Revisión sistemática sobre el diagnóstico diferencial de lesiones radiotransparentes asociadas a terceros molares / Systematic review on the differential diagnosis of radiolucent lesions associated third molar

Introducción: Los quistes dentígeros son quistes odontogénicos de malformación y origen epitelial, según la clasificación de los tumores, realizada por la Organización Mundial de la Salud (OMS). Es el más común después del quiste radicular y están asociados a la corona de un diente en desarrollo, no erupcionado o incluido. En ocasiones, la presencia de un quiste dentígero a nivel de un tercer molar no erupcionado, puede llevará un diagnóstico erróneo, pudiéndose confundir con el folículo dental de propio diente. Objetivos: Determinar qué imágenes radiotransparentes, a nivel de los terceros molares, corresponden a folículos dentales o aquistes dentígeros. Material y método: Se realizó una revisión sistemática de los artículos publicados en las bases de datos Pubmed / Medline, Cochrane Database of Systematic Reviews y Embase hasta el 1 de marzo de 2013 incluido, utilizando las palabras clave «third molar» AND «dentigerous cyst» AND «dental follicle». Los criterios de inclusión de los artículos se establecieron según el formato PICO. Resultados: Los resultados de los estudios consultados, indican que no existe un criterio estandarizado, en cuanto a las dimensiones a nivel del espacio pericoronario, que sean los utilizados por todos los autores para diferenciar el límite entre folículo dental y quiste dentígero. Conclusiones: Se ha observado que la presencia de una imagen radiotransparente a nivel de los terceros molares, no siempre es excluyente a la hora de establecer un diagnóstico final. Por ello, es necesario considerar siempre la anatomía patológica, que nos proporcionará o corroborará el diagnóstico

Introduction: The dentigerous cysts areodontogenic cysts and epithelial malformation, by classification of tumors by the World health Organization (WhO). It is most common after radicular cyst and are associated with the crown of a developing tooth, unerupted or included. Sometimes the presence of a dentigerous level of a third molar unerupted cyst can lead to misdiagnosis, and may be confused with the dental follicle of the tooth itself. Objectives: To determine what lucencies at the level of the third molars, are dental dentigerous cysts or follicles. Methods: A systematic review of published articles in the database Pubmed / Medline, Cochrane Database of Systematic Reviews, Embase and Ebsco data until March 1, 2013 inclusive was performed using keywords 'third molar' AND the words ' dentigerous cyst’ AND ‘Dental follicle’. The criteria for inclusion of articles was established according to PICO format. Results: The results of the studies consulted, indicate that there is no standardized criteria, in terms of dimensions pericoronal level space, which are used by all the authors to distinguish the boundary between dental follicle and dentigerous cyst. Conclusions: It has been observed that the presence of a radiolucent image at the level of third molars is not always exclusive to when establishing a final diagnosis. Therefore, you must always include pathology, which will provide or corroborate the diagnosis

Implante dental migrado al seno maxilar: a propósitode un caso / Dental implant migrated into maxillary sinus: a case report

Introducción: La pérdida dental en sectores posteriores del maxilar, implica en muchos casos una escasa cantidad de hueso remanente que imposibilita la colocación de implantes dentales. Para solucionar este problema existen técnicas como la elevación sinusal que si bien soluciona el problema en muchos casos, no está exenta de complicaciones. La migración o el desplazamiento de implantes dentales a regiones anatómicas como el seno maxilar, es una rara pero posible complicación. Objetivo: Presentar un caso clínico de un implante dental desplazado accidentalmente al seno maxilar, para describir los factores que justifican este fenómeno y establecer una pauta terapéutica para este tipo de casos. Caso clínico: Paciente varón de 32 años al que se le realizó la colocación de implantes osteoinegrados en el segundo cuadrante, acude a nuestro servicio y se le realiza un estudio radiológico en el que evidenciamos la imagen de un implante dental a nivel del seno maxilar que fue extraído mediante abordaje intraoral. Se realizaron controles radiográficos con un seguimiento de un año es de la extracción del implante. Conclusión: Existen múltiples factores que explican la migración de un implante dental al interior del seno maxilar, la actitud siempre debe ser la de extraerlo bien sea con abordaje intraoral o mediante endoscopio por vía nasal (AU)

Introduction: Tooth loss in the maxillary posterior sites, in many cases involves a small amount of remaining bone which precludes placing dental implants. To solve this problem there are techniques such as sinus lifting, but although it solves the problem in many cases, it is not without its complications. The migration or displacement of dental implants to anatomical regions such as the maxillarysinus is a rare but possible complication. Objective: To present a clinical case of a dental implant that accidentally moved to the maxillary sinus, to describe the factors causing this phenomenon and establish guidelines for treatment of this type of case. Clinical case: Male patient, aged 32, who was given osseointegrated implants in the second quadrant, came to our service and through a radiology study we saw the image of a dental implant at the level of the maxillary sinus that was extracted using the intraoral approach. There were radiography controls monitoring progress for a year after the extraction of the implant. Conclusion: There are many factors that can explain the migration of a dental implant into the maxillary sinus, and the current approach must be to extract it well using either with intraoral approach or through nasal endoscopy (AU)

Exodoncia de un segundo molar en relación con el nervio dentario inferior / Extraction of a second molar in relation to the inferior

El nervio dentario inferior está muy relacionado con los ápices del tercer molar, y a veces con el segundo molar, por ello durante la extracción de los mismos es posible la presión sobre el conducto por donde discurre el nervio. Se considera, por tanto, la causa traumática la más frecuente en la aparición de parestesias, existiendo una correlación directa entre el pronóstico de la misma y la importancia del traumatismo causado al nervio. Describimos un caso clínico de relación directa del nervio dentario inferior con las raíces de un segundo molar (AU)

The inferior dental nerve is closely related to the apex of the third molar, and at times to the second molar; therefore, during their extraction it is possible that there is pressure on the duct through which the nerve runs. Hence, trauma is the most frequent cause in the presentation of paresthesia, with direct correlation existing between the prognosis and the importance of the trauma caused to the nerve. We discovered a clinical case with the inferior dental nerve directly related to the roots of a second molar (AU)

Social demand in ambulatory oral surgery. Experience in the Master of Oral Surgery of Madrid Complutense University (Spain).

