process of tissue regeneration and healing when the PRF is also used in the treatment, which makes it an important ally in periodontal therapy.(AU)

Efectos de la terapia periodontal no quirúrgica sobre el control glucémico de la Diabetes Mellitus Tipo 2: Revisión de literatura / Effects of non-surgical periodontal therapy on glycemic control of Type 2 Diabetes Mellitus: A literature review

Resumen Objetivo: Conocer la relación entre la enfermedad periodontal y la diabetes mellitus tipo 2, en el control de la glucemia. Diseño y métodos de investigación: Se realizó una búsqueda bibliográfica utilizando una base de datos (PubMed) con restricción del idioma inglés, buscando las investigaciones más recientes y con el mayor número de sujetos de investigación. Resultados: Los artículos revisados coinciden en que el tratamiento de la enfermedad periodontal mejora el control glucémico en pacientes con diabetes mellitus tipo 2, con una disminución promedio de 0,69% en el nivel de hemoglobina glucosilada (HbA1c). Conclusiones: El tratamiento periodontal mejora el control de la glucemia en pacientes con Diabetes Mellitus Tipo 2, debido a que disminuye el estado de inflamación sistémica y por lo tanto, también la cantidad de células inflamatorias (como IL6 y TNF- α) que provocan alteraciones en la actividad de la insulina.

Abstract Objective: To know the relationship between periodontal disease and type 2 diabetes mellitus in the control of blood glucose. Design and research methods: A bibliographic search was conducted using a database (PubMed) with english language restriction, looking for the most recent research and with the largest number of research subjects. Results: The articles reviewed coincide in the treatment of periodontal disease improves glycemic control in patients with diabetes mellitus type 2, with an average of 0.69% in the level of glycosylated hemoglobin (HbA1c). Conclusions: Periodontal treatment improves glycemic control in patients with Type 2 Diabetes Mellitus, as well as the number of inflammatory cells (such as IL6 and TNF-α) that cause alterations in insulin activity.

Periodontal disease distribution, risk factors, and importance of primary healthcare in the clinical parameters improvement / Distribución de la enfermedad periodontal, factores de riesgo e importancia de la atención primaria en salud en la mejora de los parámetros clínicos

The objective of this study is to show the distribution of periodontal disease, risk factors, and importance of primary healthcare, for the improvement of clinical parameters. Two phases study transversal and nonrandomized trial (before - after), with educational intervention and conservative treatment, were carried out at Dental School of the Universidad Autónoma de Guerrero México, in 161 subjects who met the inclusion criteria. Oral healthcare education was carried out as well as conservative periodontal treatment, with six months follow up. Clinical measurements were performed with a Williams probe, O'Leary plaque index, calculus index and dental mobility Miller method. Periodontal disease was found on 82 % of all participants. Multinomial logistic regression analysis showed an odds ratio of 14.3 (95 % CI: 2.5, 82.1), 13.4 (95 % CI: 1.7, 103.5), 29.2 (95 % CI: 3.2, 260.9) and 68 (95 % CI: 6.6, 711.0) plaque in gingivitis, mild, moderate and severe chronic periodontitis, respectively. The longitudinal panel data analysis showed a significant effect (p <0.001) in the mean decrease of the clinical parameters after intervention, probing depth 0.4 mm (95 % CI: -0.5, -0.3), pockets depth 1.1 mm (95 % CI: -1.3, -0.9), amount of pockets 4.5 (95 % CI: -5.2, -3.7), bleeding 5.2 (95 % CI: -5.9, -4.5) and dental mobility 0.6 degrees (95 % CI: -0.7, -0.5). Primary healthcare is still the best option to improve the periodontal health in population who do not have access to specialty services. Dentists can achieve significant clinical improvement at very low cost, if they are aware of primary health care.

El objetivo del estudio fue mostrar la distribución de la enfermedad periodontal, los factores de riesgo y la importancia de la atención primaria de salud, para la mejora de los parámetros clínicos. Material y método: Estudio de dos fases transversal y no aleatorizado (antes - después), con intervención educativa y tratamiento conservador, realizado en la Facultad de Odontología de la Universidad Autónoma de Guerrero México, en 161 sujetos que cumplieron con los criterios de inclusión. Se llevó a cabo una educación sanitaria oral, así como un tratamiento periodontal conservador, con un seguimiento de seis meses. Las mediciones clínicas se realizaron con una sonda Williams, el índice de placa O'Leary, el índice de cálculo y el método Miller de movilidad dental. Resultados: se encontró enfermedad periodontal en el 82 % de todos los participantes. El análisis de regresión logística multinomial mostró un odds ratio de 14.3 (IC 95 %: 2.5, 82.1), 13.4 (IC 95 %: 1.7, 103.5), 29.2 (IC 95 %: 3.2, 260.9) y 68 (IC 95 %: 6.6, 711.0) placa en gingivitis, periodontitis crónica leve, moderada y grave, respectivamente. El análisis de datos del panel longitudinal mostró un efecto significativo (p <0.001) en la disminución media de los parámetros clínicos después de la intervención, profundidad de sondeo 0.4 mm (IC 95 %: -0.5, -0.3), profundidad de bolsillos 1.1 mm (IC 95 %: -1.3, -0.9), cantidad de bolsillos 4.5 (IC 95 %: -5.2, -3.7), hemorragia 5.2 (IC 95 %: -5.9, -4.5) y movilidad dental 0.6 grados (IC 95 %: -0.7, - 0.5). Conclusiones: la atención primaria de salud sigue siendo la mejor opción para mejorar la salud periodontal en la población que no tiene acceso a servicios especializados. Relevancia clínica: los dentistas pueden lograr una mejora clínica significativa a un costo muy bajo, si conocen la atención primaria de salud.

