ABSTRACT
En el siguiente trabajo se desarrollan, luego de una extensa búsqueda bibliográfica, los hallazgos clíni- cos y radiográficos existentes en lesiones de la ATM en pacientes con artritis reumatoidea, para luego proponer una metodología de abordaje odontoló- gico que logre un buen tratamiento para devolverle al paciente un mejor funcionamiento de la ATM, aliviando el dolor y la inflamación, pero sobre todo mejorando su calidad de vida. Ello, siempre desde los estadios tempranos de la enfermedad, ya que facilita el tratamiento y previene secuelas. De ser necesario, se realiza una rehabilitación protética y evalúan los riesgos de procedimientos odontológicos conside- rando la medicación habitual de estos pacientes, como los aines y corticoides (AU)
In the following work, after an extensive bibliographical search, the existing clinical and radiographic findings in Temporo Mandibular Joint (TMJ) lesions in patients with rheumatoid arthritis are developed in order to later propose a dental approach methodology achieving a good treatment to restore better TMJ function to that patient relieving pain and inflammation but above all improving the quatity of life , always from the early stages of the disease to facilitate treatment and prevent sequelae, perform prosthetic rehabilitation if necessary and assess the risks of dental procedures considering the usual medication of these patients such as NSAIDs and corticosteroids (AU)
Subject(s)
Humans , Male , Female , Arthritis, Rheumatoid/diagnostic imaging , Temporomandibular Joint Disorders/therapy , Dental Care for Chronically Ill/methods , Clinical Diagnosis , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Minimally Invasive Surgical ProceduresABSTRACT
BACKGROUND: Ventilator-associated pneumonia (VAP) is a nosocomial infection of multifactorial etiology and has a negative influence on cardiovascular surgery (CVS) outcomes. OBJECTIVES: Determine the effect of toothbrushing plus 0.12% chlorhexidine gluconate oral rinse in preventing VAP after CVS. METHODS: In a quasi-experimental study, patients undergoing heart surgery were enrolled in a protocol for controlling dental biofilm by proper oral hygiene (toothbrushing) and oral rinses with 0.12% chlorhexidine gluconate (Group 1), and they were compared with a historical control group (Group 2), which included patients who underwent cardiac surgery between 2009 and 2010 and who received regular oral hygiene care. Seventy-two hours before surgery, a dentist provided instruction and supervised oral hygiene with toothbrushing and chlorhexidine oral rinses to patients in Group 1. RESULTS: Each group comprised 150 patients. A lower incidence of VAP (2.7% [95% CI 0.7-7.8] vs 8.7% [95% CI 4.9-14.7], P = .04) and a shorter hospital stay (9 ± 3 d [95% CI 8.5-9.5] vs 10 ± 4 d [95% CI 9.4-10.7], P = .01) were observed in Group 1. No significant differences in all-cause in-hospital death were observed between groups (5.3% vs 4.7%, P > .99). The risk for developing pneumonia after surgery was 3-fold higher in Group 2 (3.9, 95% CI 1.1-14.2). CONCLUSIONS: Oral hygiene and mouth rinses with chlorhexidine under supervision of a dentist proved effective in reducing the incidence of VAP.