OBJECTIVES: An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery. STUDY DESIGN: A descriptive statistical analysis (frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years. RESULTS: A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62% versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was tooth extraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%. CONCLUSIONS: Our results show third molar extraction to be the most commonly demanded intervention in ambulatory oral surgery.

Social demand in ambulatory oral surgery. Experience in the Master of Oral Surgery of Madrid Complutense University (Spain)

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Objectives. An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery.Study design. A descriptive statistical analysis(frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years.Results. A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62%versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was toothextraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%.Conclusions. Our results show third molar extraction to be the most commonly demanded intervention in ambulatoryoral surgery

An observational study of the frequency of supernumerary teeth in a population of 2000 patients.

OBJECTIVES: An evaluation is made of the epidemiological characteristics of supernumerary teeth, with an analysis of the associated clinical-eruptive complications. STUDY DESIGN: A longitudinal observational study was made of 2000 patients, with the documentation of demographic data, the presence of supernumerary teeth, their location, mechanical accidents and the presence of associated pathology. RESULTS: The presence of supernumerary teeth was recorded in 1.05% of the study subjects (mean age 20.2 years), with a greater frequency in males. The most frequent location was in the upper maxilla (79.2%), fundamentally in the retromolar zone and at premaxillary level. The presence of mechanical accidents was the most frequent complication (54%)--the displacement of adjacent teeth being the most common finding--along with the presence of follicular cysts. CONCLUSIONS: The prevalence of supernumerary teeth in our series was 1.05%, the most frequent location being at upper distomolar level. Mechanical accidents were the most frequent complication.

Clinical and radiological course in apicoectomies with the Erbium:YAG laser.

OBJECTIVE: A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls. MATERIAL AND METHODS: The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively. RESULTS: The clinical course proved asymptomatic in 95.5% of the cases. As regards remodeling of the bone cavity, 77.7% had completed ossification after 24 months, 13.3% were in an advanced stage of ossification and 4.5% in an intermediate stage, while 4.5% showed treatment failure. CONCLUSIONS: The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7% bone cavity remodeling rate after 24 months.

Clinical and radiological course in apicoectomies with the Erbium: YAG LASER

Objetivo. Valorar la eficacia del láser de Erbium:YAG en lesiones granulomatosas periapicales, mediante controles clínicos y radiográficos. Material y método. Estudio clínico en el que participó una muestra de 45 pacientes susceptibles de tratamiento quirúrgico periapical en dientes incisivos, caninos y premolares. Realizándose una técnica quirúrgica convencional con relleno retrógrado de amalgama de plata e irradiación del defecto óseo y cemento radicular remanente con láser de Erbium: YAG. Se realizaron controles clínicos y radiográficos durante 24 meses, valorando la ausencia de síntomas o la presencia de dolor, inflamación o fístula y osificación de las lesiones respectivamente. Resultados. La evolución clínica de los pacientes en un 95,5 por ciento de los casos fue asintomática. En cuanto a la remodelación de la cavidad ósea el 77,7 por ciento terminaron su osificación a los 24 meses, el 13,3 por ciento se encontraban en un estadio avanzado, el 4,5 por ciento en un estadio intermedio y en otro 4,5 por ciento fracasó el tratamiento. Conclusiones.- La combinación de amalgama de plata e irradiación con láser de Erbium:YAG en cirugía periapical supuso un éxito clínico muy elevado y una remodelación de la cavidad ósea del 77,7 por ciento a los 24 meses

Objective. A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls. Material and methods. The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively. Results. The clinical course proved asymptomatic in 95.5 percents of the cases. As regards remodeling of the bone cavity, 77.7 percents had completed ossification after 24 months, 13.3 percents were in an advanced stage of ossification and 4.5 percents in an intermediate stage, while 4.5 percents showed treatment failure. Conclusions. The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7 percents bone cavity remodeling rate after 24 months

Sterilizing effects of the Erbium:Yag laser upon dental structures: an in vitro study.

AIM: An evaluation was made of the sterilizing effects of the Erbium:YAG laser at different power ratings upon dental structures in vitro. DESIGN: An in vitro study was made of 47 single-root teeth removed for periodontal reasons in the Oral and Maxillofacial Surgery Teaching Unit (Department of Medicine and Orofacial Surgery, Madrid Complutense University Dental School, Spain). The teeth were divided into three laser irradiation groups (250, 350 and 450 mJ) and a non-irradiated control group. The teeth were then immersed in an enrichment medium for 72 hours under conditions of anaerobiosis, with visual controls after 24, 48 and 72 hours. Posteriorly, microbiological cultures were made in blood agar to confirm the results of the visual inspections. RESULTS: Increased percentage sterilization of the samples was recorded with increasing irradiation power - statistically significant differences being observed between all irradiated groups versus the controls. CONCLUSIONS: The Erbium:YAG laser exerts a sterilizing effect upon dental structures in vitro. This effect increases with increasing laser power ratings.