Orofacial space infections, etiology, microbiological susceptibility and surgical management / Infecciones del espacio orofacial, etiología, susceptibilidad microbiológica y manejo quirúrgico

Orofacial infections are considered as one of most common infections and need rapid and adequate treatment as they affect a very delicate region and are associated with serious life-threatening complications. Orofacial infections can be either odontogenic that is with an origin in teeth and associated structures or non-odontogenic, not associated with teeth, can affect facial spaces and spread from one space to another, so a good knowledge about diagnosis and treating these infections is of utmost importance, and can include both non-surgical and surgical treatment. The aim of our study was to determine the most common cause of orofacial infections, the most common bacterial microorganisms and their antibiotic susceptibility. Materials and Methods: A descriptive study was undertaken in the Department of Oral and Maxillofacial Surgery, Al-Shaheed Ghazi Al-Hariry Hospital, Baghdad, Iraq from 1st January to 30th September 2015. This study included 45 patients with different forms of orofacial infections; data regarding age, gender, underlying cause, facial space involvement, presenting signs were collected through history, clinical examination and radiographs, incision and drainage with swab sample for culture and sensitivity test was performed. Results: Patients with orofacial infections showed a female to male ratio of 1.25:1. The mean age was 32.8 years. Most of the patients were in their 4th decade of life (27%). Most infections were odontogenic in origin (62%), the most common facial space involved was submandibular (65%), the most common isolated microorganism was Streptococcus pyogenes (59%), and most patients were treated using an extra-oral surgical approach (78%). Antibiotics to which bacterial isolated showed the most sensitivity were netilmicin, cefoperazone and rifampicin (91%). Pain and limitation of mouth opening gradually decreased in most of patients during the two weeks follow up period. Conclusion: Orofacial infections were more common in females, in the third and fourth decade of life, were odontogenic in origin, were mostly caused by Streptococcus pyogenes, and most isolates were susceptible to netilmicin, cefoperazone and rifampicin. Pain and trismus decreased over two weeks post-treatment.

Las infecciones orofaciales se consideran una de las infecciones más comunes y necesitan un tratamiento rápido y adecuado, ya que afectan una región muy delicada y se asocian con complicaciones graves que amenazan la vida. Las infecciones orofaciales pueden ser odontogénicas que se originan en los dientes y las estructuras asociadas, o no odontogénicas, no asociadas con los dientes, pueden afectar los espacios faciales y propagarse de un espacio a otro, por lo que un buen conocimiento sobre el diagnóstico y el tratamiento de estas infecciones es de suma importancia, y puede incluir tratamiento no quirúrgico y quirúrgico. El objetivo de nuestro estudio fue determinar la causa más común de infecciones orofaciales, los microorganismos bacterianos más comunes y su susceptibilidad a los antibióticos. Material y Métodos: se realizó un estudio descriptivo en el Departamento de Cirugía Oral y Maxilofacial, Hospital Al-Shaheed Ghazi Al-Hariry, Bagdad, Iraq del 1 de enero al 30 de septiembre de 2015. Este estudio incluyó a 45 pacientes con diferentes formas de infecciones orofaciales; Se recopilaron datos sobre edad, sexo, causa subyacente, afectación del espacio facial, signos de presentación a través de la historia, examen clínico y radiografías, incisión y drenaje con muestra de hisopo para cultivo y prueba de sensibilidad. Resultado: Los pacientes con infecciones orofaciales mostraron una relación mujer/hombre de 1.25: 1. La edad media fue de 32,8 años. La mayoría de los pacientes estaban en su cuarta década de vida (27%). La mayoría de las infecciones fueron de origen odontogénico (62%), el espacio facial más común involucrado fue submandibular (65%), el microorganismo aislado más común fue Streptococcus pyogenes (59%), y la mayoría de los pacientes fueron tratados con un abordaje quirúrgico extraoral (78%). Los antibióticos a los que las bacterias aisladas mostraron mayor sensibilidad fueron netilmicina, cefoperazona y rifampicina (91%). El dolor y la limitación de la apertura de la boca disminuyeron gradualmente en la mayoría de los pacientes durante el período de seguimiento de dos semanas. Conclusión:Las infecciones orofaciales fueron más comunes en las mujeres, en la tercera y cuarta década de la vida, fueron de origen odontogénico, fueron causadas principalmente por Streptococcus pyogenes y la mayoría de los aislamientos fueron susceptibles a la netilmicina, cefoperazona y rifampicina. El dolor y el trismo disminuyeron durante las dos semanas posteriores al tratamiento.

Periodontal disease and its impact on general health in Latin America: LAOHA Consensus Meeting Report

Abstract: Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.